MO HB99

Health carriers must provide contracted providers secure website access to standard fee schedules specific to their geographic area, reflecting current payment rates for all goods and services identified by procedure codes or diagnosis related groups.

Health carriers cannot refuse to contract with any willing Missouri provider in their coverage area who meets participation terms and conditions, including those willing to accept 99% of standard rates.

Standard fee schedules cannot include rates lower than the lowest individually-contracted rate for the same good or service in a geographic area.

Health care providers must fully inform patients of all medically appropriate facilities within their health plan's network where the provider has privileges, or all facilities where the provider has privileges if the patient is uninsured.

Health carriers cannot restrict referrals to or selection of medically appropriate in-network facilities, and cannot discriminate between medically appropriate facilities regarding benefit coverage or reimbursement rates for the same service.