| 9 | 9 | | BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows: |
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| 10 | 10 | | SectionA.Chapter376,RSMo,isamendedbyaddingtheretoonenewsection,tobe |
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| 11 | 11 | | 2knownassection376.1245,toreadasfollows: |
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| 12 | 12 | | 376.1245.1.Asusedinthissection,thefollowingtermsmean: |
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| 13 | 13 | | 2 (1)"Anesthesiatime",theperiodduringwhichananesthesiapractitioneris |
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| 14 | 14 | | 3presentwiththepatient,startingwhentheanesthesiapractitionerbeginstopreparethe |
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| 15 | 15 | | 4patientforanesthesiaservicesintheoperatingroomoranequivalentareaandending |
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| 16 | 16 | | 5whentheanesthesiapractitionerisnolongerfurnishinganesthesiaservicestothe |
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| 17 | 17 | | 6patientbecausethepatientmaybeplacedsafelyunderpostoperativeorpostanesthesia |
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| 18 | 18 | | 7care.Theterm"anesthesiatime"includes,ifcountedbytheanesthesiapractitioner, |
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| 19 | 19 | | 8blocksoftimearoundaninterruptioninanesthesiatimeprovidedtheanesthesia |
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| 20 | 20 | | 9practitionerisfurnishingcontinuousanesthesiacarewithinthetimeperiodsaroundthe |
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| 21 | 21 | | 10interruption; |
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| 22 | 22 | | 11 (2)"Anesthesiatimeunits",timeunitsrecognizedwithappropriatetime |
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| 23 | 23 | | 12intervalsthatdonotexceedfifteenminutesinlengthforeachintervalandthat,taken |
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| 24 | 24 | | 13together,representthetotalanesthesiatimeforaparticularanesthesiaservice; |
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| 31 | | - | intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 19consolidatedhealthcareplanestablishedunderchapter103,andanyotherstate- |
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| 32 | | - | 20sponsoredhealthinsuranceprogram; |
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| 33 | | - | 21 (5)"Healthcarrier",thesamemeaninggiventotheterminsection376.1350. |
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| 34 | | - | 22Theterm"healthcarrier"shallalsoincludetheMOHealthNetdivisionandany |
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| 35 | | - | 23Medicaidmanagedcareorganizationasdefinedinsection208.431; |
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| 36 | | - | 24 (6)"Paymentofanesthesiaservices",anamountpaidforanesthesiaservices: |
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| 37 | | - | 25 (a)Determinedbyusingprevailingmedicalcodingandbillingstandardsinthe |
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| 38 | | - | 26professionalmedicalbillingcommunity,suchastheCurrentProceduralTerminology |
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| 39 | | - | 27codebookpublishedbytheAmericanMedicalAssociation,theMedicareClaims |
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| 40 | | - | 28ProcessingManual,orguidancepublishedbytheAmericanSocietyof |
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| 41 | | - | 29Anesthesiologists;and |
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| 42 | | - | 30 (b)Calculatedastheproductobtainedbymultiplyingthefollowingtogether: |
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| 43 | | - | 31 a.Thesumofthebaseunitsfortheappropriatemedicalcodeplusanesthesia |
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| 44 | | - | 32timeunits;and |
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| 45 | | - | 33 b.Ananesthesiaconversionfactorthatisdefinedintheindividualcontract |
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| 46 | | - | 34betweenthehealthcarrierorhealthbenefitplanandtheanesthesiapractitioneror |
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| 47 | | - | 35group. |
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| 48 | | - | 36 2.Nohealthcarrierorhealthbenefitplanshallestablish,implement,orenforce |
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| 49 | | - | 37anypolicy,practice,orprocedurethatimposesatimelimitforthepaymentof |
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| 50 | | - | 38anesthesiaservicesprovidedduringamedicalorsurgicalprocedure. |
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| 51 | | - | 39 3.Nohealthcarrierorhealthbenefitplanshallestablish,implement,orenforce |
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| 52 | | - | 40anypolicy,practice,orprocedurethatrestrictsorexcludesallanesthesiatimein |
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| 53 | | - | 41calculatingthepaymentofanesthesiaservices. |
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| 54 | | - | 42 4.Exceptedbenefitplansshallbesubjecttotherequirementsofthissection. |
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| 55 | | - | SectionB.Becauseimmediateactionisnecessarytoprotecttheabilityofhealthcare |
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| 56 | | - | 2providerstodelivermedicallynecessaryhealthcareservicestoMissourians,sectionAofthis |
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| 57 | | - | 3actisdeemednecessaryfortheimmediatepreservationofthepublichealth,welfare,peace, |
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| 58 | | - | 4andsafety,andisherebydeclaredtobeanemergencyactwithinthemeaningofthe |
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| 59 | | - | 5constitution,andsectionAofthisactshallbeinfullforceandeffectuponitspassageand |
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| 60 | | - | 6approval. |
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| 29 | + | intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 17consolidatedhealthcareplanestablishedunderchapter103,andanyotherstate- |
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| 30 | + | 18sponsoredhealthinsuranceprogram; |
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| 31 | + | 19 (4)"Healthcarrier",thesamemeaninggiventotheterminsection376.1350. |
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| 32 | + | 20Theterm"healthcarrier"shallalsoincludetheMOHealthNetdivisionandany |
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| 33 | + | 21Medicaidmanagedcareorganizationasdefinedinsection208.431; |
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| 34 | + | 22 (5)"Paymentofanesthesiaservices",anamountpaidforanesthesiaservices: |
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| 35 | + | 23 (a)Determinedbyusingprevailingmedicalcodingandbillingstandardsinthe |
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| 36 | + | 24professionalmedicalbillingcommunity,suchastheCurrentProceduralTerminology |
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| 37 | + | 25codebookpublishedbytheAmericanMedicalAssociation,theMedicareClaims |
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| 38 | + | 26ProcessingManual,orguidancepublishedbytheAmericanSocietyof |
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| 39 | + | 27Anesthesiologists;and |
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| 40 | + | 28 (b)Calculatedastheproductobtainedbymultiplyingthefollowingtogether: |
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| 41 | + | 29 a.Thesumofthebaseunitsfortheappropriatemedicalcodeplusanesthesia |
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| 42 | + | 30timeunits;and |
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| 43 | + | 31 b.Ananesthesiaconversionfactorthatisdefinedintheindividualcontract |
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| 44 | + | 32betweenthehealthcarrierorhealthbenefitplanandtheanesthesiapractitioneror |
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| 45 | + | 33group. |
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| 46 | + | 34 2.Nohealthcarrierorhealthbenefitplanshallestablish,implement,orenforce |
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| 47 | + | 35anypolicy,practice,orprocedurethatimposesatimelimitforthepaymentof |
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| 48 | + | 36anesthesiaservicesprovidedduringamedicalorsurgicalprocedure. |
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| 49 | + | 37 3.Nohealthcarrierorhealthbenefitplanshallestablish,implement,orenforce |
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| 50 | + | 38anypolicy,practice,orprocedurethatrestrictsorexcludesallanesthesiatimein |
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| 51 | + | 39calculatingthepaymentofanesthesiaservices. |
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