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SECOND REGULAR SESSION
HOUSE BILL NO. 1710
103RD GENERAL ASSEMBL Y
INTRODUCED BY REPRESENT A TIVE VEIT .
4262H.01I JOSEPH ENGLER, Chief Clerk
AN ACT
T o 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Section A. Section 332.081, RSMo, is repealed and one new section enacted in lieu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 surgeo n 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, or gan 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 sur gical team for the fabrication of appliances following ablative sur gery , surgery to correct
16 birth anomalies, extensive radiation treatment of the head or neck, or trauma-related sur gery .
EXPLANA TION — 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.
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 surge on, 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 V eterans Bureau; or
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54 (1 1) 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 or ganized under the provisions of chapter 355 or 356 provided that a
60 corporation org anized under the provisions of chapter 355 and qualifying as an or ganization
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 or ganized 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 or ganized 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 pr ovide car e in a corr ectional 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
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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 or ganization shall practice dentistry as defined in section
96 332.071 unless such org anization 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 or ganizations 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 or ganized under the provisions of chapter 355 and
104 qualifying as an or ganization under 26 U.S.C. Section 501(c)(3), an unincorporated
105 or ganization 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 or ganizations 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 char ge 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
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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 char ge 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 1 1. All not-for-p rofit corporations or ganized or operated pursuant to the provisions of
143 chapter 355 and qualifying as an or ganization 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.
✔
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