MO HB925

Adds "accountable care organizations" and "community mental health centers" as authorized entities to purchase medical services for Medicaid recipients.

Prohibits prepaid health plans from providing pharmacy benefits, services from community psychiatric rehabilitation providers, substance abuse treatment providers, and certain community mental health center services subject to clinic upper payment limits.

Requires prepaid health plans to provide MO HealthNet electronic notice of inpatient admission authorizations or denials within 24 hours and electronic copies of all other claims within 10 days of submission and payment.

Mandates MO HealthNet and the Department of Mental Health collaborate by mutual consent to determine behavioral health sub-capitation rates, managed care procurement language, medical necessity definitions, and quality assurance protocols.

Ensures recipients maintain freedom of choice among contracted health plans and primary care physicians, except in cases of Medicaid service overutilization.