MO SB319

Establishes a debt setoff procedure allowing ambulance service providers to collect unpaid healthcare bills (over $50 unpaid for more than 90 days) from patients' Missouri income tax refunds and lottery prize payouts.

Creates a three-tier review process: patients can request review by a provider-appointed review officer within 30 days of notice, then appeal to an appeals committee within 30 days, with failure to request review resulting in automatic claim submission for setoff.

Requires providers to notify patients in writing before submitting claims, including the claim basis, notification of setoff intent, collection assistance fee disclosure, and patient rights to contest validity or amount.

Establishes collection assistance fees of $7 to the Department of Revenue and $17 to the claim clearinghouse per claim, with administration costs not exceeding 20 percent of collected amounts charged to providers.

Allows patients to request a hearing to contest setoffs, with hearings conducted under Chapter 536 procedures; setoff collection assistance fees take priority over claim amounts if full setoff is not possible.