Proposed Rules
The following are summaries and other information related to Proposed Rules that the Department of Commerce and Insurance (DCI) has submitted to the Secretary of State for Publication in the Missouri Register. These rules will not go into effect until the public has had an opportunity to submit written comments, and to attend a public hearing if one is scheduled. Any person may offer comments on a Proposed Rule. The instructions for submitting comments, and the location and date of a hearing if one is scheduled, are located after the text of each rule. Please note that the official text of a Proposed Rule is the version that appears in the Missouri Register, not the draft copy on this site. Refer to the official copy if you wish to submit comments. We hope you find this site helpful and informative.
Proposed Rule | Summary | Fiscal Note(s) | Link to Missouri Register /Supporting Documents |
Small Business Impact Statement |
Division |
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PROPOSED AMENDMENT 20 CSR 2010-4.020Qualifying Programs |
This amendment updates a publication date. | PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate. PRIVATE COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate. |
April 1, 2024 | This proposed rulemaking does not have an adverse impact on small businesses. |
Professional Registration – Accountancy |
PROPOSED AMENDMENT 20 CSR 2200-4.200Collaborative Practice |
This amendment reflects changes made to sections 334.104 and 335.175, RSMo, eliminating geographic areas. | PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate. PRIVATE ENTITY COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate. |
March 1, 2024 | This proposed rule does not have an adverse impact on small businesses. |
Professional Registration – Nursing |
PROPOSED AMENDMENT 20 CSR 2150-5.100Collaborative Practice Arrangement with Nurses |
This amendment reflects changes made to sections 334.104 and 335.175, RSMo, eliminating geographic areas. | PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate. PRIVATE ENTITY COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate. |
March 1, 2024 | This proposed rule does not have an adverse impact on small businesses. |
Professional Registration – Healing Arts |
PROPOSED AMENDMENT 20 CSR 2267-5.010Standards of Practice |
This amendment deletes language regarding tattoo removal. | PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate. PRIVATE ENTITY COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate. |
March 1, 2024 | This proposed rule does not have an adverse impact on small businesses. |
Professional Registration – Tattoo |
PROPOSED AMENDMENT 20 CSR 2270-2.031Examinations |
This amendment updates examination requirements. | PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate. PRIVATE ENTITY COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate. |
February 15, 2024 | This proposed amendment does not have an adverse impact on small businesses. |
Professional Registration – Veterinary |
PROPOSED AMENDMENT 20 CSR 2270-2.041Reexamination |
This amendment updates the requirements for retaking the licensure examination. | PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate. PRIVATE ENTITY COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate. |
February 15, 2024 | This proposed amendment does not have an adverse impact on small businesses. |
Professional Registration – Veterinary |
PROPOSED AMENDMENT 20 CSR 2270-3.020Examinations |
This amendment updates the examination requirements. | PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate. PRIVATE ENTITY COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate. |
February 15, 2024 | This proposed amendment does not have an adverse impact on small businesses. |
Professional Registration – Veterinary |
PROPOSED AMENDMENT 20 CSR 2270-4.041Minimum Standards for Medical Records |
This amendment clarifies the term reasonable period of time. | PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate. PRIVATE ENTITY COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate. |
February 15, 2024 | This proposed amendment does not have an adverse impact on small businesses. |
Professional Registration – Veterinary |
PROPOSED AMENDMENT 20 CSR 400-5.900Suitability in Annuity Transactions |
This proposed amendment implements the National Association of Insurance Commissioners (NAIC) Suitability in Annuity Transactions Model Regulation #275. | PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate. PRIVATE COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate. |
February 15, 2024 | This proposed amendment does not have an adverse impact on small businesses. |
Insurance |
PROPOSED AMENDMENT 20 CSR 400-13.100Health Insurance Rates |
This proposed amendment requires an actuarial value and cost-sharing factor spreadsheet be included in proposed rates and rate filings for health benefit plans. | PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate. PRIVATE COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate. |
February 15, 2024 | This proposed amendment does not have an adverse impact on small businesses. |
Insurance |
PROPOSED AMENDMENT 20 CSR 2270-1.021Fees |
This amendment increases renewal fees and cleans up language. | PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate. PRIVATE COST: This proposed amendment will cost private entities sixty-eight thousand, two hundred thirty-five dollars ($68,235) annually for the life of the rule. It is anticipated that the costs will recur for the life of the rule, may vary with inflation and are expected to increase at the rate projected by the Legislative Oversight Committee. |
February 15, 2024 | This proposed amendment does have an adverse impact on small businesses. |
Professional Registration – Veterinary |
PROPOSED AMENDMENT 20 CSR 2200-6.030Intravenous Infusion Treatment Administration by Qualified Practical Nurses; Supervision by a Registered Professional Nurse |
This amendment will lift the IV push or bolus medication administration restriction on qualified practical nurses and list two (2) additional types of IV medication that qualified practical nurses will not administer. The need for these changes was determined after the Board of Nursing reviewed a petition for rule review sent by a practicing Licensed Practical Nurse (LPN). It has been determined that restricting qualified practical nurses from utilizing the IV push or bolus route of medication administration places an undue interruption and delay in patient care. | PUBLIC COST: This proposed rule will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate. PRIVATE COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate. |
February 15, 2024 | This proposed amendment does not have an adverse impact on small businesses. |
Professional Registration – Nursing |
EMERGENCY AMENDMENT 20 CSR 2200-6.030Intravenous Infusion Treatment Administration by Qualified Practical Nurses; Supervision by a Registered Professional Nurse |
This amendment will lift the IV push or bolus medication administration restriction on qualified practical nurses and list two (2) additional types of IV medication that qualified practical nurses will not administer. The need for these changes was determined after the Board of Nursing reviewed a petition for rule review sent by a practicing Licensed Practical Nurse (LPN). It has been determined that restricting qualified practical nurses from utilizing the IV push or bolus route of medication administration places an undue interruption and delay in patient care. | PUBLIC COST: This emergency amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the time the emergency is effective. PRIVATE COST: This emergency amendment will not cost private entities more than five hundred dollars ($500) in the time the emergency is effective. |
February 15, 2024 | This proposed amendment does not have an adverse impact on small businesses. |
Professional Registration – Nursing |
PROPOSED AMENDMENT 20 CSR 2231-2.010Designation of License Renewal Dates and Related Application and Renewal Information |
This amendment adds a convenience fee. | PUBLIC COST: This proposed rule will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate. PRIVATE COST: This proposed rule will cost private entities three hundred forty-six thousand five hundred dollars ($346,500) annually, one million, nine hundred six thousand two hundred thirty-three dollars ($1,906,233) biennially beginning in FY25, and one million, six hundred thousand six hundred ninety dollars ($1,600,690) biennially beginning in FY26. It is anticipated that the costs will recur for the life of the rule, may vary with inflation, and are expected to increase at the rate projected by the Legislative Oversight Committee. |
February 1, 2024 | This proposed amendment does have an adverse impact on small businesses. |
Professional Registration – Professional Registration |
EMERGENCY AMENDMENT 20 CSR 2231-2.010Designation of License Renewal Dates and Related Application and Renewal Information |
This amendment adds a convenience fee. | PUBLIC COST: This emergency amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the time the emergency is effective. PRIVATE COST: This emergency amendment will cost private entities seven hundred twenty-three thousand three hundred fifty-nine dollars ($723,359) in the time the emergency is effective. |
February 1, 2024 | This proposed amendment does have an adverse impact on small businesses. |
Professional Registration – Professional Registration |
PROPOSED AMENDMENT 20 CSR 2165-2.050Continuing Education Requirements |
This amendment updates the continuing education requirements. | PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate. PRIVATE COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate. |
February 1, 2024 | This proposed amendment does have an adverse impact on small businesses. |
Professional Registration – Hearing Instrument Specialists |
PROPOSED AMENDMENT 20 CSR 2250-5.020Application and License Fees |
The amendment increases original issuance and renewal fees. | PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate. PRIVATE COST: This proposed amendment will cost private entities sixty thousand fifty dollars ($60,050) annually and one million, one hundred thirteen thousand eight hundred twenty-five dollars ($1,113,825) biennially for the life of the rule. It is anticipated that the costs will recur for the life of the rule, may vary with inflation and are expected to increase at the rate projected by the Legislative Oversight Committee. |
January 16, 2024 | This proposed amendment does have an adverse impact on small businesses. |
Professional Registration – Real Estate Commission |
PROPOSED AMENDMENT 20 CSR 2200-4.010Fees |
The board is amending the fees to include an Advanced Practice Registered Nurse (APRN) application and renewal fee, correct outdated information, and renumber as necessary pursuant to statutory and other regulatory changes that have occurred. | PUBLIC COST: This proposed rule will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate. PRIVATE COST: This proposed rule will cost private entities one hundred eighty thousand two hundred eighty-five dollars ($180,285) beginning in FY24 and biennially thereafter over the life of the rule. It is anticipated that the costs will recur for the life of the rule, may vary with inflation, and are expected to increase at the rate projected by the Legislative Oversight Committee. |
January 2, 2024 | This proposed rule does not have an adverse impact on small businesses. |
Professional Registration – Nursing |
PROPOSED AMENDMENT 20 CSR 2200-4.020Requirements for Licensure |
This amendment updates the rule to current standards. | PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate. PRIVATE COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate. |
January 2, 2024 | This proposed rule does not have an adverse impact on small businesses. |
Professional Registration – Nursing |
PROPOSED AMENDMENT 20 CSR 2200-4.100Advanced Practice Registered Nurse |
This amendment changes the recognition to a license. | PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate. PRIVATE COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate. |
January 2, 2024 | This proposed rule does not have an adverse impact on small businesses. |
Professional Registration – Nursing |
PROPOSED AMENDMENT 20 CSR 2263-1.035Fees |
This amendment reduces the renewal fee. | PUBLIC COST: This proposed amendment will cost state agencies or political subdivisions eighty thousand dollars ($80,000) beginning in FY24 and biennially thereafter. It is anticipated that the costs will recur for the life of the rule, may vary with inflation and are expected to increase at the rate projected by the Legislative Oversight Committee. PRIVATE COST: This proposed amendment will save private entities eighty thousand dollars ($80,000) beginning in FY24 and biennially thereafter for the life of the rule. |
December 15, 2023 | This proposed rule does not have an adverse impact on small businesses. |
Professional Registration – Social Workers |
PROPOSED AMENDMENT 20 CSR 2220-2.900Class N: Health Care Facility Automated Dispensing [and Storage] Systems |
This amendment clarifies and updates supervision, technology, and operational requirements for Class N Health Care facility automated dispensing systems. | PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate. PRIVATE COST: The board estimates private fiscal costs of forty-five thousand dollars ($45,000) annually, recurring over the life of the rule as reflected in the accompanying fiscal note. |
October 16, 2023 | This proposed amendment does not have an adverse impact on small businesses. |
Professional Registration – Pharmacy |
PROPOSED AMENDMENT 20 CSR 2220-2.910Class O: Automated Dispensing Systems (Ambulatory Care) |
This rule establishes licensing standards and requirements for Class O: Automated Dispensing Systems (Ambulatory Care). | PUBLIC COST: This proposed rule will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate. PRIVATE COST: The Board estimates private fiscal costs of one million one hundred ten thousand seven hundred twenty dollars ($1,110,720) annually, recurring over the life of the rule as reflected in the accompanying fiscal note. |
October 16, 2023 | This proposed rule does not have an adverse impact on small businesses. |
Professional Registration – Pharmacy |
PROPOSED AMENDMENT 20 CSR 2030-14.020Definition of Baccalaureate Degree From Approved Curriculum as Used in Section 327.312.1(1), RSMo |
This rule is being amended to come into compliance with a statutory amendment via HB 2149 which became effective on August 28, 2022 increasing the required number of Legal Principles of Surveying, Missouri Surveying Law, Legal Principles and Boundary Control, Legal Aspects of Surveying, United States Public Land Surveying System (UPLSS) from three (3) hours to six (6) hours effective January 1, 2024. | PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate. PRIVATE COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate. |
October 16, 2023 | This proposed rule does not have an adverse impact on small businesses. |
Professional Registration – Land Surveyors |
PROPOSED AMENDMENT 20 CSR 2030-14.030Definition of Twenty Semester Hours of Approved Surveying Course Work as Used in Section 327.312.1(2), RSMo |
This rule is being amended to come into compliance with a statutory amendment via HB 2149 which became effective on August 28, 2022 increasing the required number of Legal Principles of Surveying, Missouri Surveying Law, Legal Principles and Boundary Control, Legal Aspects of Surveying, United States Public Land Surveying System (UPLSS) from 3 hours to 6 hours effective January 1, 2024. | PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate. PRIVATE COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate. |
October 16, 2023 | This proposed rule does not have an adverse impact on small businesses. |
Professional Registration – Land Surveyors |
PROPOSED AMENDMENT 20 CSR 2030-14.040Definition of [Twelve] Fifteen Semester Hours of Approved Surveying Course Work as Used in Section 327.312.1(3), RSMo |
This rule is being amended to come into compliance with a statutory amendment via HB 2149 which became effective on August 28, 2022 increasing the required number of Legal Principles of Surveying, Missouri Surveying Law, Legal Principles and Boundary Control, Legal Aspects of Surveying, United States Public Land Surveying System (UPLSS) from three (3) hours to six (6) hours effective January 1, 2024. | PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate. PRIVATE COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate. |
October 16, 2023 | This proposed rule does not have an adverse impact on small businesses. |
Professional Registration – Land Surveyors |