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MO HB1529

Bill

Status

Introduced

1/26/2012

Primary Sponsor

Caleb Jones

Click for details

Origin

House of Representatives

2012 Regular Session

AI Summary

  • Requires that any denial of diagnostic radiology testing authorization must be made by a Missouri-licensed physician subject to state board of healing arts regulation.

  • Mandates that denials of diagnostic radiology authorization include the full name, mailing address, telephone number, and employer of the physician making the denial decision.

  • States that once authorization for diagnostic radiology testing is granted, the provider's claim for payment cannot be denied and must be paid timely unless fraud occurred in obtaining authorization.

  • Defines "diagnostic radiology testing" to include X-ray, CT, MRI, PET scans, fluoroscopy, ultrasound, and nuclear imaging studies including cardiac nuclear imaging.

  • Exempts electronic clinical decision support tools that offer ordering guidance and document clinical appropriateness from the bill's requirements.

Legislative Description

Restricts the authority of a radiology benefit manager to deny coverage for diagnostic testing ordered and recommended by a licensed physician

Last Action

Public Hearing Completed (H)

2/22/2012

Committee Referrals

Health Care Policy2/9/2012

Full Bill Text

No bill text available