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Public Policy Update - Updates on the 100th General Assembly

18 Mar 2019 10:07 AM | Deleted user

Author:  Sarah Cox, PharmD, MS. MSHP Public Policy Chair/Assistant Professor, UMKC School of Pharmacy at MU

The General Assembly Kicked off its 100th year on January 9, 2019 and will close its session at 6pm on May 17, 2019. Since the kickoff, lawmakers have been entrenched in the policy process in which a bill becomes a law. And this year, a number of bills have been introduced in both the house and senate that would impact pharmacy and the care of our patients. In this article, we list the pharmacy-related bills and walk through how a bill becomes a law.

2019 Pharmacy-Related Bills

  • SB 155/HB 188: Establishes the Narcotics Control Act for a Prescription Drug Monitoring Program
  • SB 253/HB 257: Authorizes the Board of Pharmacy to enter into voluntary compliance agreements with pharmacists in lieu of disciplinary action
  • SB 262/HB 293: Requires prescriptions to be issued electronically, with some exceptions
  • SB 274/HB 851: Allows the Board of Pharmacy to establish pharmacy pilot projects regarding remote verification and remote dispensing
  • SB 309/HB 725: Authorizes pharmacists to prescribe and dispense tobacco cessation products
  • SB 127: Requires the Department of Health and Human Services to conduct a study regarding the importation of certain prescription drugs by the state
  • HB 667: Modifies and establishes provisions relating to pharmacies, specifically regarding drug importation
  • SB 357/HB 1234: Allows pharmacists to prescribe drugs and controlled substances according to a written medication therapy services protocol from a physician
  • HB 251: Establishes the Tricia Leann Tharp Act, which requires certain pharmacists to receive two hours of continuing education on suicide Prevention
  • HB 487: changes the laws regarding the dispensing of oral contraception by allowing pharmacists to dispense under medication therapy services protocol
  • HB 727: Allows certain medications in multi-dose containers used by a patient during a hospital stay to be sent with the patient at discharge

Each of these bills have been introduced in their respective chamber. Click here to look up these bills and see where they are in the policy process.

How a Bill Becomes a Law


Step 1. Bill introduction, first and second read:

  • Legislators may file and introduce bills to their respective chamber (i.e. House or Senate). The last day to introduce a bill is the 60th day of the session.
  • Each bill introduced has a first and second reading. Following the first reading, it is placed on the calendar for a second reading. Following the second reading, the bill will be assigned a committee.

Step 2. Committee and Public Hearing:

  • The committee will hold a public hearing for each bill that is assigned to it.
  • In a public hearing, the sponsor will introduce the bill to the assigned committee. Additionally, proponents and opponents will be invited to provide a testimony.
Following the public hearing, the committee will vote to either:
  1. Recommend to the chamber that the bill “do pass”
  2. Recommend to the chamber that the bill “do pass” with committee amendments
  3. Recommend to the chamber that a committee substitute “do pass”
  4. Recommend to the chamber that the bill “do not pass”
  5. Report to the chamber with no recommendation

Step 3. Perfection:

  • When a bill receives a positive recommendation, it is placed on the calendar to be “perfected” by the full chamber.
  • During the Perfection process, the bill is:
    • Debated on the chamber floor
    • Amendments recommended are debated and voted on
    • Chamber votes to have the bill “perfected and printed”

Step 4. Third reading and final passage:

  • Perfected bills once again debated by the full chamber, followed by a recorded vote
  • Approval requires a majority (82 in the House, 34 in the Senate)
  • Any bill passed out of one chamber will be introduced in the opposite chamber and will go through steps one through four again.
    • If the bill is passed out of the opposite chamber, it will go to step five
    • If the bill is amended and then passed out of the opposite chamber it will go back to the original chamber for approval
    • If the original chamber rejects any changes,  five members from each chamber will constitute the conference committee to discuss and compromise on further changes
    • The conference committee will then take its recommendation back to their respective chambers for a vote
    • If either chamber rejects the conference committee recommendation, a new conference committee will be developed and the process will repeat

Step 5. “Truly Agreed To and Finally Passed” and Governor signature

  • Bills that have passed by majority of both chambers are designated as “Truly Agreed To and Finally Passed” and signed by both the Speaker of the House and President Pro Tem of the Senate.
  • Following this action, the Governor has 15 days to make one of the following actions:
  1. Sign a bill will become Missouri Law
  2. Veto a bill returned to the General Assembly and requires two-third majority to override
  3. Not sign a bill will be presented to the Secretary of State who will enroll the bill as an authentic act a bill becomes Missouri Law
  4. Veto line-items (only appropriation bills) a General Assembly may veto with a two-thirds majority

Step 6. Becoming a Law

  • Once signed by the Governor and filed with the Secretary of State, a bill will go into effect as a law ninety days after the close of the General Assembly session.
  • Laws are published in Laws of Missouri.

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