MO HB1222

Authorizes direct primary care services agreements as an approved delivery method under Missouri's MO HealthNet (Medicaid) program, allowing physicians to contract directly with enrollees for comprehensive primary care services

Physicians providing direct primary care services are not required to enter into participating provider agreements with MO HealthNet; the division will establish minimum service requirements and a sliding scale fee structure based on patient co-morbidities and demographic/geographic factors

Enrollee participation in direct primary care agreements is voluntary, and enrollees may choose their own physician; if agreement fees exceed MO HealthNet's maximum reimbursement, enrollees may pay the difference out-of-pocket

Direct primary care services agreements are explicitly defined as not constituting insurance under Missouri law

MO HealthNet division must submit necessary state plan amendments and waivers to the federal Centers for Medicare and Medicaid Services for implementation