MO SB231

Repeals existing section 143.790 and enacts new sections 143.789 and 143.790 establishing a debt setoff system for unpaid healthcare expenses from ambulance service providers.

Allows ambulance service providers to submit claims for unpaid healthcare services (minimum $50) that have not been paid for more than 160 days to a claim clearinghouse for collection via tax refund setoff.

Requires providers to send written notice to patients before submitting claims, establish a financial hardship policy consistent with Medicare guidelines, and provide patients with review and appeals processes through a review officer and appeals committee.

Establishes collection assistance fees of $14 to the state general fund and $17 to the claim clearinghouse for each debt being processed, recovered from eligible claims.

Makes lottery prize payouts under section 313.321 subject to the same setoff procedures and specifies that setoff priority follows: state taxes, state agency debts, collection assistance fees, eligible healthcare claims, and federal taxes.