HB 2231 requires facilities advertising dual diagnosis treatment (addressing both substance use disorders and mental health conditions) to meet specific operational standards. It mandates medication management systems for tracking prescriptions, regular patient reviews, and education; requires integrated, evidence-based treatment plans tailored to individual patients; and prohibits misleading advertising claims about services or licensure. Facilities must clearly disclose their credentials in all marketing materials. The Department of Mental Health enforces these rules, with violations subject to penalties under existing licensing laws. This bill directly affects all treatment centers in the state that market themselves as providing dual diagnosis care.
HB 2557 requires hospitals with emergency departments to have a physician physically present and on duty at all times when the emergency department is open. This bill directly affects hospitals operating emergency services by mandating continuous on-site physician coverage. The key provision specifies that a physician must be responsible for the emergency department during all operational hours, without exceptions. This policy change aims to establish consistent staffing standards for emergency care, though it does not address other hospital resources or patient outcomes.
SB 979 expands prescribing authority for advanced practice registered nurses (APRNs) in Missouri under specific conditions. It allows certified APRNs (excluding nurse anesthetists) to prescribe Schedule III-V controlled substances and limited Schedule II medications (like hydrocodone, hospice medications, and behavioral health stimulants) through written agreements with collaborating physicians. The bill restricts APRN prescriptions for Schedule II drugs to a 120-hour supply without refill, prohibits self-prescribing, and requires clear patient disclosures about care coordination with a physician. These changes aim to clarify APRN scope of practice while maintaining physician oversight for controlled substances.
HB 2184 prohibits noncompete clauses in employment contracts between healthcare employers and licensed physicians, making any clause that restricts a physician’s ability to practice medicine in a specific geographic area after leaving a job unenforceable. This directly affects physicians who might otherwise face restrictions on where they can work following employment termination. The bill specifically bans these geographic and time-based restrictions while leaving other contract terms valid. It does not alter other employment terms but ensures physicians cannot be barred from practicing in a region after their employment ends.
SB 1445 would allow certified registered nurse anesthetists (CRNAs) to independently select, issue orders for, and administer certain controlled substances without requiring a physician's order. This change directly affects CRNAs by expanding their scope of practice in anesthesia care, particularly for pain management and surgical procedures involving these medications. The bill does not specify which controlled substances are included but would remove current barriers for CRNAs to manage them within their professional role. The bill is currently in early legislative stages, having been prefaced in 2025 and scheduled for its first reading in 2026.
HB 2137 modifies Missouri's rules for dental hygienists, primarily requiring them to work under the supervision of a licensed dentist in most settings. The bill creates two key exceptions: (1) hygienists can provide basic services like oral screenings and fluoride varnish in any location without a dentist's supervision, and (2) experienced hygienists (with 3+ years in public health) can perform cleanings, sealants, and fluoride treatments for Medicaid-eligible children without supervision, with Medicaid reimbursing providers. This directly affects dental hygienists, dentists, public health facilities, and Medicaid-eligible children. The changes aim to expand access to preventive dental care in community settings while maintaining oversight for more complex procedures.
HB 1636 modifies rules for collaborative practice between physicians and advanced practice registered nurses (APRNs). It allows APRNs to prescribe certain controlled substances (including Schedule III-V drugs and hydrocodone) under written agreements, with a 120-hour supply limit for most prescriptions. The law requires clear patient disclosure about seeing an APRN, specifies physician review of APRN care, and adds flexibility for rural areas and telehealth regarding geographic proximity requirements between physicians and APRNs. This directly affects APRNs, their patients, and collaborating physicians by expanding prescribing authority while maintaining oversight safeguards.
HB 2287 expands prescribing authority for advanced practice registered nurses (APRNs) in specific scenarios. It allows APRNs with a controlled substance prescriptive certificate to prescribe Schedule III-V controlled substances and limited Schedule II (hydrocodone) medications for hospice patients or those under designated mental health providers, with prescriptions capped at a 120-hour supply without refill. The bill requires written collaborative agreements between APRNs and physicians, including patient disclosure statements about seeing an APRN instead of a physician. It prohibits APRNs from prescribing for themselves or family members and maintains existing restrictions on Schedule II prescribing for sedation or anesthesia.
