| 1 | 1 | | FIRSTREGULARSESSION |
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| 2 | 2 | | HOUSEBILLNO.1071 |
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| 3 | 3 | | 103RDGENERALASSEMBLY |
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| 4 | 4 | | INTRODUCEDBYREPRESENTATIVEREEDY. |
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| 5 | 5 | | 2492H.01I JOSEPHENGLER,ChiefClerk |
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| 6 | 6 | | ANACT |
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| 7 | 7 | | Toamendchapter376,RSMo,byaddingtheretoonenewsectionrelatingtoinsurance |
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| 8 | 8 | | coverageformentalhealthservices. |
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| 9 | 9 | | BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows: |
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| 10 | 10 | | SectionA.Chapter376,RSMo,isamendedbyaddingtheretoonenewsection,tobe |
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| 11 | 11 | | 2knownassection376.1553,toreadasfollows: |
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| 12 | 12 | | 376.1553.1.Asusedinthissection,termsshallhavethesamemeaningsas |
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| 13 | 13 | | 2ascribedtotheminsection376.1350,andtheterm"cost-sharing"shallincludeanyco- |
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| 14 | 14 | | 3payment,coinsurance,deductible,amountpaidbyanenrolleeforhealthcareservicesin |
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| 15 | 15 | | 4excessofacoveragelimitation,orsimilarchargerequiredbyoronbehalfofanenrollee |
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| 16 | 16 | | 5inordertoreceiveaspecifichealthcareservicecoveredbyahealthbenefitplan. |
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| 17 | 17 | | 6 2.Ifanenrolleeisadmittedtoahospitalemergencyroomwithabehavioralor |
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| 18 | 18 | | 7mentalhealthconditionandistransferredtoanotherhospitalthatisnotaparticipating |
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| 19 | 19 | | 8providerforthatconditionunderthepatient'shealthbenefitplan: |
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| 20 | 20 | | 9 (1)Thehealthcarriershallnotimposecost-sharingrequirementsfortreatment |
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| 21 | 21 | | 10ofthebehavioralormentalhealthconditionthataregreaterthanthecost-sharing |
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| 22 | 22 | | 11requirementswouldbefortreatmentofthebehavioralormentalhealthconditionbya |
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| 23 | 23 | | 12participatingprovider;and |
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| 24 | 24 | | 13 (2)Thehealthcarriershallreimbursethehospitalfortreatmentofthe |
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| 25 | 25 | | 14behavioralormentalhealthconditionatthesameratethehospitalwouldbereimbursed |
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| 26 | 26 | | 15byMOHealthNet. |
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| 27 | 27 | | 16 3.Itshallconstituteanunlawfulpracticewithinthemeaningofsection407.020, |
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| 28 | 28 | | 17andanyactionauthorizedinsections407.010to407.130maybetaken,ifahealth |
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| 29 | 29 | | EXPLANATION—Matterenclosedinbold-facedbrackets[thus] intheabovebillisnotenactedandis |
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| 30 | 30 | | intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 18benefitplan'sprovidernetworkfortreatmentofbehavioralormentalhealthconditions |
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| 31 | 31 | | 19issoinadequatethatitthreatensthelifeofitsenrollees.Itshallbearebuttable |
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| 32 | 32 | | 20presumptionthatthehealthbenefitplan'sprovidernetworkissoinadequatethatit |
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| 33 | 33 | | 21threatensthelifeofitsenrolleesifmorethanfifteenpercentofitsenrolleestreatedfora |
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| 34 | 34 | | 22behavioralormentalhealthconditionaretreatedfortheconditionoutsideofthehealth |
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| 35 | 35 | | 23benefitplan'sprovidernetwork. |
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| 36 | 36 | | âś” |
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| 37 | 37 | | HB1071 2 |
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