SB 841: Modifies provisions relating to health care - Missouri

4/28/2026 - SA 1 to SA 4 to SS for SCS S offered & adopted (Coleman)--(4822S07.23S) 4/28/2026 - Moot → 4/28/2026 - SA 5 to SS for SCS S offered & adopted (Moon)--(4822S07.13S) 4/28/2026 - Adopted · 4 edits

MODERATE

The bill was amended to add a new section defining key terms related to hospital debt collection, specifically focusing on hospitals that fail to comply with price transparency laws. It establishes a prohibition on hospitals initiating collection actions against patients for services provided while they were not in compliance with these federal transparency requirements. Additionally, it grants patients the right to sue to verify a hospital's compliance status if a collection attempt occurs.

Scope change

The bill's scope expanded from a general Medicaid managed care provision to include specific protections for patients regarding debt collection by non-compliant hospitals.

DEFINITION

Added a new section (197.1040) defining critical terms such as 'collection action,' 'collection agency,' 'debt collector,' and 'hospital price transparency laws' to clarify the rules.

REQUIREMENT

Added a requirement that hospitals not in material compliance with price transparency laws cannot initiate or pursue debt collection against patients for services provided during that non-compliant period.

ENFORCEMENT

Added a mechanism allowing patients to file a lawsuit to determine if a hospital was actually out of compliance with price transparency laws if the hospital attempts to collect a debt.

TECHNICAL

Changed the bill's reference from Senate Amendment No. 4822S07.23S to 4822S07.13S and updated the target section from 376.1364 to 197.708.

4/28/2026 - SA 3 to SS for SCS S offered & adopted (Hudson)--(4822S07.29S) 4/28/2026 - Adopted → 4/28/2026 - SA 1 to SA 4 to SS for SCS S offered & adopted (Coleman)--(4822S07.23S) 4/28/2026 - Moot · 1 edit

MINOR

The bill was amended to exempt specific Medicaid managed care organizations from certain provisions of the bill. This change limits the bill's application to only those organizations not contracted to serve MO HealthNet beneficiaries, effectively creating an exemption for these specific providers.

Scope change

The bill's scope was narrowed by adding an exemption for Medicaid managed care organizations contracted to provide services to MO HealthNet beneficiaries.

SCOPE

Added a new provision stating that subsections 4 through 10 of the section do not apply to Medicaid managed care organizations contracted to serve MO HealthNet beneficiaries.

4/28/2026 - SA 2 to SS for SCS S offered (Hudson)--(4822S07.06S) 4/28/2026 - Adopted → 4/28/2026 - SA 3 to SS for SCS S offered & adopted (Hudson)--(4822S07.29S) 4/28/2026 - Adopted · 1 edit

MINOR

This amendment completely removes a specific section of the bill that previously added licensed physicians to a list of eligible providers. By striking this section, the bill no longer expands eligibility to include physicians under chapter 334, reverting the provision to its original state.

Scope change

The bill's scope regarding provider eligibility was reduced by removing the addition of licensed physicians to the list of qualified providers.

ELIGIBILITY

The amendment deletes language that would have allowed licensed physicians to be included in the list of eligible service providers.

4/28/2026 - SA 1 to SA 1 to SS for SCS S offered & adopted (Nicola)--(4822S07.31S) 4/28/2026 - Adopted → 4/28/2026 - SA 2 to SS for SCS S offered (Hudson)--(4822S07.06S) 4/28/2026 - Adopted · 1 edit

MINOR

The bill was amended to remove a specific requirement restricting the dispensing of ivermectin and hydroxychloroquine to pharmacy personnel only. Instead, the amendment adds 'a physician licensed under chapter 334' to the list of authorized individuals who can dispense these medications, thereby expanding who is legally permitted to provide them.

Scope change

The scope of authorized dispensers was expanded from pharmacy staff to include licensed physicians.

ELIGIBILITY

Removed the restriction that ivermectin and hydroxychloroquine must be dispensed only by pharmacists or pharmacy technicians, and added licensed physicians to the list of authorized dispensers.

4/28/2026 - SA 1 to SS for SCS S offered (Lewis)--(4822S07.21S) 4/28/2026 - Adopted, as amended → 4/28/2026 - SA 1 to SA 1 to SS for SCS S offered & adopted (Nicola)--(4822S07.31S) 4/28/2026 - Adopted · 3 edits

MINOR

The amendment shifts the bill's focus from authorizing pharmacists to dispense ivermectin and hydroxychloroquine without prescriptions to imposing strict storage and access restrictions on those drugs. Instead of creating a new legal pathway for dispensing, the change mandates that any such drugs dispensed without a prescription must be kept behind the counter, stored securely, and only handled by pharmacy staff under supervision.

Scope change

The scope of the amendment narrowed from establishing a new dispensing authority to enforcing specific security and access controls for existing or future non-prescription dispensing.

ELIGIBILITY

Removed language that would have allowed pharmacists to dispense ivermectin and hydroxychloroquine without a prescription order.

REQUIREMENT

Added new requirements mandating that non-prescription ivermectin and hydroxychloroquine be kept behind the counter, stored in secure areas accessible only to pharmacy personnel, and dispensed only under a pharmacist's supervision.

TECHNICAL

Changed the amendment reference from Senate Amendment No. 21 to Senate Amendment No. 31 and updated the target section of the bill.

4822S.02C - Senate Committee Substitute → 4/28/2026 - SA 1 to SS for SCS S offered (Lewis)--(4822S07.21S) 4/28/2026 - Adopted, as amended · 4 edits

MODERATE

The bill was amended to remove several sections related to hospital investment rules, fertility awareness, and student medication self-administration. Additionally, a controversial new section was added that would allow pharmacists to dispense ivermectin and hydroxychloroquine without a prescription, a move intended to address misinformation but likely to face legal challenges.

Scope change

The bill's scope was significantly reduced by deleting provisions regarding hospital investment strategies, infertility awareness, and asthma medication policies in schools. Conversely, the scope was expanded to include a new, standalone provision authorizing pharmacist dispensing of specific drugs.

FISCAL

Deleted a section allowing hospital boards to invest up to 50% of available funds in stocks, bonds, and mutual funds, replacing the previous 25% limit and removing specific investment grade requirements.

SCOPE

Removed a section designating the last full week of April as 'Infertility Awareness Week' and defining infertility.

REQUIREMENT

Deleted a section permitting students to self-administer asthma or allergy medication in school under specific conditions.

Added a new section allowing pharmacists to dispense ivermectin and hydroxychloroquine without a prescription, based on a warning label and board protocols.

4822S.01I - Introduced → 4822S.02C - Senate Committee Substitute · 3 edits

MINOR

The bill was amended to reduce the total number of new health care sections from forty-three to thirty-seven by removing several new section numbers. Additionally, the text was updated to reflect that this is a Senate Committee Substitute version, and minor formatting adjustments were made to the definitions and investment rules for hospitals.

Scope change

The bill's scope was reduced by removing references to several new section numbers (376.417, 376.1245, 376.1280, 376.2100, 376.2102, 376.2104, 376.2106, 376.2108) that were originally planned but are no longer included in this version.

SCOPE

Removed references to eight new section numbers (376.417, 376.1245, 376.1280, 376.2100, 376.2102, 376.2104, 376.2106, 376.2108) from the list of enacted sections, reducing the total count from forty-three to thirty-seven.

TECHNICAL

Updated the bill header and page footers to indicate this is a 'Senate Committee Substitute' (SCS) version rather than the original 'Introduced' version.

Adjusted line spacing and indentation in the definitions for 'Epinephrine delivery device' and 'Self-administration' to improve readability.

Modifies provisions relating to health care

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