2024 Legislative Session Summary By: Henrio T elemaque, Director of Government Aff airs
T
he 2024 legislative session, which adjourned on May 17, was a historically unproductive year. Of the 2,547 bills and resolutions introduced (863 in the
Senate and 1,684 in the House), 46 pieces of legislation passed, including the 18 bills that comprise the operating budget. Only 28 non- budget bills and resolutions passed this year. T is is even lower than the 31 bills passed in 2020 when session was interrupted by COVID-19. Much of this was due to Senate gridlock; the chamber was unable to pass any bills during the fi nal week, which is when the bulk of legislation advances to the Governor’s desk in an ordinary session. T is session, two record setting fi libusters
occurred. T e fi rst by the Senate Freedom Caucus was an attempt to thwart the passage of the Federal Reimbursement Allowance (FRA), which highlighted deep divisions between the Freedom Caucus and the majority of the Senate Republican caucus. T e second was a dramatic 50-hour fi libuster led by Senate Democrats in the fi nal week over proposed changes to the state constitution's amendment process. Despite the gridlock the fi nal week, the
Legislature passed several meaningful packages on education reform and workforce development as well as controversial bills barring Planned Parenthood from receiving state funds. T e ~$51.7 billion budget contained large investments into the state’s infrastructure, as well as worked to put the surplus of funding towards meaningful projects for Missouri.
T is report provides an overview of specifi c bills of interest.
Missouri Pharmacy Association Issues 2024
340B Legislation – Passed T e legislature worked this session to pass
reforms regarding the 340B program. MPA, and various stakeholder groups, worked to fi nd a path for the legislation given the strong opposition to these provisions. Given the uphill battle, a compromise was reached that contained provisions allowing providers to work to ensure that patients have access to this sought aſt er program. T e bill in its fi nal form allows a covered entity as defi ned by 42 U.S.C. Section 256b to utilize a contract pharmacy of their choosing. T e bill also preempts a pharmaceutical manufacturer from restricting the medications that can be accessed through this program, however this provision is currently being litigated. T e fi nal language also grants the Board of Pharmacy the authority to investigate complaints that are brought to them.
Federal Reimbursement
Allowance – Passed T rough the FRA, Missouri levies provider
taxes that are used as a state match to draw down federal dollars to fund Missouri's Medicaid program. T e FRA is responsible for over $4 billion of the Medicaid budget. T e provider taxes would expire on September 30 unless extended in law. Senate
Appropriations Chair Lincoln Hough (R-Springfi eld), fi led SB 748 to remove the program’s sunset. Even before the FRA was taken up for
fl oor debate, the issue generated signifi cant controversy. Senator Bill Eigel (R-Weldon Spring) attempted to characterize the FRA as a multi-billion tax raising healthcare costs. In advance of the FRA coming to the fl oor, members of the Freedom Caucus insisted they would block action on the bill until: • T e Governor signed the defund Planned
Parenthood bill. • T e Senate gave fi nal approval to SJR 74,
the IP reform resolution. Eventually SB 748 made it through the
Senate process, despite the opposition from the Freedom Caucus. T e House moved the bill through the process fairly quickly to ensure that the bill made it through the process before the end of session.
Scope of Practice
Expansion – Did Not Pass During the 2023 session MPA worked to
pass the largest scope expansion package in recent history for the profession of pharmacy. T ese provisions allow pharmacists to administer all vaccines approved by the FDA as of January 1, 2023, with exclusions for certain travel vaccines. While the job was done last year, the FDA recently approved of an RSV vaccine. During the 2024 session MPA worked to fi nd a path to ensure that pharmacists could administer these new vaccines to patients that wanted to have them. T is provision was attached to various
THE LEADING VOICE FOR THE MISSOURI PHARMACIST |
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