Modifies provisions relating to health care

AWARENESS DAYS (Sections 9.021, 9.025, 9.238, 9.412, 9.418, and 9.502) This act designates the last full week of September each year as "Frontotemporal Degeneration (FTD) Awareness Week" in Missouri.

This provision is identical to SB 1709 (2026) and substantially similar to a provision in the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026) and the truly agreed to and finally passed SS#2/SCS/HS/HB 2576 (2026).

This act designates the month of January as "Blood Donor Awareness Month" in Missouri.

This provision is identical to a provision in the truly agreed to and finally passed SS#2/SCS/HS/HB 2576 (2026), the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026), the truly agreed to and finally passed HCS/SB 1544 (2026) and SB 1328 (2026).

This act establishes September each year as "Pediatric Cancer Awareness Month" in Missouri.

This provision is identical to a provision in the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026) and SS#2/SCS/HS/HB 2576 (2026).

This act designates each September as "Brain Aneurysm Awareness Month" in Missouri and the last full week of April each year as "Infertility Awareness Week" in Missouri.

This provision is identical to a provision in the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026) and the truly agreed to and finally passed SS#2/SCS/HS/HB 2576 (2026).

This act designates March 26 of each year as "Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS)/Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus (PANDAS) Awareness Day" in Missouri.

This provision is identical to a provision in the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026), the truly agreed to and finally passed SS#2/SCS/HS/HB 2576 (2026), and the truly agreed to and finally passed HCS/SB 1544 (2026).

HOSPITAL INVESTMENTS AND SERVICE AREAS (Sections 96.192, 96.196, 206.110, and 206.158) This act modifies the investment authority of boards of trustees of municipal hospitals in third class cities and hospital district hospitals. Current law permits investment of up to 25% of funds not required for operations of the hospital or other obligations. This act permits investment of up to 50% of funds not required for operations or other obligations in a manner described in the act, with the remaining portion to be invested into any investment in which the state Treasurer is allowed to invest. These provisions shall only apply if the hospital receives less than three percent of its annual revenues from municipal, county, hospital district, or state taxes or appropriated funds from the municipality in which such hospital is located.

Under this act, municipal hospitals in third class cities may operate in areas where hospital district hospitals and county hospitals operate. Hospital district hospitals may operate in areas where municipal hospitals in third class cities and county hospitals operate.

These provisions are identical to provisions in the truly agreed to and finally passed HCS/SB 1019 (2026), the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026), SCS/HCS/HB 943 (2025), and SCS/SB 317 (2025) and substantially similar to SB 244 (2025).

EPINEPHRINE PRODUCTS (Sections 167.627, 167.630, 190.246, 196.990, and 321.621) This act changes "epinephrine auto-injector" to "epinephrine delivery system" throughout statute.

These provisions are identical to provisions in the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026) and the perfected HCS/HBs 1826 et al (2026) and similar to provisions in HB 165 (2025) and HB 553 (2025).

COMMUNITY PARAMEDIC SERVICES (Sections 190.098 and 190.165) This act modifies provisions relating to certification of community paramedics and the provision of community paramedic services. Community paramedic services shall mean those services provided by an entity that employs licensed paramedics certified by the Department of Health and Senior Services as community paramedics, that is endorsed by the Department, and that provides services in a nonemergent setting, consistent with the education and training of a community paramedic and the supervisory standard approved by the medical director, and documented in the entity's patient care plans or protocols.

Ambulance service shall enter into written contracts with another ambulance service provider to provide community paramedic services in that provider's service area.

The Department shall establish regulations for the purpose of recognizing community paramedic services entities that have met the standards necessary to provide such services. The Department shall endorse such entities to provide community paramedic services for a period of 5 years.

These provisions are similar to provisions in the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026) and similar to provisions in SCS/HCS/HB 943 (2025), SCS/SB 317 (2025), SB 548 (2025), SB 206 (2025), and SCS/SB 1382 (2024).

SICKLE CELL STANDING COMMITTEE (Section 191.117) This act creates the "Lori Zena Baker Act". This act establishes the "Sickle Cell Standing Committee" as a subcommittee of the Missouri Genetic Advisory Committee within the Department of Health and Senior Services, with membership as specified in the act. The Director of the Department of Health and Senior Services shall appoint the committee members. The committee shall assess the impact of sickle cell disease on the state and make recommendations to the General Assembly and Governor regarding services and policies to address the state's needs, as described in the act.

This provision is identical to a provision in the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026) and SB 1735 (2026) and substantially similar to HB 1483 (2016).

DOULA SERVICES (Sections 191.708, 208.662, 208.1400-1425, 376.1758, and 376.1765) This act creates the "Missouri Doula Reimbursement Act". Under this act, the chief medical officer or chief medical director of the Department of Health and Senior Services or the MO HealthNet Division of the Department of Social Services may issue nonspecific recommendations for doula services, a medical standing order for prenatal vitamins, or a medical standing order for a purpose promulgated in rule, to terminate as specified in the act.

Additionally, this act adds doula services and childbirth education classes for pregnant women and a support person to the list of covered MO Healthnet and "Show-Me Healthy Babies Program" services, to be reimbursed as described in the act. The Department of Social Services shall study the impact of the childbirth education classes on infant and maternal mortality and shall submit a report to the General Assembly prior to January 1, 2028.

These provisions are identical to provisions in the perfected HCS/HB 2372 (2026) and substantially similar to provisions HCS/SB 94 (2025) and HCS/HB 1095 (2025).

Finally, the Department of Health and Senior Services shall review and approve doula registration for purposes of insurance coverage of doula services. Beginning January 1, 2027, every health carrier or health benefit plan shall provide coverage of doula services, except as otherwise provided.

This provision is identical to a provision in the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026).

TELEHEALTH (Sections 191.1146 and 334.108) Currently, the establishment of a physician-patient relationship for purposes of telehealth shall include an interview and a physical examination. Under this act, an evaluation is required, but a physical examination shall be required only if needed to meet the standard of care.

Current law prohibits the use of an internet or telephone questionnaire completed by a patient from constituting an acceptable medical interview for the provision of treatment by telehealth. This act permits such questionnaires if the information provided is sufficient as though the medical evaluation was performed in person, with a report to be provided to the patient's primary health care provider within fourteen days of evaluation, as described in the act.

Additionally, current law requires a physician-patient relationship for purposes of telehealth to include a sufficient dialogue with the patient regarding treatment. This act changes "dialogue" to "exchange" with the patient regarding treatment.

Finally, current law prohibits a health care provider from prescribing any drug, controlled substance, or other treatment to a patient based solely on an internet request or questionnaire. Under this act, a health care provider shall not prescribe any drug, controlled substance, or other treatment to a patient in the absence of a proper provider-patient relationship.

These provision are identical to provisions in the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026) and SB 1453 (2026), substantially similar to SB 108 (2025) and SB 851 (2024), and similar to SCS/SB 418 (2023) and HB 710 (2023).

ALPHA-GAL SYNDROME (Section 192.020) This act requires the Department of Health and Senior Services to include alpha-gal syndrome in its list of diseases that are required to be reported to the Department.

Laboratories shall submit any required alpha-gal syndrome case reports to the Department within 7 days of receiving a positive laboratory confirmation, as described in the act. Subject to appropriation, the Department may follow up on reported cases of alpha-gal syndrome. The Department shall submit an annual report to the Centers for Disease Control and Prevention on the reporting and incidence of alpha-gal syndrome in Missouri.

This provision is similar to a provision in the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026), HCS/HB 1855 (2026), and SB 1630 (2026).

DEPARTMENT OF HEALTH AND SENIOR SERVICES CONTRACTS FOR PUBLIC HEALTH (Section 192.021) This act authorizes the Department of Health and Senior Services to contract with a Missouri affiliate of a national public health association or public health institute, or a similar or successor entity, in order to assist in carrying out its duties to promote the health and well-being of Missouri residents. Such contracts may include efforts to assist in the delivery of health services throughout the state and the administration of grant funds and related programs. The Department and the designated affiliate shall provide a report to the General Assembly as specified in the act.

This act is identical to SB 1525 and substantially similar to provisions in SB 1037 (2026), HCS/SB 94 (2025), and SB 549 (2025).

DEMENTIA SERVICES COORDINATOR (Section 192.2155) This act requires the Division of Senior and Disability Services within the Department of Health and Senior Services to establish a dementia services coordinator as a full-time position. The coordinator shall perform duties specified in the act, including coordinating information resources affecting Missourians living with dementia and their caregivers, streamlining applicable services to increase efficiency and improve the quality of care in certain settings, identifying any duplicated services, promoting public awareness and education, and collecting and monitoring relevant data.

This act is identical to a provision in the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026) and HCS/HB 2149 (2026) and substantially similar to SB 1230 (2026), SB 410 (2025), SB 1410 (2024), and HB 2071 (2024).

MULTIDISCIPLINARY ADULT PROTECTION TEAMS (Sections 192.2400 and 192.2435) This act modifies current law relating to protective services for elderly and disabled adults by authorizing multidisciplinary adult protection teams to access confidential reports of abuse and neglect and case information to the extent necessary to conduct team activities and to share such information with other team members. Additionally, the Department of Social Services and the Department of Mental Health shall have limited access to such confidential reports, as described in the act.

This provision is identical to a provision in the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026) and SB 1505 (2026).

DISCLOSURE OF VITAL RECORDS (Section 193.245) This act repeals a provision of law permitting the Department of Health and Senior Services to disclose a listing of persons who are born or who die on a particular date upon a person's request.

This provision is identical to SB 1137 (2026), SB 598 (2025), and a provision in SCS/HCS/HB 943 (2025).

LIMITS ON SALE OF OVER-THE-COUNTER DRUGS (Sections 195.417 and 579.060) Currently, no person shall sell, dispense, or purchase, over a 12 month period, more than a total amount of 43.2 grams of certain meth precursors. This act increases the amount to 61.2 grams.

Beginning October 1, 2026, any manufacturer of a meth precursor drug that is sold in or into this state shall pay a monthly fee to the administrator of the real-time electronic pseudoephedrine tracking system, as described in the act. The fee is set by the administrator.

A manufacturer commits the offense of unlawful, sale, distribution, or purchase of over-the-counter methamphetamine precursor drugs if the manufacturer knowingly fails to pay the fees required by this act.

This act is identical to provisions in the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026), the truly agreed to and finally passed HCS/SS/SCS/SB 878 (2026), and the truly agreed to and finally passed CCS/SS/SB 1421 (2026) and substantially similar to provisions in SB 1069 (2026), SB 726 (2025), HB 1036 (2025), provisions of HCS/SS/SB 7 (2025), SCS/SB 317 (2025), SCS/HCS/HB 943 (2025), SB 548 (2025), and SB 143 (2025).

IVERMECTIN AND HYDROXYCHLOROQUINE (Section 195.1000) Under this act, ivermectin and hydroxychloroquine tablets suitable for human use may be sold or purchased as over-the-counter medications in Missouri without a prescription or consultation with a pharmacist or other health care professional.

This provision is identical to a provision in the perfected HCS/HB 2372 (2026), SB 1086 (2026), SB 1275, and SB 1489 (2026) and substantially similar to SB 744 (2025) and HB 2581 (2024).

ADMINISTRATION OF MEDICATIONS (Sections 196.990 and 335.081) This act adds licensed long-term care facilities and child care facilities to the definition of "authorized entity" in current law permitting such entities to stock a supply of epinephrine delivery devices for use in an emergency. Additionally, the administration by technicians, nurses' aides, or their equivalent in long-term care facilities of epinephrine delivery devices and subcutaneous injectable medications to treat diabetes shall not be prohibited by nurse licensing laws.

These provisions are identical to provisions in the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026) and similar to provisions in SCS/HCS/HB 943 (2025), SB 548 (2025), SCS/SB 317 (2025), and HCS/HB 2824 (2024).

HOSPITAL WORKPLACE VIOLENCE (Section 197.708) Under this act, each hospital shall prominently display a printed sign, in all capital letters, warning that assaulting a health care professional is a serious crime which may be punishable as a class A misdemeanor.

This provision is identical to a provision in the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026) and substantially similar provisions in HCS/SB 94 (2025), and HCS/HB 1213 (2025) and substantially similar to SB 791 (2025).

INSPECTIONS OF LONG-TERM CARE FACILITIES (Section 198.022) Under this act, the Department of Health and Senior Services may accept, in lieu of an inspection conducted by the Department, a written report of a survey or inspection conducted by any state or federal agency, provided the survey or inspection is comparable in scope or method to the Department's inspections and conducted in accordance with Title XVIII of the Social Security Act. A residential care or assisted living facility shall be subject to an inspection by the Department if the facility fails to maintain an accredited status by a recognized accreditation entity. Finally, if a facility exempt from an annual inspection under this act has one or more violations of any class I standards, then the facility shall be subject to a full inspection by the Department.

This provision is identical to a provision in the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026), substantially similar to a provision in SCS/HCS/HB 943 (2025), and similar to SB 689 (2025).

MO HEALTHNET TICKET TO WORK (Section 208.146) Under current law, the "Ticket to Work Health Assurance Program" expired on August 28, 2025. This act repeals that expiration date.

This provision is identical to a provision in the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026) and SB 1708 (2026).

MO HEALTHNET COVERAGE OF CERTAIN CLINICAL PATHOLOGY SERVICES (Section 208.149) This act requires that the fee for the professional component of clinical pathology services shall be paid by MO HealthNet for professional services provided by a hospital-based pathologist for inpatient clinical pathology services rendered to MO HealthNet patients. The reimbursement shall be set at no less than thirty percent of the approved MO HealthNet Independent Lab-Technical Component fee schedule, as described in the act, as shall be made directly to the physician providing the services or the entity the physician has assigned the right to receive payment.

This provision is identical to a provision in the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026) and substantially similar to a provision in SB 1469 (2026), HCS/SB 94 (2025), and SCS/HCS/HB 943 (2025).

MO HEALTHNET THIRD PARTY LIABILITY (Section 208.215) Under this act, any health benefit plan, third-party administrator, administrative service organization, or pharmacy benefits manager paying all properly submitted medical assistance subrogation claims or MO HealthNet subrogation claims shall respond to any inquiry by the state regarding a claim for payment for any health care item or service not later than 60 days after receiving the inquiry. Additionally, such entity shall not deny a claim submitted by the state for failure to provide prior authorization for the item or service, except that this provision shall not apply to certain programs or plans, including the original Medicare fee-for-service program, a Medicare Advantage plan, a reasonable cost reimbursement plan, a health care prepayment plan, or a prescription drug plan.

A health benefit plan, third-party administrator, administrative service organization, or pharmacy benefits manager shall accept authorization provided by the state that an item or service is covered under the state plan or a waiver for the individual as if the authorization were the prior authorization made by the third party, except that this provision shall not apply to certain programs or plans, including the original Medicare fee-for-service program, a Medicare Advantage plan, a reasonable cost reimbursement plan, a health care prepayment plan, or a prescription drug plan.

This provision is identical to a provision in the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026) and SB 1687 (2026).

"FOOD IS MEDICINE ACT" (Section 208.270) This act creates the "Food is Medicine Act". Under this act, the Department of Social Services shall submit a waiver to the Centers for Medicare and Medicaid Services for a "Food is Medicine" program. The program shall be designed to improve health outcomes for MO HealthNet participants with nutrition-related chronic diseases through nutrition services and to reduce the need for medical care for those participants. Covered nutrition services may include case management, nutrition counseling, food provisions, medically tailored groceries and meals, and produce prescriptions. When feasible, the MO HealthNet Division shall prioritize the inclusion of community-based organizations and local growers to support the purchase of locally grown food in nutrition prescription.

This provision is substantially similar to a provision in the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026), SB 1075 (2026), and SB 1499 (2026).

CHILDREN'S HEALTH SCREENINGS (Section 210.110) Under this provision, a physician or nurse practitioner shall perform a physical health screening on an abused or neglected child within 72 hours of the child entering the custody of the state, as described in the act. No vaccine shall be administered to the child during the physical without the consent of the biological parent. Within 30 days of the physical, a referral shall be made for additional screenings, which may be performed by a licensed mental health professional or a primary care physician using a standardized assessment tool.

This provision is identical to HCS/HB 2745 (2026) and substantially similar to a provision in the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026).

FOOD-BORNE ALLERGIES (Section 210.225) This act establishes "Elijah's Law". Before July 1, 2028, each licensed child care provider shall adopt a policy on allergy prevention and response with a focus on potentially deadly food-borne allergies, as specified in the act. The Department of Elementary and Secondary Education shall develop a model policy or policies before July 1, 2027. Adoption of a policy on allergy prevention and response shall be required for licensure as a child care provider.

This provision is identical to a provision in the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026) and substantially similar to SB 783 (2025) and HB 580 (2025).

LICENSE PLATES (Section 301.142) This act adds licensed occupational therapists to the definition of "other authorized health care practitioner" for purposes of the physician's statement required for issuance of a disabled license plate or placard. Additionally, removable windshield placards shall be renewed every eight years, instead of the four years in current law. The Department of Transportation shall have the authority to automatically renew placards, as described in the act.

This provision is identical to the truly agreed to and finally passed HB 1827 (2026) and a provision in the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026) and substantially similar to SB 1634 (2026) and SB 616 (2025).

LICENSE RECIPROCITY (Section 324.009) Those health care providers, who hold a current license issued by another jurisdiction and are licensed in Missouri with a waiver of examination, educational, or experience requirements, shall be deemed to be fully licensed to practice within the profession's scope of practice in Missouri and may provide telehealth services to the same extent and manner as health care providers who receive a license without a waiver.

This provision is identical to a provision in the truly agreed to and finally passed SS/HCS/HB 2974 (2026), the truly agreed to and finally passed HCS/SS#2/SB 1233 (2026), SB 1691 (2026), SCS/HCS/HB 2372 (2026).

PRACTICE OF DENTISTRY IN CORRECTIONAL CENTERS (Section 332.081) Current law provides that no corporation shall practice dentistry unless that corporation is a nonprofit corporation or a professional corporation under Missouri law. This act provides that such provision shall not apply to entities contracted with the state to provide care in correctional centers.

This provision is identical to a provision in the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026), the truly agreed to and finally passed HCS/SS#2/SB 1233 (2026), SCS/HCS/HB 943 (2025), SB 143 (2025), SB 548 (2025), SCS/SB 317 (2025), SS/SCS/HCS/HB 1659 (2024), SB 1287 (2024), and HB 2280 (2024).

ADMINISTRATION OF CERTAIN VACCINES (Section 338.010) Currently, the practice of pharmacy includes the ordering and administration of vaccines approved or authorized by the FDA, but excludes certain vaccines and those vaccines approved after January 1, 2023. This act instead provides that the practice of pharmacy includes the ordering and administration of certain vaccines approved or authorized by the FDA as of January 1, 2026, but excludes certain vaccines and those that are not included by joint rules promulgated by the Board of Pharmacy and the State Board of Registration for the Healing Arts.

This provision is identical to a provision in the truly agreed to and finally passed HCS/SS/SCS/SB 878 (2026), the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026), and the perfected HCS/HB 3009 (2026) and substantially similar to a provision in the truly agreed to and finally passed HCS/SS#2/SB 1233 (2026) and HB 1976 (2026).

LICENSURE OF WHOLESALE DRUG DISTRIBUTORS (Section 338.333) Under this act, the Board of Pharmacy may permit an out-of-state wholesale drug distributor or third-party logistics provider to be licensed in this state despite not having a license issued by the distributor's or provider's resident state if the distributor or provider has a current and valid drug distributor accreditation from the National Association of Boards of Pharmacy.

This provision is identical to a provision in the truly agreed to and finally passed HCS/SS#2/SB 1233 (2026), the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026), SCS/HCS/HB 943 (2025), HCS/SB 94 (2025), and HB 1465 (2025).

RX CARES FOR MISSOURI PROGRAM (Section 338.710) This act removes the expiration date of August 28, 2026, from the "RX Cares for Missouri Program".

This provision is identical to provisions in the truly agreed to and finally passed HCS/SS#2/SB 1233 (2026), the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026), and HB 1445 (2025).

SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS (Section 345.050) This act modifies the requirements for licensure as a speech-language pathologist or audiologist by providing for completion of a clinical fellowship under the direct supervision of a licensed speech-language pathologist in good standing, rather than under the direct supervision of a person licensed by the state of Missouri in the profession in which the applicant seeks to be licensed.

This provision is identical to a provision in SB 1405 (2026), the perfected HCS/HB 2372 (2026), in HCS/SS/SB 7 (2025), in the perfected SS/SB 61 (2025), in the perfected HCS/HB 268 (2025), SB 431 (2025), in the perfected HB 478 (2025), in HB 765 (2025), and in SCS/HB 834 (2025), and is substantially similar to the perfected HB 2591 (2026) and a provision in the truly agreed to and finally passed HCS/SS#2/SB 1233 (2026).

340B DRUGS (Section 376.417) Under this act, a health carrier, a pharmacy benefits manager, or an agent or affiliate of such, shall not discriminate against a covered entity, as defined in the act, including by reimbursing the covered entity for a quantity of a 340B drug in an amount less than it would pay similarly situated non-covered entities for such drugs, imposing different terms and conditions as compared to similarly situated entities, refusing to cover 340B drugs or discriminating in reimbursement for 340B drugs, and other situations described under this act. The Director of the Department of Commerce and Insurance shall impose a civil penalty on any health carrier, pharmacy benefits manager, or agent or affiliate of such, that violates this provision, not to exceed $5,000 per violation per day.

This provision is identical to a provision in the truly agreed to and finally passed HCS/SS/SCS/SB 878 (2026), the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026), SCS/HCS/HB 943 (2025), and HB 784 (2025).

MULTIPLE EMPLOYER SELF-INSURED HEALTH PLANS (Sections 376.1000-376.1017) This act modifies the definition of "multiple employer-self insure health plan" by including two or more self-employed individuals, each with at least one common-law employee, and their dependents.

Currently, funds collected from the participating employers under the health plans are held in trust and trustees are required to file an annual report with the director of the Department of Commerce and Insurance showing the condition and affairs of the plan as of the preceding thirty first day of December. This act requires the annual report be filed with the National Association of Insurance Commissioners and comply with current law.

This act requires plans to establish a surplus account equal to the greater of six hundred thousand dollars or an amount equal to two times the authorized control level risk-based capital, as defined by current law.

These provisions are identical to provisions in the truly agreed to and finally passed CCS/SS/HCS/HB 2596 (2026) and the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026) and similar to SB 1464 (2026).

CONTRAST ENHANCED MAMMOGRAPHY (Section 376.1183) Currently, each health carrier or health benefit plan that provides coverage for diagnostic breast examinations, supplemental breast examinations, coverage required under current law, or any combination of such coverage shall not impose any cost-sharing requirements on diagnostic breast examinations or supplemental breast examinations. This act modifies when supplemental breast examinations may be necessary and specifies that diagnostic and supplemental examinations may include contrast enhanced mammographies.

This provision is identical to a provision in the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026).

INSURANCE COVERAGE OF ANESTHESIA SERVICES (Section 376.1245) Under this act, no health carrier or health benefit plan shall establish, implement, or enforce any policy that imposes a time limit for the payment of anesthesia services provided during a medical or surgical procedure, as described in the act.

This provision is identical to a provision in the perfected HCS/HB 2372 (2026) and substantially similar to provisions in SCS/HCS/HB 943 (2025), HCS/SB 94 (2025), and HCS/HBs 1126 & 932 (2025).

INSURANCE COVERAGE OF ALTERNATIVES TO OPIOID DRUGS (Section 376.1280) This act provides that an enrollee's health benefit plan shall not deny coverage of a non-opioid prescription drug in favor of an opioid drug, require the enrollee to try an opioid drug before covering the non-opioid prescription drug, or require a higher level of cost-sharing for a non-opioid prescription drug than for an opioid drug.

This act shall apply to health benefit plans delivered, issued for delivery, continued, or renewed in this state on or after January 1, 2027.

These provisions shall only be applicable when multiple nonopioid medications are approved by the U.S. Food and Drug Administration for the treatment of chronic or acute pain.

This provision is identical to a provision in the truly agreed to and finally passed HCS/SS/SCS/SB 878 (2026) and substantially similar to a provision in the perfected HCS/HB 2372 (2026) and SB 158 (2025).

ARTIFICIAL INTELLIGENCE IN MENTAL HEALTH (Section 407.3007) The act provides that no person or entity that develops or deploys artificial intelligence (AI) shall advertise or represent to the public that the AI is or is able to act as a mental health professional, as defined in the act, or is capable of providing therapy services, psychotherapy services, or a mental health diagnosis.

A violation under the act shall be considered an unlawful practice under the Missouri Merchandising Practices Act.

The Attorney General shall enforce the provisions of the act. Any individual may report violations of the act to the Attorney General. If the Attorney General finds that a violation occurred, the Attorney General shall commence a civil action. If the court finds that a violation occurred, the court may grant relief as described in the act.

This provision is identical to a provision in the perfected HCS/HB 2372 (2026) and SCS/SB 1444 (2026) and similar to HB 2368 (2026).

CRITICAL INCIDENT STRESS MANAGEMENT PROGRAM (Section 590.192) Under current law, all peace officers and first responders are required to have a mental health check-in with a program service provider once every three to five years. This act allows a department to satisfy this requirement if they have an established behavioral health or mental health program that meets enumerated requirements. This act also adds first responder commanding officers to the list of people approved to receive notification that the check-in requirement has been met.

This provision is identical to a provision in the truly agreed to and finally passed CCS/HCS/SS/SB 975 (2026), SB 1731 (2026), and SB 1745 (2026).

MENTAL HEALTH TREATMENT (Section 632.305) This act modifies notarization requirements for applications for detention for evaluation and treatment at a mental health facility. Under this act, no notarization shall be required for the application or any affidavits, declarations, or other supporting documents filed under certain provisions of law, including when filed in court by an adult, when a peace officer takes a person into custody for detention at the facility for a period of 96 hours, when a person presents themselves at the facility and the health care provider completes the application, or if the person executing the application is an employee acting on behalf of a hospital.

This provision is identical to the perfected SS/SCS/SB 1015 (2026), the perfected HB 1977 (2026), a provision in the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026), and provisions in SCS/HCS/HB 1259 (2025) and substantially similar to SB 1274 (2026) and SB 436 (2025). SARAH HASKINS