MO Pharmacist August 2022

Licensure System Upgrade $21millionwas appropriated this session to aid theDepartment of Commerce and Insurance inupdating the state’s professional licensure sys tem.This will aid in bringingMissouri forward inhow the state’s licensing happens, andmitigate the current headaches the system has. The House approved HJR 117 , sponsored by Representative Cody Smith (R-Carthage), a proposed constitutional amendment to subject coverage for theMedicaidExpansionpopulation to annual appropriations. This is in response to theMissouri Supreme Court decision directing the administration to complywith the Expansion language in the constitution even though the Legislature declined to allocate additional funds last year. HJR117would also enact work or com munity engagement requirements for able-bod ied adultMedicaid participants.This resolution passed the SenateAppropriations Committee in mid-April. It was never approved by the Senate GAFO Committee, chaired by Senator Lincoln Hough (R-Springfield), meaning it could not come to the Senate floor for debate. MoRX Program Legislation passed this year to extend the durationof theMORXprogram, whichprovides prescription drug assistance to dual eligible se niors, to 2029. It was set to expireAugust of 2022. This provision passed on SB 710 and HB 2400 . Pharmacy Benefit Managers HB1677 and SB921 , sponsoredbyRepresen tativeDaleWright (R-116) andSenatorBillWhite (R-Joplin), respectively, sought to bring greater transparencyandregulatoryoversight to theprac ticesofpharmacybenefitmanagers (PBMs).These contained provisions that would prevent a PBM from requiring patients to use mail-order phar macies, rather thana pharmacy of their choosing, andcontainedprovisions tocreate reimbursement parity for non-PBM affiliated pharmacies. These bills also codified the definition of a rebate, estab lished thefiduciarydutyof PBMs, andprohibited categorizingbrandnamemedications as generics. The House passed HB 1677 by a vote of 113-31. While therewas support for thesebills intheSenate, bothHB 1677 and SB 921 ultimately did not get a vote in the Senate Insurance Committee. Medicaid Expansion

Statewide Standing Order for Naltrexone HCL Legislation that permits theDepartment of Health and Senior Services to issue a statewide standing order to authorize pharmacists to dis pense naltrexone, anopioid antagonist, without the need passed this legislative session.This pro vision is similar to legislationpassed to authorize pharmacists to dispense Naloxone. Scope of Practice Expansion HB2452 and SB1126 , sponsored byRepre sentative BennieCook (R-142) and SenatorHolly Rehder (R-Scott), respectively, were pieces of leg islation filed to expand the scope of Pharmacy. Bothbillswould allowpharmacists to administer all vaccines and create a framework for statewide standing orders. Acompromisewasworked out between various stakeholders to allow pharma cists to administer all vaccines to those who are seven years and older.This languagewas amend ed onto various senate and house bills but was met by threats of a filibuster andultimately could not make it through the process. Vaccine Mandates Limiting the ability of employers to enact Covid-19 vaccination requirements was amajor issue coming into this session, and numerous bills were filed and started moving early in the House. Compromise language passed theHouse on HB 1686 , sponsored by Representative Bill Hardwick (R-Waynesville), to ensure religious and medical exemptions for employees. How ever, this language was blocked in the Senate by conservative caucus members who said it did not go far enough. Far-right proposals to punish businesses with vaccine requirements were defeated by Senate Democrats and mod erate Republicans. The only provisions sent to the Governor’s desk prohibit Covid-19 vaccine mandates for state and other public employees. This language passed on HB1606 , sponsored by Representative PeggyMcGaugh (R-Carrollton), and HB2090 , sponsored byRepresentativeDave Griffith (R-Jefferson City). Both bills exempt fa cilities governed by CMS.

The 2022 Legislative Session began January 5th and concluded May 13th. Republicans hold supermajorities in both Chambers and all but one statewide office. Over the past 40 years, the average number of bills passed each session has been about 150. This session, only 45 non-appropriations bills and resolutions passed and were sent to the Governor. Quick Points: Session Overview

Looking Ahead

The MPA would like to take this time to thank our members for your continuous sup port throughout the 2022 Legislative Session. Your passion and stories allow theMPA to be the voice for all ofMissouri pharmacy.With session over, we ask that you continue to educate your legislators on the impact that you have in your community, especially given that this is an elec tion year. As we gear up for the 2023 Legislative Session, it is crucial that pharmacy plays a role in setting the agenda for the healthcare battles that will take place in the state capitol. With the headwinds we face, due to a robust legislative agenda for 2023 as well as this year being an election year, your support by donating to the Pharmacist Political Action Committee of Mis souri will play a crucial role in ensuring that the voice of pharmacy is heard.

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