HOUSE BILL NO. 1710 103RD GENERAL ASSEMBLY
INTRODUCED BY REPRESENTATIVE VEIT.
4262H.01I JOSEPH ENGLER, Chief Clerk
AN ACT To repeal section 332.081, RSMo, and to enact in lieu thereof one new section relating to the practice of dentistry.
Be it enacted by the General Assembly of the state of Missouri, as follows:
Section A. Section 332.081, RSMo, is repealed and one new section enacted in lieu 2 thereof, to be known as section 332.081, to read as follows: 332.081. 1. Notwithstanding any other provision of law to the contrary, hospitals 2 licensed under chapter 197 shall be authorized to employ any or all of the following oral 3 health providers: 4 (1) A dentist licensed under this chapter for the purpose of treating on hospital 5 premises those patients who present with a dental condition and such treatment is necessary to 6 ameliorate the condition for which they presented such as severe pain or tooth abscesses; 7 (2) An oral and maxillofacial surgeon licensed under this chapter for the purpose of 8 treating oral conditions that need to be ameliorated as part of treating the underlying cause of 9 the patient's medical needs including, but not limited to, head and neck cancer, HIV or AIDS, 10 severe trauma resulting in admission to the hospital, organ transplant, diabetes, or seizure 11 disorders. It shall be a condition of treatment that such patients are admitted to the hospital on 12 either an in- or out-patient basis; and 13 (3) A maxillofacial prosthodontist licensed under this chapter for the purpose of 14 treating and supporting patients of a head and neck cancer team or other complex care or 15 surgical team for the fabrication of appliances following ablative surgery, surgery to correct 16 birth anomalies, extensive radiation treatment of the head or neck, or trauma-related surgery.
EXPLANATION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is intended to be omitted from the law. Matter in bold-face type in the above bill is proposed language. HB 1710 2
17 2. No person or other entity shall practice dentistry in Missouri or provide dental 18 services as [defined] described in section 332.071 unless and until the board has issued to the 19 person a certificate certifying that the person has been duly registered as a dentist in Missouri 20 or the board has issued such certificate to an entity that has been duly registered to provide 21 dental services by licensed dentists and dental hygienists and unless and until the board has 22 issued to the person a license, to be renewed each period, as provided in this chapter, to 23 practice dentistry or as a dental hygienist, or has issued to the person or entity a permit, to be 24 renewed each period, to provide dental services in Missouri. Nothing in this chapter shall be 25 so construed as to make it unlawful for: 26 (1) A legally qualified physician or surgeon, who does not practice dentistry as a 27 specialty, from extracting teeth; 28 (2) A dentist licensed in a state other than Missouri from making a clinical 29 demonstration before a meeting of dentists in Missouri; 30 (3) Dental students in any accredited dental school to practice dentistry under the 31 personal direction of instructors; 32 (4) Dental hygiene students in any accredited dental hygiene school to practice dental 33 hygiene under the personal direction of instructors; 34 (5) A duly registered and licensed dental hygienist in Missouri to practice dental 35 hygiene as defined in section 332.091; 36 (6) A dental assistant, certified dental assistant, or expanded functions dental assistant 37 to be delegated duties as defined in section 332.093; 38 (7) A duly registered dentist or dental hygienist to teach in an accredited dental or 39 dental hygiene school; 40 (8) A person who has been granted a dental faculty permit under section 332.183 to 41 practice dentistry in the scope of his or her employment at an accredited dental school, 42 college, or program in Missouri; 43 (9) A duly qualified anesthesiologist or nurse anesthetist to administer an anesthetic 44 in connection with dental services or dental surgery; 45 (10) A person to practice dentistry in or for: 46 (a) The United States Armed Forces; 47 (b) The United States Public Health Service; 48 (c) Migrant, community, or health care for the homeless health centers provided in 49 Section 330 of the Public Health Service Act (42 U.S.C. Section 254b); 50 (d) Federally qualified health centers as defined in Section 1905(l) (42 U.S.C. Section 51 1396d(l)) of the Social Security Act; 52 (e) Governmental entities, including county health departments; or 53 (f) The United States Veterans Bureau; or HB 1710 3
54 (11) A dentist licensed in a state other than Missouri to evaluate a patient or render an 55 oral, written, or otherwise documented dental opinion when providing testimony or records 56 for the purpose of a civil or criminal action before any judicial or administrative proceeding 57 of this state or other forum in this state. 58 3. No corporation shall practice dentistry as defined in section 332.071 unless that 59 corporation is organized under the provisions of chapter 355 or 356 provided that a 60 corporation organized under the provisions of chapter 355 and qualifying as an organization 61 under 26 U.S.C. Section 501(c)(3) may only employ dentists and dental hygienists licensed in 62 this state to render dental services to Medicaid recipients, low-income individuals who have 63 available income below two hundred percent of the federal poverty level, and all participants 64 in the SCHIP program, unless such limitation is contrary to or inconsistent with federal or 65 state law or regulation. This subsection shall not apply to: 66 (1) A hospital licensed under chapter 197 that provides care and treatment only to 67 children under the age of eighteen at which a person regulated under this chapter provides 68 dental care within the scope of his or her license or registration; 69 (2) A federally qualified health center as defined in Section 1905(l) of the Social 70 Security Act (42 U.S.C. Section 1396d(l)), or a migrant, community, or health care for the 71 homeless health center provided for in Section 330 of the Public Health Services Act (42 72 U.S.C. Section 254b) at which a person regulated under this chapter provides dental care 73 within the scope of his or her license or registration; 74 (3) A city or county health department organized under chapter 192 or chapter 205 at 75 which a person regulated under this chapter provides dental care within the scope of his or her 76 license or registration; 77 (4) A social welfare board organized under section 205.770, a city health department 78 operating under a city charter, or a city-county health department at which a person regulated 79 under this chapter provides dental care within the scope of his or her license or registration; 80 (5) Any entity that has received a permit from the dental board and does not receive 81 compensation from the patient or from any third party on the patient's behalf at which a 82 person regulated under this chapter provides dental care within the scope of his or her license 83 or registration; or 84 (6) Any hospital nonprofit corporation exempt from taxation under Section 501(c)(3) 85 of the Internal Revenue Code, as amended, that engages in its operations and provides dental 86 services at facilities owned by a city, county, or other political subdivision of the state, or any 87 entity contracted with the state to provide care in a correctional center, as such term is 88 defined in section 217.010, at which a person regulated under this chapter provides dental 89 care within the scope of his or her license or registration. 90 HB 1710 4
91 If any of the entities exempted from the requirements of this subsection are unable to provide 92 services to a patient due to the lack of a qualified provider and a referral to another entity is 93 made, the exemption shall extend to the person or entity that subsequently provides services 94 to the patient. 95 4. No unincorporated organization shall practice dentistry as defined in section 96 332.071 unless such organization is exempt from federal taxation under Section 501(c)(3) of 97 the Internal Revenue Code of 1986, as amended, and provides dental treatment without 98 compensation from the patient or any third party on their behalf as a part of a broader 99 program of social services including food distribution. Nothing in this chapter shall prohibit 100 organizations under this subsection from employing any person regulated by this chapter. 101 5. A dentist shall not enter into a contract that allows a person who is not a dentist to 102 influence or interfere with the exercise of the dentist's independent professional judgment. 103 6. A not-for-profit corporation organized under the provisions of chapter 355 and 104 qualifying as an organization under 26 U.S.C. Section 501(c)(3), an unincorporated 105 organization operating pursuant to subsection 4 of this section, or any other person should not 106 direct or interfere or attempt to direct or interfere with a licensed dentist's professional 107 judgment and competent practice of dentistry. Nothing in this subsection shall be so 108 construed as to make it unlawful for not-for-profit organizations to enforce employment 109 contracts, corporate policy and procedure manuals, or quality improvement or assurance 110 requirements. 111 7. All entities defined in subsection 3 of this section and those exempted under 112 subsection 4 of this section shall apply for a permit to employ dentists and dental hygienists 113 licensed in this state to render dental services, and the entity shall apply for the permit in 114 writing on forms provided by the Missouri dental board. The board shall not charge a fee of 115 any kind for the issuance or renewal of such permit. The provisions of this subsection shall 116 not apply to a federally qualified health center as defined in Section 1905(l) of the Social 117 Security Act (42 U.S.C. Section 1396d(l)). 118 8. Any entity that obtains a permit to render dental services in this state is subject to 119 discipline pursuant to section 332.321. If the board concludes that the person or entity has 120 committed an act or is engaging in a course of conduct that would be grounds for disciplinary 121 action, the board may file a complaint before the administrative hearing commission. The 122 board may refuse to issue or renew the permit of any entity for one or any combination of 123 causes stated in subsection 2 of section 332.321. The board shall notify the applicant in 124 writing of the reasons for the refusal and shall advise the applicant of his or her right to file a 125 complaint with the administrative hearing commission as provided by chapter 621. 126 9. A federally qualified health center as defined in Section 1905(l) of the Social 127 Security Act (42 U.S.C. Section 1396d(l)) shall register with the board. The information HB 1710 5
128 provided to the board as part of the registration shall include the name of the health center, the 129 nonprofit status of the health center, sites where dental services will be provided, and the 130 names of all persons employed by, or contracting with, the health center who are required to 131 hold a license pursuant to this chapter. The registration shall be renewed every twenty-four 132 months. The board shall not charge a fee of any kind for the issuance or renewal of the 133 registration. The registration of the health center shall not be subject to discipline pursuant to 134 section 332.321. Nothing in this subsection shall prohibit disciplinary action against a 135 licensee of this chapter who is employed by, or contracts with, such health center for the 136 actions of the licensee in connection with such employment or contract. 137 10. The board may promulgate rules and regulations to ensure not-for-profit 138 corporations are rendering care to the patient populations as set forth herein, including 139 requirements for covered not-for-profit corporations to report patient census data to the board. 140 The provisions of this subsection shall not apply to a federally qualified health center as 141 defined in Section 1905(l) of the Social Security Act (42 U.S.C. Section 1396d(l)). 142 11. All not-for-profit corporations organized or operated pursuant to the provisions of 143 chapter 355 and qualifying as an organization under 26 U.S.C. Section 501(c)(3), or the 144 requirements relating to migrant, community, or health care for the homeless health centers 145 provided in Section 330 of the Public Health Service Act (42 U.S.C. Section 254b) and 146 federally qualified health centers as defined in Section 1905(l) (42 U.S.C. Section 1396d(l)) 147 of the Social Security Act, that employ persons who practice dentistry or dental hygiene in 148 this state shall do so in accordance with the relevant laws of this state except to the extent that 149 such laws are contrary to, or inconsistent with, federal statute or regulation. ✔
Statutes affected: