Back to Work in the Missouri House

The House resumed work this week. With only six weeks remaining, the time for bills to pass out of their original chamber is fading. This week, I was pleased that one of my sponsored bills passed through the chamber.

House Bill 1923 passed on Thursday with only a single no vote. It is this year’s version of what I called the “Medicaid Modernization Act” last year. It updates state law to bring our Medicaid program into the 21st century by providing reimbursement for health care services that are delivered through modern technologies like video-conferencing or high-definition “store-and-forward” medical diagnosis.

The goal is to ensure that state taxpayers and Medicaid recipients benefit from the reduced costs and improved quality of care of modern technology. For example, one section of the bill creates a “home tele-monitoring” service within Medicaid that would give recipients at risk of hospitalization the option of receiving care and monitoring at home so we can prevent expensive hospitalizations.

Last year, the House passed the bill by an overwhelming margin, but it was one of dozens of bills that languished on the Senate calendar late in session due to a Democrat filibuster the last week of session. This year, passing the bill is critical. After last session, some major health care providers in the state noticed that, even though many doctors were using telehealth, there’s nothing in state law that explicitly authorizes use of modern technologies to deliver health care. While 41 other states have statutes or rules that define the terms under which a physician can provide their services via video-conference or store-and-forward technology, Missouri has no such law or administrative rule.

In debate this week, one representative said he believed HB 1923 was the most important bill we’ve taken up this year. I appreciate the superlative, and, as far as positive impact on the most people, he may be right. By making telehealth services available in Medicaid and ensuring its continued use in private health care, we are increasing access to care for all Missourians simply by allowing health care professionals to take advantage of new technologies. Under HB 1923, a person in an area without medical specialist will have a better opportunity to access specialty care. They will not necessarily have to drive to St. Louis, Kansas City, or even a regional hospital, but instead can have some specialty services delivered in their local family physician’s office.

On Thursday, the House also passed legislation to help homeowners in Holts Summit. Sponsored by Rep. Travis Fitzwater (R-Holts Summit), House Bill 1684 allows residents of Lake Mykee and Holts Summit to consolidate if they so choose. Residents of Lake Mykee have been told they have to build a new sewer system that would cost tens of thousands of dollars for every homeowner. A better option would be to consolidate with Holts Summit, which has enough capacity in its sewer system to assume these new residents. Consolidating would reduce costs for residents of both Lake Mykee and Holts Summit. This bill is a great example of a common-sense, good government measure where Rep. Fitzwater is working for all of his constituents.

Ethics Update

On Thursday, the Senate sent the first ethics bill of the session to Gov. Nixon. House Bill 1983, sponsored by Rep. Shamed Dogan, which prohibits statewide elected officials and members of the General Assembly from serving as paid political consultants. This bill is important because when a person signs up to be a public servant, they should not also be creating a side business that profits from that position.

As a side-note, HB 1983 was an example of how the legislative process should work more often. The bill improved at each step of the process. We learn in grade school that when the House and Senate pass different versions of the same bill that they have to figure out a way to resolve the differences. In practice, this means each side appoints members to a conference committee to reach a compromise. Typically, the results of conference committees are foregone conclusions. As a House conferee on HB 1983, it was different from almost any other conference committee on which I’ve served. Every member – from both sides and both sides of the aisle – contributed. And the end result, which split the difference between the House and Senate versions of the bill, made the bill a better product. (Sen. Kehoe also served on the conference committee.)

I believe this is just the first of several ethics bills that will reach Gov. Nixon’s desk. House Bill 1979, which closes the “revolving door,” is in conference and set for a hearing next Wednesday morning. Senator Kehoe and I are conferees on that bill as well. House Bill 2203, which I sponsored to prohibit exotic investments with campaign funds, is also in conference and ready to be set for hearing. (Again, Senator Kehoe and I are conferees.) Finally, I remain hopeful that legislation to ban lobbyists’ gifts and to update Missouri’s self-dealing laws to cover special gubernatorial advisors will also pass through the Senate in some form.