Enacts provisions relating to payment for health care services
By requiring off-campus outpatient departments to follow stringent billing practices that include using a unique NPI, HB502 is set to impact how healthcare services are billed and reimbursed in Missouri. The bill applies to all facilities licensed and operating in the state and will take effect for claims submitted after December 31, 2025. This legislation seeks to protect enrollees from being liable for services that are not billed correctly, thereby addressing potential billing discrepancies and unethical practices associated with healthcare claims.
House Bill 502, titled the 'Honest Billing Act', aims to amend Chapter 191 of the Revised Statutes of Missouri by establishing new provisions related to the payment for healthcare services, particularly focusing on the claims billing process for off-campus outpatient departments of healthcare facilities. The bill mandates that such departments must apply for and obtain a unique National Provider Identifier (NPI) distinct from that of their main campus when submitting claims for healthcare services. This change is designed to enhance transparency and ensure that facilities are accountable to health carriers and enrollees.
Despite the intentions behind HB502, the bill has sparked discussions regarding the enforcement measures and penalties imposed for non-compliance. Facilities that fail to adhere to the outlined billing requirements could face administrative fines and potential repercussions regarding their licensure. Some legislators and stakeholders are concerned that the penalties might disproportionately affect smaller healthcare providers who may struggle with the administrative burden of compliance, raising questions about the balance between regulation and accessibility to healthcare services.