MO HB1972

Adds "accountable care organizations" and "community mental health centers" as authorized providers for purchasing medical services under Medicaid.

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

Requires prepaid health plans to electronically notify MO HealthNet within 24 hours of authorizing or denying inpatient admission requests and provide electronic copies of all other claims within 10 days.

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

Expands the requirement to ensure reasonable access to medical services to "all geographic areas of the state" rather than limiting it to areas where managed care programs are initiated.