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MO SB519
Bill
AI Summary
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Amends chapter 376, RSMo to add section 376.393 relating to health insurance provider contracts and fee schedules
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Requires each health carrier to provide contracted providers with secure website access to the carrier's standard fee schedule specific to the provider's geographic area, including current payment rates defined by procedure codes, diagnosis related groups, or other payment mechanisms
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Mandates that standard fee schedules cannot set rates lower than the lowest rate individually contracted by any provider in the applicable geographic area for the same good or service
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Prohibits health carriers and their subsidiaries, networks, contractors, or subcontractors from refusing to contract with any Missouri provider willing to meet established provider participation terms and conditions at rates equal to 99 percent of the standard rates
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Applies to licensed pharmacies and home health agencies in addition to providers defined in section 376.1350, and includes MO HealthNet and Medicare programs
Legislative Description
Requires health carriers to provide Internet access to its standard fee schedules and prohibits carriers from refusing to contract with providers willing to meet certain provider participation terms and conditions
Last Action
Second Read and Referred S Health, Mental Health, Seniors and Families Committee
1/5/2012