hb0762t-Truly Bill Text
FIRST REGULAR SESSION
[TRULY AGREED TO AND FINALLY PASSED]
CONFERENCE COMMITTEE SUBSTITUTE FOR
SENATE SUBSTITUTE FOR
SENATE COMMITTEE SUBSTITUTE FOR
HOUSE SUBSTITUTE FOR
HOUSE COMMITTEE SUBSTITUTE FOR
HOUSE BILL NO. 762
91ST GENERAL ASSEMBLY
1642L.16T 2001
AN ACT
To repeal sections 197.285, 208.151 and 376.1209, RSMo 2000, relating to women's health services, and to enact in lieu
thereof five new sections relating to the same subject.
Be it enacted by the General Assembly of the state of Missouri, as follows:
Section A. Sections 197.285, 208.151 and 376.1209, RSMo 2000, are repealed and five new sections enacted in lieu
thereof, to be known as sections 197.285, 208.151, 376.1199, 376.1209 and 1, to read as follows:
197.285. 1. Hospitals and ambulatory surgical centers shall establish and implement a written policy adopted by each
hospital and ambulatory surgical center relating to the protections for employees who disclose information pursuant to
subsection 2 of this section. This policy shall include a time frame for completion of investigations related to complaints,
not to exceed thirty days, and a method for notifying the complainant of the disposition of the investigation. This policy
shall be submitted to the department of health to verify implementation. At a minimum, such policy shall include the
following provisions:
(1) No supervisor or individual with authority to hire or fire in a hospital or ambulatory surgical center shall prohibit
employees from disclosing information pursuant to subsection 2 of this section;
(2) No supervisor or individual with authority to hire or fire in a hospital or ambulatory surgical center shall use or threaten
to use his or her supervisory authority to knowingly discriminate against, dismiss, penalize or in any way retaliate against or
harass an employee because the employee in good faith reported or disclosed any information pursuant to subsection 2 of
this section, or in any way attempt to dissuade, prevent or interfere with an employee who wishes to report or disclose such
information;
(3) Establish a program to identify a compliance officer who is a designated person responsible for administering the
reporting and investigation process and an alternate person should the primary designee be implicated in the report.
2. This section shall apply to information disclosed or reported in good faith by an employee concerning:
(1) Alleged facility mismanagement or fraudulent activity;
(2) Alleged violations of applicable federal or state laws or administrative rules concerning patient care, patient safety or
facility safety; or
(3) The ability of employees to successfully perform their assigned duties.
All information disclosed, collected and maintained pursuant to this subsection and pursuant to the written policy
requirements of this section shall be accessible to the department of health at all times and shall be reviewed by the
department of health at least annually. Complainants shall be notified of the department of health's access to such
information and of the complainant's right to [appeal to the department of health] notify the department of health of any
information concerning alleged violations of applicable federal or state laws or administrative rules concerning
patient care, patient safety or facility safety.
3. Prior to any disclosure to individuals or agencies other than the department of health, employees wishing to make a
disclosure pursuant to the provisions of this section shall first report to the individual or individuals designated by the
hospital or ambulatory surgical center pursuant to subsection 1 of this section.
4. If the compliance officer, compliance committee or management official discovers credible evidence of misconduct
from any source and, after a reasonable inquiry, has reason to believe that the misconduct may violate criminal, civil or
administrative law, then the hospital or ambulatory surgical center shall report the existence of misconduct to the
appropriate governmental authority within a reasonable period, but not more than seven days after determining that there is
credible evidence of a violation.
5. Reports made to the department of health shall be subject to the provisions of section 197.477, provided that the
restrictions of section 197.477 shall not be construed to limit the employee's ability to subpoena from the original source
the information reported to the department pursuant to this section.
6. Each written policy shall allow employees making a report who wish to remain anonymous to do so, and shall include
safeguards to protect the confidentiality of the employee making the report, the confidentiality of patients and the integrity
of data, information and medical records.
7. Each hospital and ambulatory surgical center shall, within forty-eight hours of the receipt of a report, notify the
employee that his or her report has been received and is being reviewed.
8. The enactment of this section shall become effective January 1, 2001.
208.151. 1. For the purpose of paying medical assistance on behalf of needy persons and to comply with Title XIX, Public
Law 89-97, 1965 amendments to the federal Social Security Act (42 U.S.C. section 301 et seq.) as amended, the following
needy persons shall be eligible to receive medical assistance to the extent and in the manner hereinafter provided:
(1) All recipients of state supplemental payments for the aged, blind and disabled;
(2) All recipients of aid to families with dependent children benefits, including all persons under nineteen years of age who
would be classified as dependent children except for the requirements of subdivision (1) of subsection 1 of section 208.040;
(3) All recipients of blind pension benefits;
(4) All persons who would be determined to be eligible for old age assistance benefits, permanent and total disability
benefits, or aid to the blind benefits under the eligibility standards in effect December 31, 1973, or less restrictive standards
as established by rule of the division of family services, who are sixty-five years of age or over and are patients in state
institutions for mental diseases or tuberculosis;
(5) All persons under the age of twenty-one years who would be eligible for aid to families with dependent children except
for the requirements of subdivision (2) of subsection 1 of section 208.040, and who are residing in an intermediate care
facility, or receiving active treatment as inpatients in psychiatric facilities or programs, as defined in 42 U.S.C. 1396d, as
amended;
(6) All persons under the age of twenty-one years who would be eligible for aid to families with dependent children
benefits except for the requirement of deprivation of parental support as provided for in subdivision (2) of subsection 1 of
section 208.040;
(7) All persons eligible to receive nursing care benefits;
(8) All recipients of family foster home or nonprofit private child-care institution care, subsidized adoption benefits and
parental school care wherein state funds are used as partial or full payment for such care;
(9) All persons who were recipients of old age assistance benefits, aid to the permanently and totally disabled, or aid to the
blind benefits on December 31, 1973, and who continue to meet the eligibility requirements, except income, for these
assistance categories, but who are no longer receiving such benefits because of the implementation of Title XVI of the
federal Social Security Act, as amended;
(10) Pregnant women who meet the requirements for aid to families with dependent children, except for the existence of a
dependent child in the home;
(11) Pregnant women who meet the requirements for aid to families with dependent children, except for the existence of a
dependent child who is deprived of parental support as provided for in subdivision (2) of subsection 1 of section 208.040;
(12) Pregnant women or infants under one year of age, or both, whose family income does not exceed an income eligibility
standard equal to one hundred eighty-five percent of the federal poverty level as established and amended by the federal
Department of Health and Human Services, or its successor agency;
(13) Children who have attained one year of age but have not attained six years of age who are eligible for medical
assistance under 6401 of P.L. 101-239 (Omnibus Budget Reconciliation Act of 1989). The division of family services shall
use an income eligibility standard equal to one hundred thirty-three percent of the federal poverty level established by the
Department of Health and Human Services, or its successor agency;
(14) Children who have attained six years of age but have not attained nineteen years of age. For children who have
attained six years of age but have not attained nineteen years of age, the division of family services shall use an income
assessment methodology which provides for eligibility when family income is equal to or less than equal to one hundred
percent of the federal poverty level established by the Department of Health and Human Services, or its successor agency.
As necessary to provide Medicaid coverage under this subdivision, the department of social services may revise the state
Medicaid plan to extend coverage under 42 U.S.C. 1396a (a)(10)(A)(i)(III) to children who have attained six years of age
but have not attained nineteen years of age as permitted by paragraph (2) of subsection (n) of 42 U.S.C. 1396d using a more
liberal income assessment methodology as authorized by paragraph (2) of subsection (r) of 42 U.S.C. 1396a;
(15) The following children with family income which does not exceed two hundred percent of the federal poverty
guideline for the applicable family size:
(a) Infants who have not attained one year of age with family income greater than one hundred eighty-five percent of the
federal poverty guideline for the applicable family size;
(b) Children who have attained one year of age but have not attained six years of age with family income greater than one
hundred thirty-three percent of the federal poverty guideline for the applicable family size; and
(c) Children who have attained six years of age but have not attained nineteen years of age with family income greater than
one hundred percent of the federal poverty guideline for the applicable family size. Coverage under this subdivision shall
be subject to the receipt of notification by the director of the department of social services and the revisor of statutes of
approval from the secretary of the U.S. Department of Health and Human Services of applications for waivers of federal
requirements necessary to promulgate regulations to implement this subdivision. The director of the department of social
services shall apply for such waivers. The regulations may provide for a basic primary and preventive health care services
package, not to include all medical services covered by section 208.152, and may also establish co-payment, coinsurance,
deductible, or premium requirements for medical assistance under this subdivision. Eligibility for medical assistance under
this subdivision shall be available only to those infants and children who do not have or have not been eligible for
employer-subsidized health care insurance coverage for the six months prior to application for medical assistance.
Children are eligible for employer-subsidized coverage through either parent, including the noncustodial parent. The
division of family services may establish a resource eligibility standard in assessing eligibility for persons under this
subdivision. The division of medical services shall define the amount and scope of benefits which are available to
individuals under this subdivision in accordance with the requirement of federal law and regulations. Coverage under this
subdivision shall be subject to appropriation to provide services approved under the provisions of this subdivision;
(16) The division of family services shall not establish a resource eligibility standard in assessing eligibility for persons
under subdivision (12), (13) or (14) of this subsection. The division of medical services shall define the amount and scope
of benefits which are available to individuals eligible under each of the subdivisions (12), (13), and (14) of this subsection,
in accordance with the requirements of federal law and regulations promulgated thereunder except that the scope of benefits
shall include case management services;
(17) Notwithstanding any other provisions of law to the contrary, ambulatory prenatal care shall be made available to
pregnant women during a period of presumptive eligibility pursuant to 42 U.S.C. section 1396r-1, as amended;
(18) A child born to a woman eligible for and receiving medical assistance under this section on the date of the child's birth
shall be deemed to have applied for medical assistance and to have been found eligible for such assistance under such plan
on the date of such birth and to remain eligible for such assistance for a period of time determined in accordance with
applicable federal and state law and regulations so long as the child is a member of the woman's household and either the
woman remains eligible for such assistance or for children born on or after January 1, 1991, the woman would remain
eligible for such assistance if she were still pregnant. Upon notification of such child's birth, the division of family services
shall assign a medical assistance eligibility identification number to the child so that claims may be submitted and paid
under such child's identification number;
(19) Pregnant women and children eligible for medical assistance pursuant to subdivision (12), (13) or (14) of this
subsection shall not as a condition of eligibility for medical assistance benefits be required to apply for aid to families with
dependent children. The division of family services shall utilize an application for eligibility for such persons which
eliminates information requirements other than those necessary to apply for medical assistance. The division shall provide
such application forms to applicants whose preliminary income information indicates that they are ineligible for aid to
families with dependent children. Applicants for medical assistance benefits under subdivision (12), (13) or (14) shall be
informed of the aid to families with dependent children program and that they are entitled to apply for such benefits. Any
forms utilized by the division of family services for assessing eligibility under this chapter shall be as simple as practicable;
(20) Subject to appropriations necessary to recruit and train such staff, the division of family services shall provide one or
more full-time, permanent case workers to process applications for medical assistance at the site of a health care provider,
if the health care provider requests the placement of such case workers and reimburses the division for the expenses
including but not limited to salaries, benefits, travel, training, telephone, supplies, and equipment, of such case workers.
The division may provide a health care provider with a part-time or temporary case worker at the site of a health care
provider if the health care provider requests the placement of such a case worker and reimburses the division for the
expenses, including but not limited to the salary, benefits, travel, training, telephone, supplies, and equipment, of such a
case worker. The division may seek to employ such case workers who are otherwise qualified for such positions and who
are current or former welfare recipients. The division may consider training such current or former welfare recipients as
case workers for this program;
(21) Pregnant women who are eligible for, have applied for and have received medical assistance under subdivision (2),
(10), (11) or (12) of this subsection shall continue to be considered eligible for all pregnancy-related and postpartum
medical assistance provided under section 208.152 until the end of the sixty-day period beginning on the last day of their
pregnancy;
(22) Case management services for pregnant women and young children at risk shall be a covered service. To the greatest
extent possible, and in compliance with federal law and regulations, the department of health shall provide case
management services to pregnant women by contract or agreement with the department of social services through local
health departments organized under the provisions of chapter 192, RSMo, or chapter 205, RSMo, or a city health
department operated under a city charter or a combined city-county health department or other department of health
designees. To the greatest extent possible the department of social services and the department of health shall mutually
coordinate all services for pregnant women and children with the crippled children's program, the prevention of mental
retardation program and the prenatal care program administered by the department of health. The department of social
services shall by regulation establish the methodology for reimbursement for case management services provided by the
department of health. For purposes of this section, the term "case management" shall mean those activities of local public
health personnel to identify prospective Medicaid-eligible high-risk mothers and enroll them in the state's Medicaid
program, refer them to local physicians or local health departments who provide prenatal care under physician protocol and
who participate in the Medicaid program for prenatal care and to ensure that said high-risk mothers receive support from all
private and public programs for which they are eligible and shall not include involvement in any Medicaid prepaid,
case-managed programs;
(23) By January 1, 1988, the department of social services and the department of health shall study all significant aspects
of presumptive eligibility for pregnant women and submit a joint report on the subject, including projected costs and the
time needed for implementation, to the general assembly. The department of social services, at the direction of the general
assembly, may implement presumptive eligibility by regulation promulgated pursuant to chapter 207, RSMo;
(24) All recipients who would be eligible for aid to families with dependent children benefits except for the requirements
of paragraph (d) of subdivision (1) of section 208.150;
(25) All persons who would be determined to be eligible for old age assistance benefits, permanent and total disability
benefits, or aid to the blind benefits, under the eligibility standards in effect December 31, 1973, or those supplemental
security income recipients who would be determined eligible for general relief benefits under the eligibility standards in
effect December 31, 1973, except income; or less restrictive standards as established by rule of the division of family
services. If federal law or regulation authorizes the division of family services to, by rule, exclude the income or resources
of a parent or parents of a person under the age of eighteen and such exclusion of income or resources can be limited to
such parent or parents, then notwithstanding the provisions of section 208.010:
(a) The division may by rule exclude such income or resources in determining such person's eligibility for permanent and
total disability benefits; and
(b) Eligibility standards for permanent and total disability benefits shall not be limited by age;
(26) Within thirty days of the effective date of an initial appropriation authorizing medical assistance on behalf of
"medically needy" individuals for whom federal reimbursement is available under 42 U.S.C. 1396a (a)(10)(c), the
department of social services shall submit an amendment to the Medicaid state plan to provide medical assistance on behalf
of, at a minimum, an individual described in subclause (I) or (II) of clause 42 U.S.C. 1396a (a)(10)(C)(ii);
(27) Persons who have been diagnosed with breast or cervical cancer and who are eligible for coverage pursuant to
42 U.S.C. 1396a (a)(10)(A)(ii)(XVIII). Such persons shall be eligible during a period of presumptive eligibility in
accordance with 42 U.S.C. 1396r-1.
2. Rules and regulations to implement this section shall be promulgated in accordance with section 431.064, RSMo, and
chapter 536, RSMo. No rule or portion of a rule promulgated under the authority of this chapter shall become effective
unless it has been promulgated pursuant to the provisions of section 536.024, RSMo.
3. After December 31, 1973, and before April 1, 1990, any family eligible for assistance pursuant to 42 U.S.C. 601 et seq.,
as amended, in at least three of the last six months immediately preceding the month in which such family became
ineligible for such assistance because of increased income from employment shall, while a member of such family is
employed, remain eligible for medical assistance for four calendar months following the month in which such family would
otherwise be determined to be ineligible for such assistance because of income and resource limitation. After April 1,
1990, any family receiving aid pursuant to 42 U.S.C. 601 et seq., as amended, in at least three of the six months
immediately preceding the month in which such family becomes ineligible for such aid, because of hours of employment or
income from employment of the caretaker relative, shall remain eligible for medical assistance for six calendar months
following the month of such ineligibility as long as such family includes a child as provided in 42 U.S.C. 1396r-6. Each
family which has received such medical assistance during the entire six-month period described in this section and which
meets reporting requirements and income tests established by the division and continues to include a child as provided in
42 U.S.C. 1396r-6 shall receive medical assistance without fee for an additional six months. The division of medical
services may provide by rule the scope of medical assistance coverage to be granted to such families.
4. For purposes of section 1902(1), (10) of Title XIX of the federal Social Security Act, as amended, any individual who,
for the month of August, 1972, was eligible for or was receiving aid or assistance pursuant to the provisions of Titles I, X,
XIV, or Part A of Title IV of such act and who, for such month, was entitled to monthly insurance benefits under Title II of
such act, shall be deemed to be eligible for such aid or assistance for such month thereafter prior to October, 1974, if such
individual would have been eligible for such aid or assistance for such month had the increase in monthly insurance
benefits under Title II of such act resulting from enactment of Public Law 92-336 amendments to the federal Social
Security Act (42 U.S.C. 301 et seq.), as amended, not been applicable to such individual.
5. When any individual has been determined to be eligible for medical assistance, such medical assistance will be made
available to him for care and services furnished in or after the third month before the month in which he made application
for such assistance if such individual was, or upon application would have been, eligible for such assistance at the time
such care and services were furnished; provided, further, that such medical expenses remain unpaid.
376.1199. 1. Each health carrier or health benefit plan that offers or issues health benefit plans providing
obstetrical/gynecological benefits and pharmaceutical coverage, which are delivered, issued for delivery, continued
or renewed in this state on or after January 1, 2002, shall:
(1) Notwithstanding the provisions of subsection 4 of section 354.618, RSMo, provide enrollees with direct access to
the services of a participating obstetrician, participating gynecologist or participating obstetrician/gynecologist of
her choice within the provider network for covered services. The services covered by this subdivision shall be
limited to those services defined by the published recommendations of the accreditation council for graduate
medical education for training an obstetrician, gynecologist or obstetrician/gynecologist, including but not limited to
diagnosis, treatment and referral for such services. A health carrier shall not impose additional co-payments,
coinsurance or deductibles upon any enrollee who seeks or receives health care services pursuant to this
subdivision, unless similar additional co-payments, coinsurance or deductibles are imposed for other types of health
care services received within the provider network. Nothing in this subsection shall be construed to require a health
carrier to perform, induce, pay for, reimburse, guarantee, arrange, provide any resources for or refer a patient for
an abortion, as defined in section 188.015, RSMo, other than a spontaneous abortion or to prevent the death of the
female upon whom the abortion is performed, or to supersede or conflict with section 376.805; and
(2) Notify enrollees annually of cancer screenings covered by the enrollees' health benefit plan and the current
American Cancer Society guidelines for all cancer screenings or notify enrollees at intervals consistent with current
American Cancer Society guidelines of cancer screenings which are covered by the enrollees' health benefit plans.
The notice shall be delivered by mail unless the enrollee and health carrier have agreed on another method of
notification; and
(3) Include coverage for services related to diagnosis, treatment and appropriate management of osteoporosis when
such services are provided by a person licensed to practice medicine and surgery in this state, for individuals with a
condition or medical history for which bone mass measurement is medically indicated for such individual. In
determining whether testing or treatment is medically appropriate, due consideration shall be given to peer
reviewed medical literature. A policy, provision, contract, plan or agreement may apply to such services the same
deductibles, coinsurance and other limitations as apply to other covered services; and
(4) If the health benefit plan also provides coverage for pharmaceutical benefits, provide coverage for
contraceptives either at no charge or at the same level of deductible, coinsurance or co-payment as any other
covered drug. No such deductible, coinsurance or co-payment shall be greater than any drug on the health benefit
plan's formulary. As used in this section, "contraceptive" shall include all prescription drugs and devices approved
by the federal Food and Drug Administration for use as a contraceptive, but shall exclude all drugs and devices that
are intended to induce an abortion, as defined in section 188.015, RSMo, which shall be subject to section 376.805.
Nothing in this subdivision shall be construed to exclude coverage for prescription contraceptive drugs or devices
ordered by a health care provider with prescriptive authority for reasons other than contraceptive or abortion
purposes.
2. For the purposes of this section, "health carrier" and "health benefit plan" shall have the same meaning as
defined in section 376.1350.
3. The provisions of this section shall not apply to a supplemental insurance policy, including a life care contract,
accident-only policy, specified disease policy, hospital policy providing a fixed daily benefit only, Medicare
supplement policy, long-term care policy, short-term major medical policies of six months or less duration, or any
other supplemental policy as determined by the director of the department of insurance.
4. Notwithstanding the provisions of subdivision (4) of subsection 1 of this section to the contrary:
(1) Any health carrier may issue to any person or entity purchasing a health benefit plan, a health benefit plan that
excludes coverage for contraceptives if the use or provision of such contraceptives is contrary to the moral, ethical
or religious beliefs or tenets of such person or entity;
(2) Upon request of an enrollee who is a member of a group health benefit plan and who states that the use or
provision of contraceptives is contrary to his or her moral, ethical or religious beliefs, any health carrier shall issue
to or on behalf of such enrollee a policy form that excludes coverage for contraceptives. Any administrative costs to
a group health benefit plan associated with such exclusion of coverage not offset by the decreased costs of providing
coverage shall be borne by the group policyholder or group plan holder;
(3) Any health carrier which is owned, operated or controlled in substantial part by an entity that is operated
pursuant to moral, ethical or religious tenets that are contrary to the use or provision of contraceptives shall be
exempt from the provisions of subdivision (4) of subsection 1 of this section.
For purposes of this subsection, if new premiums are charged for a contract, plan or policy, it shall be determined to
be a new contract, plan or policy.
5. Except for a health carrier that is exempted from providing coverage for contraceptives pursuant to this section,
a health carrier shall allow enrollees in a health benefit plan that excludes coverage for contraceptives pursuant to
subsection 4 of this section to purchase a health benefit plan that includes coverage for contraceptives.
6. Any health benefit plan issued pursuant to subsection 1 of this section shall provide clear and conspicuous
written notice on the enrollment form or any accompanying materials to the enrollment form and the group health
benefit plan contract:
(1) Whether coverage for contraceptives is or is not included;
(2) That an enrollee who is a member of a group health benefit plan with coverage for contraceptives has the right
to exclude coverage for contraceptives if such coverage is contrary to his or her moral, ethical or religious beliefs;
and
(3) That an enrollee who is a member of a group health benefit plan without coverage for contraceptives has the
right to purchase coverage for contraceptives.
7. Health carriers shall not disclose to the person or entity who purchased the health benefit plan the names of
enrollees who exclude coverage for contraceptives in the health benefit plan or who purchase a health benefit plan
that includes coverage for contraceptives. Health carriers and the person or entity who purchased the health
benefit plan shall not discriminate against an enrollee because the enrollee excluded coverage for contraceptives in
the health benefit plan or purchased a health benefit plan that includes coverage for contraceptives.
8. The departments of health and insurance may promulgate rules necessary to implement the provisions of this
section. No rule or portion of a rule promulgated pursuant to this section shall become effective unless it has been
promulgated pursuant to chapter 536, RSMo.
376.1209. 1. Each entity offering individual and group health insurance policies providing coverage on an
expense-incurred basis, individual and group service or indemnity type contracts issued by a nonprofit corporation,
individual and group service contracts issued by a health maintenance organization, all self-insured group arrangements to
the extent not preempted by federal law, and all managed health care delivery entities of any type or description, that
provide coverage for the surgical procedure known as a mastectomy, and which are delivered, issued for delivery,
continued or renewed in this state on or after January 1, 1998, shall provide coverage for prosthetic devices or
reconstructive surgery necessary to restore symmetry as recommended by the oncologist or primary care physician for the
patient incident to the mastectomy. Coverage for prosthetic devices and reconstructive surgery shall be subject to the same
deductible and coinsurance conditions applied to the mastectomy and all other terms and conditions applicable to other
benefits with the exception that no time limit shall be imposed on an individual for the receipt of prosthetic devices
or reconstructive surgery and if such individual changes his or her insurer, then the new policy subject to the
federal Women's Health and Cancer Rights Act (sections 901-903 of P.L. 105-277), as amended, shall provide
coverage consistent with the federal Women's Health and Cancer Rights Act (sections 901-903 of P.L. 105-277), as
amended, and any regulations promulgated pursuant to such act.
2. As used in this section, the term "mastectomy" means the removal of all or part of the breast for medically necessary
reasons, as determined by a physician licensed pursuant to chapter 334, RSMo.
3. The provisions of this section shall not apply to a supplemental insurance policy, including a life care contract, accident
only policy, specified disease policy, hospital policy providing a fixed daily benefit only, Medicare supplement policy or
long-term care policy.
Section 1. 1. Notwithstanding any other provision of law, when the department of insurance intends to enter into
any contract or other written agreement or approve any letter of intent for payment of money by the state in excess
of one hundred thousand dollars, modification or potential reduction of a party's financial obligation to the state in
excess of one hundred thousand dollars, the department of insurance shall forward a copy to the attorney general
before entering into that contract, subcontract or other written agreement or approving the letter of intent.
2. Upon receiving the contract, other written agreement or letter of intent, the attorney general shall, within ten
days, review and approve that contract, other written contract or letter of intent for its legal form and content as
may be necessary to protect the legal interest of the state. If the attorney general does not approve, then the
attorney general shall return the contract, other written agreement or letter of intent with additional proposed
provisions as may be necessary to the proper enforcement of the contract as required to protect the state's legal
interest. If the attorney general does not respond within ten days or, in the case of any contract that involves a
payment of money by the state or a modification or potential reduction of a party's financial obligation to the state
of one million dollars or more, within thirty days, the contract shall be deemed approved.
3. Communications related to the attorney general's review are attorney-client communications. The attorney
general's written disposition shall be subject to chapter 610, RSMo.
Missouri House of Representatives