MO HB2129

Establishes a debt setoff program allowing ambulance service providers to collect unpaid medical bills by offsetting patients' Missouri income tax refunds and lottery prize payouts.

Requires providers to send written notice to patients before submitting claims, informing them of the intent to seek setoff, collection fees, and their right to contest the claim through a review process.

Creates a multi-stage dispute resolution process: patients can request review by a provider-designated review officer within 30 days, then appeal to an appeals committee within an additional 30 days.

Authorizes a single claim clearinghouse, designated by the Missouri ambulance services industry and approved by the Department of Revenue, to submit eligible claims on behalf of providers.

Imposes collection assistance fees of $7 to the Department of Revenue and $17 to the claim clearinghouse for each debt processed, recoverable from the eligible claim amount.