FIRSTREGULARSESSION
HOUSEBILLNO.1599
103RDGENERALASSEMBLY
INTRODUCEDBYREPRESENTATIVEHRUZA.
3235H.01I JOSEPHENGLER,ChiefClerk
ANACT
Toamendchapter208,RSMo,byaddingtheretoonenewsectionrelatingtoMOHealthNet
reimbursementforclinicalpathologyservices.
BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows:
SectionA.Chapter208,RSMo,isamendedbyaddingtheretoonenewsection,tobe
2knownassection208.149,toreadasfollows:
208.149.1.Asusedinthissection,thefollowingtermsmean:
2 (1)"Clinicalpathologyservices",professionalmedicalservicesprovidedbya
3pathologistfortheexamination,diagnosis,andinterpretationoflaboratorytests
4performedonpatientspecimenstoaidinthediagnosisandtreatmentofdisease.
5Clinicalpathologyservicesinclude,butarenotlimitedto,hematology,microbiology,
6immunology,clinicalchemistry,molecularpathology,andotherlaboratory-based
7diagnosticprocedures;
8 (2)"Hospital-basedpathologist",alicensedphysicianspecializinginpathology
9whoprovidesclinicalpathologyserviceswithinahospitalsetting;
10 (3)"Professionalcomponentofclinicalpathologyservices",theportionof
11clinicalpathologyservicesthatinvolvesthepathologist'sprofessionalexpertisein
12interpretingandsupervisinglaboratorytests,excludingthetechnicalcomponentof
13performingthelaboratorytests.
14 2.Thefeefortheprofessionalcomponentofclinicalpathologyservicesshallbe
15paidbyMOHealthNetforprofessionalservicesprovidedbyahospital-based
16pathologistforinpatientclinicalpathologyservicesrenderedtopatientscoveredby
17theMOHealthNetprogram.
EXPLANATION—Matterenclosedinbold-facedbrackets[thus] intheabovebillisnotenactedandis
intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 18 3.Thereimbursementamountfortheprofessionalcomponentofclinical
19pathologyservicesshallbesetatthirtypercentoftheapprovedoutpatientsimplifiedfee
20schedulebasedonMedicare'sclinicallaboratoryfeescheduleforthecorresponding
21clinicalpathologyservicespayablebyMOHealthNet.
22 4.(1)Ifthefeefortheprofessionalcomponentofclinicalpathologyservicesis
23paidforprofessionalservicesprovidedbyapathologistemployedbythehospitalwhere
24theclinicalpathologyservicesarerenderedtocoveredMOHealthNetpatients,the
25professionalfeeshallbepaiddirectlytothehospital.
26 (2)Ifthefeefortheprofessionalcomponentofclinicalpathologyservicesispaid
27forprofessionalservicesprovidedbyapathologistwhoisnotemployedbythehospital
28whereclinicalpathologyservicesarerenderedtocoveredMOHealthNetpatients,the
29professionalfeeshallbepaiddirectlytothethirdpartyprovidingtheservices.
30 5.Thedepartmentofsocialservicesshallpromulgateallnecessaryrulesand
31regulationsfortheadministrationofthissection.Anyruleorportionofarule,asthat
32termisdefinedinsection536.010,thatiscreatedundertheauthoritydelegatedinthis
33sectionshallbecomeeffectiveonlyifitcomplieswithandissubjecttoallofthe
34provisionsofchapter536and,ifapplicable,section536.028.Thissectionandchapter
35536arenonseverableandifanyofthepowersvestedwiththegeneralassembly
36pursuanttochapter536toreview,todelaytheeffectivedate,ortodisapproveandannul
37arulearesubsequentlyheldunconstitutional,thenthegrantofrulemakingauthority
38andanyruleproposedoradoptedafterAugust28,2025,shallbeinvalidandvoid.
âś”
HB1599 2