COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. No.:3235H.01I Bill No.:HB 1599 Subject:Medicaid/MO HealthNet; Physicians; Health Care Type:Original Date:April 1, 2025Bill Summary:This proposal creates provisions relating to MO HealthNet reimbursement
for the professional component of clinical pathology services.
FISCAL SUMMARY
ESTIMATED NET EFFECT ON GENERAL REVENUE FUNDFUND AFFECTEDFY 2026FY 2027FY 2028Total Estimated Net
Effect on General
Revenue* $0$0$0
* Without additional information from DSS, Oversight cannot estimate a fiscal impact for this
proposal. For purposes of this fiscal note, Oversight will assume DSS is provided with core
funding to handle a certain amount of activity each year. Oversight assumes DSS could absorb
any costs related to this proposal. If this assumption is incorrect, this would alter the fiscal
impact as presented in this fiscal note. If additional information is received, Oversight will
review it to determine if an updated fiscal note should be prepared and seek approval to publish a
new fiscal note.
ESTIMATED NET EFFECT ON OTHER STATE FUNDSFUND AFFECTEDFY 2026FY 2027FY 2028Total Estimated Net
Effect on Other State
Funds $0$0$0
Numbers within parentheses: () indicate costs or losses. L.R. No. 3235H.01I
Bill No. HB 1599
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ESTIMATED NET EFFECT ON FEDERAL FUNDSFUND AFFECTEDFY 2026FY 2027FY 2028Total Estimated Net
Effect on All Federal
Funds* $0$0$0
* Without additional information from DSS, Oversight cannot estimate a fiscal impact for this
proposal. For purposes of this fiscal note, Oversight will assume DSS is provided with core
funding to handle a certain amount of activity each year. Oversight assumes DSS could absorb
any costs related to this proposal. If this assumption is incorrect, this would alter the fiscal
impact as presented in this fiscal note. If additional information is received, Oversight will
review it to determine if an updated fiscal note should be prepared and seek approval to publish a
new fiscal note.
ESTIMATED NET EFFECT ON FULL TIME EQUIVALENT (FTE)FUND AFFECTEDFY 2026FY 2027FY 2028Total Estimated Net
Effect on FTE 000
☐ Estimated Net Effect (expenditures or reduced revenues) expected to exceed $250,000 in any
of the three fiscal years after implementation of the act or at full implementation of the act.
☐ Estimated Net Effect (savings or increased revenues) expected to exceed $250,000 in any of
the three fiscal years after implementation of the act or at full implementation of the act.
ESTIMATED NET EFFECT ON LOCAL FUNDSFUND AFFECTEDFY 2026FY 2027FY 2028Local Government$0$0$0 L.R. No. 3235H.01I
Bill No. HB 1599
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FISCAL ANALYSIS
ASSUMPTION
§ 208.149 - MO HealthNet reimbursement for the professional component of clinical pathology
services
Officials from the Department of Social Services (DSS), MO HealthNet Division (MHD)
state Medicare does not have a separate rate for pathology services. MHD is implementing a
Diagnosis Related Group (DRG) payment methodology similar to Medicare for inpatient
services starting in SFY26. This new payment structure is a bundled rate inclusive of pathology
services. Therefore, the fiscal impact of this is unknown. DSS doesn’t have any further
information as to the extent of the cost or whether there would be a cost.
Without additional information from DSS, Oversight cannot estimate a fiscal impact for this
proposal. For purposes of this fiscal note, Oversight will assume DSS is provided with core
funding to handle a certain amount of activity each year. Oversight assumes DSS could absorb
any costs related to this proposal. If this assumption is incorrect, this would alter the fiscal
impact as presented in this fiscal note. If additional information is received, Oversight will
review it to determine if an updated fiscal note should be prepared and seek approval to publish a
new fiscal note.
Oversight only reflects the responses received from state agencies and political subdivisions;
however, other hospitals were requested to respond to this proposed legislation but did not. A
listing of political subdivisions included in the Missouri Legislative Information System
(MOLIS) database is available upon request.
Rule Promulgation
Officials from the Joint Committee on Administrative Rules assume this proposal is not
anticipated to cause a fiscal impact beyond its current appropriation.
Officials from the Office of the Secretary of State (SOS) note many bills considered by the
General Assembly include provisions allowing or requiring agencies to submit rules and
regulations to implement the act. The SOS is provided with core funding to handle a certain
amount of normal activity resulting from each year's legislative session. The fiscal impact for
this fiscal note to the SOS for Administrative Rules is less than $5,000. The SOS recognizes that
this is a small amount and does not expect that additional funding would be required to meet
these costs. However, the SOS also recognizes that many such bills may be passed by the
General Assembly in a given year and that collectively the costs may be in excess of what the
office can sustain with its core budget. Therefore, the SOS reserves the right to request funding
for the cost of supporting administrative rules requirements should the need arise based on a
review of the finally approved bills signed by the governor. L.R. No. 3235H.01I
Bill No. HB 1599
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FISCAL IMPACT – State GovernmentFY 2026
(10 Mo.)
FY 2027FY 2028$0$0$0FISCAL IMPACT – Local GovernmentFY 2026
(10 Mo.)
FY 2027FY 2028$0$0$0
FISCAL IMPACT – Small Business
No direct fiscal impact to small businesses would be expected as a result of this proposal.
FISCAL DESCRIPTION
This bill requires MO HealthNet to pay the fee for the portion of clinical pathology services that
involves the pathologist's professional expertise in interpreting and supervising laboratory tests,
excluding the technical component of performing the laboratory tests that are provided by
hospital-based pathologists for inpatient services. The reimbursement rate is set at 30% of the
approved outpatient fee schedule based on Medicare's clinical laboratory fee schedule. Payments
are directed to either the hospital or the third-party provider, depending on whether the
pathologist is employed by the hospital. The Department of Social Services is responsible for
creating necessary rules and regulations for the provisions of this bill. (§ 208.149)
This legislation is not federally mandated, would not duplicate any other program and would not
require additional capital improvements or rental space. L.R. No. 3235H.01I
Bill No. HB 1599
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SOURCES OF INFORMATION
Department of Social Services
Joint Committee on Administrative Rules
Office of the Secretary of State
Julie MorffJessica HarrisDirectorAssistant DirectorApril 1, 2025April 1, 2025