Unpacking HB 2372 (Healthcare Omnibus)

Questions? Contact MSMA at advocacy@msma.org.

The 2026 legislative session felt a bit like old times.  Eighty-three policy bills made it to the Governor’s desk, a 66% increase from 2025.  That’s a pace we haven’t seen 2019.  Among the 83 bills is HB 2372, a very large healthcare omnibus bill.  Over the next few weeks, we thought it would be helpful to unpack some of the various provisions that were attached to this bill.  Like all good compromises, there are some things we like and some things we don’t.  The Governor will get his opportunity to weigh in by either signing or vetoing the legislation.  Governor Kehoe has until July 14 to take action.  The full bill text is here, but below you’ll find a few things of interest to Missouri physicians, with more to be shared in future editions of Progress Notes.

Community Paramedic Services 190.098 & EMT Scope 190.142

This provision expands and formalizes the role of community paramedics in Missouri by allowing specially trained paramedics to provide more nonemergency, home- and community-based services under physician medical oversight. Community paramedics would be able to assist with chronic disease monitoring, medication compliance, follow-up care, care coordination, and implementation of physician-directed care plans outside the traditional 911 setting. For physicians, this could create an additional extension of the care team that may help reduce avoidable emergency department visits and hospital readmissions, particularly in rural or underserved areas. However, physicians should also pay close attention to the expanded EMT scope language in Section 190.142. The bill ties practice authority to the National EMS Scope of Practice Model and allows additional scope expansion through the state EMS medical director advisory committee and local medical directors. While the requirement for physician oversight and protocols remains, the language could gradually broaden EMT and paramedic responsibilities beyond traditional emergency response functions over time through administrative or protocol changes rather than direct legislative review. This raises potential concerns about scope creep, variability in supervision standards, and the possibility of nonphysician providers performing increasingly complex clinical functions without equivalent physician education and training.

Telemedicine Adaptive Questionnaires. 191.1146

The language that was passed was negotiated by your MSMA lobbyists. It really is the Wild West out there when it comes to adaptive questionnaires. We feel this language will put some necessary guardrails on its use while enabling it to be a tool in the toolbox. This provision clarifies how Missouri physicians may establish and maintain a physician-patient relationship through telemedicine. In practical terms, it allows physicians to continue delivering care remotely when the standard of care does not require an in-person visit, but it reinforces that telehealth encounters must be clinically equivalent to an in-person evaluation. Physicians must review the patient’s medical history, perform an appropriate evaluation, and use technology capable of supporting an informed diagnosis before prescribing treatment or issuing certifications. The bill also tightens oversight of questionnaire-based telemedicine by requiring review by the treating provider and ensuring the provider is connected to a licensed Missouri healthcare entity. Additionally, if care is provided through an online or telephone questionnaire, the treating provider must send a written report to the patient’s primary care physician within 14 days, helping improve continuity and coordination of care.

Alpha Gal Reporting 192.020

This provision will have very little direct impact on how Missouri physicians deliver patient care. The main operational change is that alpha-gal syndrome will now be added to the state’s list of reportable conditions, allowing the state to better track the prevalence of the disease and monitor public health trends. Importantly, the reporting responsibility falls primarily on the laboratory performing the alpha-gal IgE blood test — not on the physician. Labs must electronically report qualifying test results to the Department of Health and Senior Services within seven days. Physicians will continue diagnosing and treating patients as they currently do, without any significant new administrative or documentation burden. The legislation also includes privacy protections that limit disclosure of patient information to the patient and the ordering provider, helping preserve confidentiality while improving statewide disease surveillance.

Food is Medicine Act 208.270

This provision creates a new opportunity for Missouri physicians to use nutrition as part of a patient’s treatment plan through the proposed “Food is Medicine” program under MO HealthNet. If approved through a federal waiver, physicians will be able to prescribe medically tailored meals, medically tailored groceries, and produce prescriptions for eligible Medicaid patients with chronic or diet-related conditions such as diabetes, hypertension, obesity, or heart disease. The program recognizes food and nutrition as part of clinical care and allows physicians to work alongside dietitians and clinical teams to address underlying health conditions through nutrition support. For physicians, this expands the tools available to improve patient outcomes, reduce preventable complications and hospitalizations, and connect patients with community-based food resources that may improve adherence to treatment plans and overall health.