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Association of Missouri Nurse Practitioners

Senate Bill 194 Update

Posted 7 months ago by Shanna Chapman

Today, the House brought SB 194 to the floor for debate. SB 194, sponsored by Sen. Wayne Wallingford is a bill originally intended to determine the adequacy of a managed care plan’s network. As mentioned in previous correspondence, the log jam of House bills in the Senate has encouraged the House to load Senate bills up with House amendments in hopes of passing legislation. SB 194 was no different.

In true end of session form, the House distributed 58 amendments for consideration on SB 194. All totaled, 26 of those amendments were adopted either as stand-alone amendments or as amendments to amendments. While the general tone of the amendments were consistent with revisions to healthcare policy, a few were not. A more extensive discussion on these actions will be provided in the weekly update, but a summarized list of the adopted amendments are as follows:

-          Medical records maintained by fire districts

-          LPN’s ability to provide personal care without RN supervision

-          Volunteer healthcare service providers

-          Insurance company’s provider list updates

-          Newborn screening requirements

-          Diabetes awareness month

-          Removal of the geographic barrier for APRN collaboration and increase of physician/APRN from 3 to 5

-          In home care service provider registry

-          Addition of x-ray definitions, licensure for childcare providers, and dentist employment in hospitals

-          Call center accreditation on telemonitoring for Medicaid patients

-          Physical therapy payments

-          STEMI centers

-          Physician assistant dispensation of medicine

-          EMS medical directors and board oversight

-          Psychology licensure requirements

-          Hemp extract oils

-          Pregnancy care for inmates

-          Suicide prevention act

-          Mental health service dogs

-          Sickle Cell Awareness month

-          Due process for the developmentally disabled

-          Prohibition on fetal tissue donation

-          Establishing life begins at conception

-          Hospital licensure procedures

-          Reversible contraceptives for Medicaid patients

Many of the amendments adopted onto the bill were similar to those added to SB 50 last week. It is unlikely that the Senate will agree with the House amendments due to the sheer volume of them, which will almost certainly force the bill to conference. How many, if any, amendments remain on the bill during conference is unknown.

Specifically as it relates to AMNP members, Rep. Lyle Rowland’s HB 244 was adopted that removes the geographic proximity barrier and increases the ratio of physician to APRN’s in collaboration from 3 to 5. The usual suspects (Frederick, White, Franklin, and Neely) criticized the measure on the floor, but Reps. Smith, Roden, Love, and Lavender offered support for the measure before it was adopted. If you have an opportunity to send a quick email to these representatives thanking them for their vocal support, I’m sure it would be welcomed.

We will continue to keep you updated as developments and time allow in the remaining two weeks.


Derek S. Leffert
Managing Principal/CEO
The 109 Group, LLC
PO Box 104853
Jefferson City, MO 65110
C: 573.280.8500


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