MO HB2537

Health carriers must submit standard reimbursement rates for covered services to the department by December 31, 2016, and annually thereafter, with rates posted on a consumer-friendly department website

Health carriers cannot refuse to contract with any Missouri provider willing to meet participation terms and accept standard reimbursement rates, including for MO HealthNet and Medicare programs

Providers making patient referrals must inform patients of every medical facility where they have privileges, and patients may choose any medically appropriate facility without restriction by insurers

Health carriers cannot discriminate between medically appropriate facilities in Missouri regarding benefit coverage or reimbursement for the same health care service

Health carriers that authorize a claim must pay the full authorized amount; providers, carriers, and health plans face licensure sanctions for non-compliance