MO SB972

Requires health maintenance organizations to provide enrollees with written disclosure information including coverage provisions, exclusions, prior authorization requirements, utilization review policies, financial responsibilities, grievance procedures, and emergency services descriptions.

Mandates disclosure of provider directories organized by specialty, updated annually, including names, addresses, telephone numbers, and physician board certifications.

Requires the Department of Insurance to develop a standard credentialing form for use by all health carriers when credentialing health care professionals in managed care plans.

Allows enrollees to request additional information upon request, including board member lists, financial statements, consumer complaint information, drug formularies, quality assurance procedures, and clinical review criteria.

Permits managed care entities to provide documents and materials online or in electronic form, but requires provision of printed copies within fifteen business days upon enrollee request made through written, oral, or electronic means.