Vice-President for Legislative Affairs
Kim Stewart, MS, CCC-SLP
Welcome to the Legislative Affairs web page. This page will provide MSHA members with information regarding legislative and regulatory issues, which will affect our practices of speech-language pathology and audiology. Both area of governance influence our clients and their families and our practices, the legislative process more generally and the regulatory process more specifically.
This web page will include information regarding current and upcoming federal and state activities, links that will give members access to state and federal legislative bodies, regulatory agencies, and other groups and associations that advocate for the same clients we work with.
The emphasis on regulatory affairs is necessary because our state and federal governments provide for regulatory agencies to oversee many aspects of those areas that the legislature creates policies for. Legislatures pass laws that are fairly broad. Regulatory agencies issue specific rules that implement legislative decisions in ways that specifically affect services we offer to our clients and the ways in which we provide those services. Our efforts to advocate must be directed to both legislation and regulation.
Advocacy is essential to our practices. Simply being aware of issues affecting our clients and us is not enough. We must actively engage ourselves in supporting the interests of those we serve in our professions by voicing our questions and concerns to those directly involved in making the decisions that affect us.
Both state and federal legislatures are currently preparing for special sessions, including veto sessions. Regular sessions will begin shortly after the new year begins. This page will include issues of interest as those issues arise.
HB 77 – Public School Retirement System
Currently, any teacher retired from the Public School Retirement System of Missouri may be employed in a position covered under the Public Education Employee Retirement System (PEERS) without stopping their retirement benefit. Such teacher may earn up to 60% of the minimum teacher’s salary as set forth in Section 163.172, RSMo, and will not contribute to the retirement system or earn creditable service.
The employer’s contribution rate will be paid by the hiring employer. If such person is employed in excess of these limitations, the person will not be eligible to receive their retirement allowance for any month the person is employed and such person shall contribute to the retirement system if he or she is in an eligible position.
This bill excludes from this provision any person retired and currently receiving a retirement allowance in accordance with Sections 169.010 to 169.141 employed by a public community college.
This bill is similar to HB 2335 (2018).
CCS SS SCS HCS HB 399 – Healthcare
This bill modifies several provisions relating to the health care services.
Offender MO HealthNet Benefits
This bill specifies that MO HealthNet benefits shall be suspended, rather than canceled or terminated, for an offender entering a correctional facility or jail if the Department of Social Services is notified of the person’s entry into the correctional center or jail, the person was currently enrolled in MO HealthNet, and the person is otherwise eligible for MO HealthNet benefits but for his or her incarcerated status. Upon release from incarceration, the suspension shall end and the person shall continue to be eligible for MO HealthNet benefits until such time as he or she is otherwise ineligible.
The Department of Corrections shall notify the Department of Social Services within 20 days of receiving information that person receiving MO HealthNet benefits is or will become an offender in a correctional center or jail and within 45 days prior to the release of such person whose benefits have been suspended under this bill. City, county, and private jails shall notify the Department of Social Services within 10 days of receiving information that person receiving MO HealthNet benefits is or will become an offender in the jail (Sections 217.930 and 221.125).
Unanticipated Out-of-Network Healthcare Services
Currently, utilizing the unanticipated out-of-network process is optional. This bill requires health care professionals to utilize the process outlined in statute for claims for charges for unanticipated out-of-network care (Section 376.690).
Multiple Employer Welfare
The bill allows multiple employer self-insured health plans having a certificate of authority approved by the Director of the Department of Insurance, Financial Institutions and Professional Registration to offer such plans to the public. Health carriers acting as an administrator for a plan shall permit any willing licensed broker to market such plans (Sections 376.1040 and 376.1042).
Healthcare for Persons With Disabilities
This bill adds therapeutic care for “developmental or physical disabilities,” as defined in the bill, to the insurance coverage mandate for autism spectrum disorders, and makes the mandate applicable to policies issued or renewed on or after January 1, 2020, rather than to group policies only. The bill specifies that autism spectrum disorder will not be subject to any limits on the number of visits an individual may make to an autism service provider. Coverage for therapeutic care provided under the bill for developmental and physical disabilities may be limited to a number of visits per calendar year, provided that additional visits shall be covered if approved and deemed medically necessary by the health benefit plan. Provisions requiring coverage for autism spectrum disorders and developmental or physical disabilities shall not apply to certain grandfathered, pre-empted, or supplemental plans as described in the bill.
This bill repeals a provision of law directing the Department of Insurance, Financial Institutions and Professional Registration to grant small employers waivers from the coverage requirements under certain circumstances. The bill also repeals a provision requiring the department to submit annual reports to the legislature and requiring health carriers to supply certain diagnosis and coverage information for the report.
These provisions apply to policies issued, delivered, or renewed on or after January 1, 2020 (Section 376.1224).
Methods of Reimbursement
This bill prohibits health carriers from restricting methods of reimbursement which require health care providers to pay a fee to redeem the amount of their claim for reimbursement.
Health carriers changing the reimbursement method used shall notify health care providers whether any fee is required to receive reimbursement through the new or different method. For health benefit plans issued, delivered, or renewed on or after August 28, 2019, the provider will be able to select an alternative method of reimbursement which does not require a fee.
Violation of these provisions shall be deemed an unfair trade practice under the Unfair Trade Practice Act (Section 376.1345).
CCS SB 17 – Public Employee Retirement Systems
This bill modifies provisions relating to public employee retirement systems.
Teacher and School Employee Retirement Systems
This bill allows a retired member of the Public School Retirement System (PSRS) or Public Education Employees Retirement System (PEERS) who has elected a reduced retirement allowance to provide for survivor benefits for his or her spouse to have the retirement allowance increased to the single life annuity amount, with no survivor benefits, if the member and his or her spouse became divorced prior to September 1, 2017 or if they get a modified dissolution decree that provides for sole retention by the retired person of all rights in the retirement allowance after September 1, 2017 (Sections 169.141 and 169.715).
Public School Retirement System
Currently, anyone retired from the PSRS may be employed by an employer included in the retirement system in a position that does not normally require a Missouri teacher certification. He or she may earn up to 60% of the statutory minimum teacher salary without a discontinuance of the person’s retirement allowance.
If any such person is employed in excess of the limitations, the person shall not be eligible to receive the person’s retirement allowance for any month during which the person is employed.
This bill exempts any person retired and currently receiving a retirement allowance from PSRS employed by a public community college from these provisions (Section 169.560).
SCS SB 101 – Hearing Aid Distribution Program
This bill requires the Missouri Commission for the Deaf and Hard of Hearing to establish, subject to appropriations, a statewide hearing aid distribution program to provide financial assistance to certain low-income individuals who are deaf or hard of hearing to obtain hearing aids. All assessments for need and distribution of hearing aids shall be performed by a licensed audiologist hearing instrument specialist or licensed physician. The bill creates the “Statewide Hearing Aid Distribution Fund,” which shall not include any funds from the Assistive Technology Trust Fund or the Deaf Relay Service and Equipment Distribution Program Fund. The Commission may accept gifts, donations, grants, and bequests for the program.
Other Legislation Not Passed
SB 235, HB 205 – Hearing Aids
The bill requires accident and health insurers to provide coverage for medically necessary hearing instruments, as defined in the act, and related services for individuals under the age of 18 when prescribed by a hearing care professional. The coverage is subject to out-of-pocket payment requirements, shall provide for one hearing aid for each ear every 36 months, shall include related selection and adjustment services when deemed necessary by a professional, and may include medically necessary repairs to the instrument.
Neither the House nor the Senate bill were heard in committee.
SB 45 – Disability Healthcare
The bill adds therapeutic care for developmental and physical disabilities, as such terms are defined in the act, to the insurance coverage mandate for autism spectrum disorders, and makes the mandate applicable to policies issued or renewed on or after January 1, 2020, rather than to group policies only. Medical necessity of coverage provided under the act shall be determined by the health benefit plan.
The bill was perfected and passed in the Senate. The bill was then heard in a House committee; however, it was not perfected.
SB 48 – Short Term Medical
The bill specifies that all short-term major medical policies sold in the state shall include on applications and fact pages a conspicuous and clearly labeled paragraph stating that the policy may not cover preexisting conditions or essential health benefits, and a recommendation to discuss the policy with the individual’s insurance broker.
The bill was voted do pass out of a Senate committee; however, it was not perfected.