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MO HB252
Bill
Status
Introduced
1/7/2015
Primary Sponsor
Sandy Crawford
Click for details
AI Summary
- MO HealthNet (Missouri Medicaid) will deny or recoup payment for early elective deliveries and deliveries before 39 weeks gestation without documented medical necessity
- Early elective delivery is defined as labor induction without medical necessity followed by vaginal or cesarean delivery, or a cesarean section before 39 weeks without medical necessity
- Nonpayment applies to both delivering physician/provider charges and institutional/facility charges, including nonroutine newborn services for conditions identified within 72 hours of delivery
- Medical necessity requires documentation showing delivery is needed to prevent significant and immediate adverse impact on mother or child, including illness, infection, or mortality risk
- Hospitals receiving transfers of newborns or mothers for higher level care are exempt from payment denial and will be reimbursed under standard MO HealthNet rules
Legislative Description
Specifies that early elective deliveries without a medical necessity shall not be reimbursed by MO HealthNet
Last Action
Referred: Health Insurance(H)
1/20/2015
Committee Referrals
Health Insurance1/20/2015
Full Bill Text
No bill text available