MO SB1664

Off-campus outpatient departments of hospitals (locations more than 250 yards from the main campus) must obtain and use a unique National Provider Identifier (NPI) separate from the main hospital's NPI for all claims submitted after December 31, 2026.

Claims for services at off-campus outpatient departments must be submitted on CMS 1500 forms or HIPAA X12 837P electronic transactions; health carriers are not required to reimburse claims that do not comply with these billing requirements.

Facilities that fail to bill properly cannot hold patients liable for payment, and violations constitute violations of Missouri's merchandising practices act enforceable by the attorney general.

Department of Health and Senior Services may impose penalties including $1,000 administrative fines per violation, license suspension or revocation, probation, and requiring providers to post penalty information on their website.

Facilities must demonstrate NPI compliance as a condition of state licensure, and the Department of Commerce and Insurance may promulgate implementing rules.