How Is This Bill Enforced
Verbatim statutory text on the left; plain-language analysis and a per-section checklist on the right. Numbered markers cross-link to the matching checklist row.
(1)(3) 1 In cases in which the act of neglect complained of is the negligent use, selection, or implementation or unduly, detrimentally, or erroneously relying on artificial intelligenceArtificial intelligence"Artificial intelligence", a computer system, computer software or algorithms, or physical hardware that provide or generate human-like perception, cognition, planning, learning, decision-making, communication, or physical action in the rendering or assisting of rendering of health care services;§ 538.205(1), as such term is defined in section 538.205, in the diagnosis, treatment, and care of a patient, the action shall be brought within two years from the date of the discovery of such alleged negligence or reliance, or from the date on which the patient in the exercise of ordinary care should have discovered such alleged negligence or reliance, whichever date first occurs; and
This section amends Missouri's existing statute of limitations for health care malpractice actions to add a new discovery rule specific to artificial intelligence. While the base two-year limitations period and existing discovery exceptions (foreign objects, failure to inform of test results) are unchanged, the bill adds a new subdivision (3) providing that claims based on negligent use, selection, or implementation of — or undue, detrimental, or erroneous reliance on — artificial intelligence in patient diagnosis, treatment, and care accrue from the date of discovery rather than the date of occurrence. This recognizes that patients may not immediately discover that AI was a contributing factor in their harm.
(1) "Artificial intelligenceArtificial intelligence"Artificial intelligence", a computer system, computer software or algorithms, or physical hardware that provide or generate human-like perception, cognition, planning, learning, decision-making, communication, or physical action in the rendering or assisting of rendering of health care services;§ 538.205(1)", a computer system, computer software or algorithms, or physical hardware that provide or generate human-like perception, cognition, planning, learning, decision-making, communication, or physical action in the rendering or assisting of rendering of health care servicesHealth care services"Health care services", any services that a health care provider renders to a patient in the ordinary course of the health care provider's profession or, if the health care provider is an institution, in the ordinary course of furthering the purposes for which the institution is organized. Professional services shall include, but are not limited to, transfer to a patient of goods or services incidental or pursuant to the practice of the health care provider's profession or in furtherance of the purposes for which an institutional health care provider is organized;§ 538.205(8);
(2) "Catastrophic personal injuryCatastrophic personal injury"Catastrophic personal injury", a physical injury resulting in: (a) Quadriplegia defined as the permanent loss of functional use of all four limbs; (b) Paraplegia defined as the permanent loss of functional use of two limbs; (c) Loss of two or more limbs; (d) An injury to the brain that results in permanent cognitive impairment resulting in the permanent inability to make independent decisions or engage in one or more of the following activities of daily living: eating, dressing, bathing, toileting, transferring, and walking; (e) An injury that causes irreversible failure of one or more major organ systems; or (f) Vision loss such that the patient's central visual acuity is no more than twenty/two-hundred in the better eye with the best correction or whose field of vision in the better eye is restricted to a degree that its widest diameter subtends an angle no greater than twenty degrees;§ 538.205(2)", a physical injury resulting in: (a) Quadriplegia defined as the permanent loss of functional use of all four limbs; (b) Paraplegia defined as the permanent loss of functional use of two limbs; (c) Loss of two or more limbs; (d) An injury to the brain that results in permanent cognitive impairment resulting in the permanent inability to make independent decisions or engage in one or more of the following activities of daily living: eating, dressing, bathing, toileting, transferring, and walking; (e) An injury that causes irreversible failure of one or more major organ systems; or (f) Vision loss such that the patient's central visual acuity is no more than twenty/two-hundred in the better eye with the best correction or whose field of vision in the better eye is restricted to a degree that its widest diameter subtends an angle no greater than twenty degrees;
(7) "Health care providerHealth care provider"Health care provider", any physician, hospital, health maintenance organization, ambulatory surgical center, long-term care facility including those licensed under chapter 198, dentist, registered or licensed practical nurse, optometrist, podiatrist, pharmacist, chiropractor, professional physical therapist, psychologist, physician-in-training, and any other person or entity that provides health care services under the authority of a license or certificate;§ 538.205(7)", any physician, hospital, health maintenance organization, ambulatory surgical center, long-term care facility including those licensed under chapter 198, dentist, registered or licensed practical nurse, optometrist, podiatrist, pharmacist, chiropractor, professional physical therapist, psychologist, physician-in-training, and any other person or entity that provides health care servicesHealth care services"Health care services", any services that a health care provider renders to a patient in the ordinary course of the health care provider's profession or, if the health care provider is an institution, in the ordinary course of furthering the purposes for which the institution is organized. Professional services shall include, but are not limited to, transfer to a patient of goods or services incidental or pursuant to the practice of the health care provider's profession or in furtherance of the purposes for which an institutional health care provider is organized;§ 538.205(8) under the authority of a license or certificate;
This section provides the definitional framework for Missouri's healthcare malpractice chapter. The bill's primary amendment is the addition of a new defined term, artificial intelligence, scoped specifically to AI used in the rendering or assisting of rendering health care services. The definition encompasses computer systems, software, algorithms, and physical hardware that provide or generate human-like perception, cognition, planning, learning, decision-making, communication, or physical action in healthcare contexts. The bill also adds a new definition of catastrophic personal injury and renumbers existing definitions accordingly.
(1) 2 A statutory cause of action for damages against a health care providerHealth care provider"Health care provider", any physician, hospital, health maintenance organization, ambulatory surgical center, long-term care facility including those licensed under chapter 198, dentist, registered or licensed practical nurse, optometrist, podiatrist, pharmacist, chiropractor, professional physical therapist, psychologist, physician-in-training, and any other person or entity that provides health care services under the authority of a license or certificate;§ 538.205(7) for personal injury or death arising out of the rendering of or failure to render health care servicesHealth care services"Health care services", any services that a health care provider renders to a patient in the ordinary course of the health care provider's profession or, if the health care provider is an institution, in the ordinary course of furthering the purposes for which the institution is organized. Professional services shall include, but are not limited to, transfer to a patient of goods or services incidental or pursuant to the practice of the health care provider's profession or in furtherance of the purposes for which an institutional health care provider is organized;§ 538.205(8) is hereby created, replacing any such common law cause of action. The elements of such cause of action are that the health care providerHealth care provider"Health care provider", any physician, hospital, health maintenance organization, ambulatory surgical center, long-term care facility including those licensed under chapter 198, dentist, registered or licensed practical nurse, optometrist, podiatrist, pharmacist, chiropractor, professional physical therapist, psychologist, physician-in-training, and any other person or entity that provides health care services under the authority of a license or certificate;§ 538.205(7) failed to use that degree of skill and learning ordinarily used under the same or similar circumstances by members of the defendant's profession and that such failure directly caused or contributed to cause the plaintiff's injury or death. A health care providerHealth care provider"Health care provider", any physician, hospital, health maintenance organization, ambulatory surgical center, long-term care facility including those licensed under chapter 198, dentist, registered or licensed practical nurse, optometrist, podiatrist, pharmacist, chiropractor, professional physical therapist, psychologist, physician-in-training, and any other person or entity that provides health care services under the authority of a license or certificate;§ 538.205(7) failing to use that degree of skill and learning ordinarily used under the same or similar circumstances by members of the defendant's profession and where the failure directly causes or contributed to cause the plaintiff's injury or death includes, but is not limited to, a health care providerHealth care provider"Health care provider", any physician, hospital, health maintenance organization, ambulatory surgical center, long-term care facility including those licensed under chapter 198, dentist, registered or licensed practical nurse, optometrist, podiatrist, pharmacist, chiropractor, professional physical therapist, psychologist, physician-in-training, and any other person or entity that provides health care services under the authority of a license or certificate;§ 538.205(7) negligently using, selecting, or implementing or unduly, detrimentally, or erroneously relying on artificial intelligenceArtificial intelligence"Artificial intelligence", a computer system, computer software or algorithms, or physical hardware that provide or generate human-like perception, cognition, planning, learning, decision-making, communication, or physical action in the rendering or assisting of rendering of health care services;§ 538.205(1) in the diagnosis, treatment, and care of a patient and such negligence or reliance directly causes or contributes to the plaintiff's injury.
(2)(1)–(3) In any action against a health care providerHealth care provider"Health care provider", any physician, hospital, health maintenance organization, ambulatory surgical center, long-term care facility including those licensed under chapter 198, dentist, registered or licensed practical nurse, optometrist, podiatrist, pharmacist, chiropractor, professional physical therapist, psychologist, physician-in-training, and any other person or entity that provides health care services under the authority of a license or certificate;§ 538.205(7) for damages for personal injury arising out of the rendering of or the failure to render health care servicesHealth care services"Health care services", any services that a health care provider renders to a patient in the ordinary course of the health care provider's profession or, if the health care provider is an institution, in the ordinary course of furthering the purposes for which the institution is organized. Professional services shall include, but are not limited to, transfer to a patient of goods or services incidental or pursuant to the practice of the health care provider's profession or in furtherance of the purposes for which an institutional health care provider is organized;§ 538.205(8), no plaintiff shall recover more than four hundred thousand dollars for noneconomic damagesNoneconomic damages"Noneconomic damages", damages arising from nonpecuniary harm including, without limitation, pain, suffering, mental anguish, inconvenience, physical impairment, disfigurement, loss of capacity to enjoy life, and loss of consortium but shall not include punitive damages;§ 538.205(10) irrespective of the number of defendants. (2) Notwithstanding the provisions of subdivision (1) of this subsection, in any action against a health care providerHealth care provider"Health care provider", any physician, hospital, health maintenance organization, ambulatory surgical center, long-term care facility including those licensed under chapter 198, dentist, registered or licensed practical nurse, optometrist, podiatrist, pharmacist, chiropractor, professional physical therapist, psychologist, physician-in-training, and any other person or entity that provides health care services under the authority of a license or certificate;§ 538.205(7) for damages for a catastrophic personal injuryCatastrophic personal injury"Catastrophic personal injury", a physical injury resulting in: (a) Quadriplegia defined as the permanent loss of functional use of all four limbs; (b) Paraplegia defined as the permanent loss of functional use of two limbs; (c) Loss of two or more limbs; (d) An injury to the brain that results in permanent cognitive impairment resulting in the permanent inability to make independent decisions or engage in one or more of the following activities of daily living: eating, dressing, bathing, toileting, transferring, and walking; (e) An injury that causes irreversible failure of one or more major organ systems; or (f) Vision loss such that the patient's central visual acuity is no more than twenty/two-hundred in the better eye with the best correction or whose field of vision in the better eye is restricted to a degree that its widest diameter subtends an angle no greater than twenty degrees;§ 538.205(2) arising out of the rendering or failure to render heath care services, no plaintiff shall recover more than seven hundred thousand dollars for noneconomic damagesNoneconomic damages"Noneconomic damages", damages arising from nonpecuniary harm including, without limitation, pain, suffering, mental anguish, inconvenience, physical impairment, disfigurement, loss of capacity to enjoy life, and loss of consortium but shall not include punitive damages;§ 538.205(10) irrespective of the number of defendants. (3) In any action against a health care providerHealth care provider"Health care provider", any physician, hospital, health maintenance organization, ambulatory surgical center, long-term care facility including those licensed under chapter 198, dentist, registered or licensed practical nurse, optometrist, podiatrist, pharmacist, chiropractor, professional physical therapist, psychologist, physician-in-training, and any other person or entity that provides health care services under the authority of a license or certificate;§ 538.205(7) for damages for death arising out of the rendering of or the failure to render health care servicesHealth care services"Health care services", any services that a health care provider renders to a patient in the ordinary course of the health care provider's profession or, if the health care provider is an institution, in the ordinary course of furthering the purposes for which the institution is organized. Professional services shall include, but are not limited to, transfer to a patient of goods or services incidental or pursuant to the practice of the health care provider's profession or in furtherance of the purposes for which an institutional health care provider is organized;§ 538.205(8), no plaintiff shall recover more than seven hundred thousand dollars for noneconomic damagesNoneconomic damages"Noneconomic damages", damages arising from nonpecuniary harm including, without limitation, pain, suffering, mental anguish, inconvenience, physical impairment, disfigurement, loss of capacity to enjoy life, and loss of consortium but shall not include punitive damages;§ 538.205(10) irrespective of the number of defendants.
(8) Any provision of law or court rule to the contrary notwithstanding, an award of punitive damagesPunitive damages"Punitive damages", damages intended to punish or deter malicious misconduct or conduct that intentionally caused damage to the plaintiff, including exemplary damages and damages for aggravating circumstances;§ 538.205(12) against a health care providerHealth care provider"Health care provider", any physician, hospital, health maintenance organization, ambulatory surgical center, long-term care facility including those licensed under chapter 198, dentist, registered or licensed practical nurse, optometrist, podiatrist, pharmacist, chiropractor, professional physical therapist, psychologist, physician-in-training, and any other person or entity that provides health care services under the authority of a license or certificate;§ 538.205(7) governed by the provisions of sections 538.205 to 538.235 shall be made only upon a finding by the jury that the evidence clearly and convincingly demonstrated that the health care providerHealth care provider"Health care provider", any physician, hospital, health maintenance organization, ambulatory surgical center, long-term care facility including those licensed under chapter 198, dentist, registered or licensed practical nurse, optometrist, podiatrist, pharmacist, chiropractor, professional physical therapist, psychologist, physician-in-training, and any other person or entity that provides health care services under the authority of a license or certificate;§ 538.205(7) intentionally caused damage to the plaintiff or demonstrated malicious misconduct that caused damage to the plaintiff. Evidence of negligence including, but not limited to, indifference to or conscious disregard for the safety of others shall not constitute intentional conduct or malicious misconduct.
This section creates Missouri's statutory cause of action for health care malpractice, replacing the common law cause of action. The bill amends subsection 1 to explicitly confirm that the standard of care — failure to use that degree of skill and learning ordinarily used under the same or similar circumstances — encompasses a health care provider negligently using, selecting, or implementing or unduly, detrimentally, or erroneously relying on artificial intelligence in patient diagnosis, treatment, and care. This clarification ensures that AI-related malpractice fits squarely within the existing statutory framework, including existing noneconomic damages caps and the clear-and-convincing standard for punitive damages.
The bill does not alter the standard of care itself — it merely confirms that AI use falls within the existing professional negligence standard. Health care providers remain liable under the same framework whether their negligence involved AI or not.