MO HB234

Establishes a debt setoff procedure allowing ambulance service providers to collect unpaid medical bills through income tax refunds and lottery prize payouts, with debts prioritized after state taxes, federal taxes, and child support obligations.

Requires providers to send written notice to patients 30 days before submitting claims, informing them of the right to contest validity or amount through a review officer and appeals committee process.

Defines "eligible claims" as unpaid ambulance service bills of $50 or more that have gone unpaid for more than 160 days after the provider exhausted collection efforts, excluding claims covered by Medicaid or uninsured children's health insurance or subject to financial hardship policies.

Authorizes a "claim clearinghouse" entity to receive and submit eligible claims to the Department of Revenue, which processes setoffs and charges collection assistance fees of $14 to the state general fund and $17 to the claim clearinghouse per debt processed.

Allows patients to challenge appeals committee decisions by requesting court proceedings; if the patient prevails in court, the provider is barred from further collection and must reimburse the patient's court costs and attorney's fees.