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MO HB1529
Bill
Status
1/26/2012
Primary Sponsor
Caleb Jones
Click for details
AI Summary
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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.
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Mandates that denials of diagnostic radiology authorization include the full name, mailing address, telephone number, and employer of the physician making the denial decision.
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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.
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Defines "diagnostic radiology testing" to include X-ray, CT, MRI, PET scans, fluoroscopy, ultrasound, and nuclear imaging studies including cardiac nuclear imaging.
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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