HB 2067 revises Missouri law governing who may prescribe, administer, and dispense controlled substances, with a focus on advanced practice registered nurses (APRNs). The bill repeals and reenacts sections 195.070 and 334.104 to expand and clarify APRN prescriptive authority within collaborative practice arrangements with physicians. Under the bill, APRNs with the proper certificate could prescribe controlled substances in Schedules III, IV, and V, and would have limited Schedule II authority for hydrocodone, hospice patients, and certain stimulants, subject to specific conditions and supply limits. The bill also expressly allows APRNs to prescribe buprenorphine for medication-assisted treatment for substance use disorders under physician direction.
The bill adds or retains detailed requirements for collaborative practice agreements, including written agreements, disclosure to patients, chart review, physician oversight, geographic proximity rules, and limits on the number of APRNs and other practitioners a physician may supervise. It also creates exceptions and waivers for rural health clinics, telehealth arrangements, correctional centers, hospice care, and certain public health settings. In addition, the bill preserves restrictions on self-prescribing, prohibits practitioners from accepting unused controlled substances except in limited circumstances, and maintains separate provisions for certified registered nurse anesthetists, including anesthesia practice under supervision and limited prescribing authority.
HB 2067 would affect Missouri statutes regulating controlled substances, nursing practice, physician delegation, pharmacy oversight, hospice care, correctional health care, and telehealth-related collaborative practice. It would change the scope of practice for APRNs and the obligations of collaborating physicians, while also requiring public reporting of collaborative arrangements and allowing joint rulemaking by the healing arts and nursing boards, with pharmacy and health department approval for medication-related rules. The bill also limits disciplinary consequences for physicians in compliant arrangements and protects both physicians and APRNs from being forced by contract to enter collaborative relationships against their will.
No committee transcript or vote history was provided, so there is no recorded debate or roll-call sentiment to assess from the available materials. Based on the bill text alone, the measure appears to be a scope-of-practice expansion with significant regulatory guardrails, suggesting a policy balance between increasing access to care and preserving physician oversight. The absence of recorded opposition or support in the provided context means the overall sentiment cannot be measured from discussion or votes, though the detailed supervision requirements indicate an effort to address safety and professional oversight concerns.
The main points of contention likely involve the extent of APRN prescriptive authority, especially the limited expansion into Schedule II drugs, the required physician collaboration and chart-review obligations, and the geographic proximity and supervision rules. Supporters would likely emphasize improved access to care in rural areas, correctional facilities, hospice, and telehealth settings, as well as expanded treatment options for substance use disorder. Opponents or skeptics would likely focus on patient safety, physician oversight, and whether the bill goes far enough or too far in loosening controlled-substance prescribing rules.
HB 2067 would repeal and replace Missouri statutes 195.070 and 334.104 to expand APRN authority to prescribe certain controlled substances under collaborative practice arrangements, while preserving physician oversight and adding detailed compliance requirements. It would also affect related statutes and regulatory authority involving the boards of nursing, healing arts, pharmacy, and health and senior services, and would alter practice rules for hospice, correctional facilities, telehealth, and certified registered nurse anesthetists.
No votes or committee testimony were provided, so there is no direct record of legislative sentiment in the supplied materials. From the bill text, the measure appears generally supportive of expanding APRN practice authority, but it does so with extensive restrictions and oversight provisions that suggest an attempt to balance access-to-care goals with safety and professional supervision concerns.
The likely points of contention are the expansion of APRN prescriptive authority, especially limited Schedule II prescribing, the requirement for physician collaboration and chart review, and the geographic proximity rules for collaborative practice. Supporters would likely favor broader access in rural, hospice, correctional, and telehealth settings, while critics would likely question whether the supervision framework is sufficient to protect patient safety and maintain physician control over controlled-substance prescribing.