MO HB1145

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

Standard fee schedules cannot be lower than the lowest individually negotiated rate for any good or service in an applicable geographic area if all providers in that area have different contracted rates.

Health carriers cannot refuse to contract with any Missouri provider willing to meet established participation terms and accept payment at standard rates, including providers in MO HealthNet and Medicare programs.

Health care providers must fully inform patients of all medically appropriate medical facilities within their insurance provider network where the provider has privileges, and must provide services at the patient's facility choice if it is in-network.

Health carriers cannot discriminate between medically appropriate in-network facilities regarding benefit coverage or reimbursement for the same health care service, and violations are subject to licensure sanctions.