Healthcare (Medicaid)

in committee · Missouri · House May 15, 2026

HB 2065: Repeals provisions relating to gender transition procedures

HB 2065 repeals Missouri's current laws specifically addressing gender transition procedures (sections 191.1720, 208.152, 217.230, and 221.120) and replaces them with general Medicaid coverage rules. The new provisions, codified as sections 208.152, 217.230, and 221.120, integrate gender transition procedures into standard Medicaid coverage criteria like medical necessity, without explicit reference to gender transition. This bill removes the prior specific legal framework for gender transition services and subjects them to the same general Medicaid process as other medical treatments. It does not explicitly exclude gender transition procedures from coverage but changes their legal basis to align with standard Medicaid rules.

Topics ✓ HealthcareSupports HealthcareRepeals specific restrictions on gender transition procedures in Medicaid, integrating them into general medical necessity coverage rules, expanding access to healthcare services under standard Medicaid criteria.95% confidence

Sub-Topics Medicaid

Track

in committee · Missouri · House May 15, 2026

HB 1822: Specifies that children diagnosed with certain conditions shall be eligible for MO HealthNet benefits

HB 1822 expands Missouri's MO HealthNet program to include children diagnosed with certain medical conditions by adding a new eligibility category for children aged one to six. This change aligns with federal standards under the Omnibus Budget Reconciliation Act of 1989, which covers children meeting specific income and medical criteria. The bill directly affects young children in Missouri who qualify under these federal guidelines but previously faced eligibility gaps. It ensures these children can access state health coverage without requiring additional state-specific documentation.

Topics ✓ Budget & TaxesSupports Budget & TaxesExpands MO HealthNet eligibility, increasing state healthcare funding for essential services aligned with federal standards.95% confidence ✓ HealthcareSupports HealthcareExpands MO HealthNet eligibility for children with specific conditions, aligning with federal standards to close coverage gaps and ensure access to healthcare benefits.95% confidence

Sub-Topics Children's Health Medicaid

Track

in committee · Missouri · House May 15, 2026

HB 2413: Modifies provisions relating to long-term care facilities

HB 2413 modifies regulations for assisted living facilities and residential care facilities. It allows facilities licensed as "Residential Care Facility II" as of 2006 to transition to "Assisted Living Facility" status without immediate compliance with new standards, but they must meet full requirements when Medicaid reimbursement for residents reaches $41 per day. The bill requires facilities to create individualized care plans, maintain 24-hour staffing, develop disaster evacuation plans, and prohibit admission of residents needing skilled nursing care, physical or chemical restraints, or who cannot safely evacuate without significant assistance. Facilities must also disclose services, costs, and discharge conditions to prospective residents and conduct medical screenings upon admission. These changes directly affect assisted living facilities and their residents, particularly those with disabilities requiring specialized care.

Topics ✓ HealthcareSupports HealthcareRequires individualized care plans, 24-hour staffing, and disaster plans, strengthening long-term care standards for elderly residents under healthcare facilities.92% confidence

Sub-Topics Long-Term Care Medicaid

Track

in committee · Missouri · Senate Feb 5, 2026

SB 1479: Authorizes state agencies to incorporate certain Medicaid regulations by reference when promulgating rules

SB 1479 allows state health agencies to adopt existing Medicaid regulations by simply referencing them in new rules, rather than rewriting the full text. This directly affects agencies that create Medicaid-related rules, such as the Department of Health, by streamlining their rulemaking process. The key mechanism is "incorporating by reference," meaning agencies can cite approved Medicaid rules from other sources instead of duplicating them. This reduces administrative burden and ensures consistency with established Medicaid standards. The bill does not change Medicaid benefits or eligibility, only the process for agencies to update their rules.

Topics ✓ HealthcareSupports HealthcareStreamlines Medicaid rulemaking by incorporating existing regulations, reducing administrative burden and ensuring consistency in healthcare program implementation.85% confidence

Sub-Topics Medicaid

Track

in committee · Missouri · Senate Mar 3, 2026

SB 897: Enacts provisions relating to prior authorization of health care services

SB 897 limits when health insurance companies can require prior authorization for medical services. It mandates that insurers must approve at least 90% of prior authorization requests from a provider for a specific service in the previous six-month period before requiring authorization. The bill also requires insurers to notify providers within 25 days of such determinations, establish appeal processes, and maintain an online portal for tracking authorization decisions. This primarily affects health insurance companies and healthcare providers in Missouri who participate in commercial health plans (excluding Medicaid managed care).

Topics ✓ HealthcareSupports HealthcareLimits insurer prior authorization barriers, mandates 90% approval rate for services, improves provider access to care per bill requirements.90% confidence

Sub-Topics Insurance Medicaid

Track

in committee · Missouri · House May 15, 2026

HB 2137: Modifies provisions relating to the scope of practice of dental hygienists

HB 2137 modifies Missouri's rules for dental hygienists, primarily requiring them to work under the supervision of a licensed dentist in most settings. The bill creates two key exceptions: (1) hygienists can provide basic services like oral screenings and fluoride varnish in any location without a dentist's supervision, and (2) experienced hygienists (with 3+ years in public health) can perform cleanings, sealants, and fluoride treatments for Medicaid-eligible children without supervision, with Medicaid reimbursing providers. This directly affects dental hygienists, dentists, public health facilities, and Medicaid-eligible children. The changes aim to expand access to preventive dental care in community settings while maintaining oversight for more complex procedures.

Topics ✓ HealthcareSupports HealthcarePermits experienced dental hygienists to provide Medicaid dental services without dentist supervision, expanding access for children in public health settings.85% confidence

Sub-Topics Healthcare Workforce Medicaid Medical Licensing

Track

in committee · Missouri · House May 15, 2026

HB 2538: Modifies provisions relating to administrative remedies in MO HealthNet cases

HB 2538 modifies Missouri Medicaid (MO HealthNet) appeal procedures to give beneficiaries clearer rights when their benefits are denied, reduced, or terminated. It requires state divisions to notify recipients of appeal options within 10 days of proposed changes or 90 days for denials/closed cases, and ensures benefits continue during appeals unless the recipient requests otherwise. The bill mandates fair hearings where recipients can present evidence, and decisions must be based on facts existing at the time of the original benefit denial or change. This directly affects Missouri Medicaid recipients and state administrative divisions handling benefit determinations.

Topics ✓ HealthcareSupports HealthcareModifies Medicaid appeal procedures to protect beneficiaries' rights during denials, ensuring benefits continue during appeals and requiring clear notification per bill summary.95% confidence

Sub-Topics Medicaid

Track

passed · Missouri · House May 7, 2026

HB 2355: Creates provisions relating to a MO HealthNet waiver for nutrition services

HB 2355 would authorize Missouri's Department of Social Services to seek a federal waiver from Medicare and Medicaid to create a "Food is Medicine" program within MO HealthNet. This program would provide nutrition services - including counseling, meals, prescriptions, and grocery support - to MO HealthNet participants diagnosed with nutrition-related chronic diseases like diabetes or heart conditions. The bill requires prioritizing community organizations and local farms for food purchases in nutrition prescriptions. It directly affects low-income Missourians enrolled in MO HealthNet who manage chronic health conditions linked to diet. The bill is currently in the Health and Mental Health committee for review.

Topics ✓ HealthcareSupports HealthcareAuthorizes Medicaid nutrition services for chronic disease patients via federal waiver, expanding healthcare access through food-based treatment programs within MO HealthNet.95% confidence

Sub-Topics Medicaid Medicare Mental Health

Track