COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. No.:1688H.01I Bill No.:HB 530 Subject:Insurance - Health; Health Care Professionals Type:Original Date:February 21, 2025Bill Summary:This proposal creates provisions relating to health care provider participation
in health insurance plans.
FISCAL SUMMARY
ESTIMATED NET EFFECT ON GENERAL REVENUE FUNDFUND AFFECTEDFY 2026FY 2027FY 2028General Revenue
Fund
(Unknown, greater
than $18,900,000)
(Unknown, greater
than $18,900,000)
(Unknown, greater
than $18,900,000)
Total Estimated Net
Effect on General
Revenue
(Unknown, greater
than $18,900,000)
(Unknown, greater
than $18,900,000)
(Unknown, greater
than $18,900,000)
ESTIMATED NET EFFECT ON OTHER STATE FUNDSFUND AFFECTEDFY 2026FY 2027FY 2028
Other State Funds
(Unknown, greater
than $4,500,000)
(Unknown, greater
than $4,500,000)
(Unknown, greater
than $4,500,000)
State Road Fund
(0320)
($8,000,000 to
$12,000,000)
($8,000,000 to
$12,000,000)
($8,000,000 to
$12,000,000)
Total Estimated Net
Effect on Other State
Funds
(Unknown, Greater
than $12,500,000 to
$16,500,000)
(Unknown, Greater
than $12,500,000 to
$16,500,000)
(Unknown, Greater
than $12,500,000 to
$16,500,000)
Numbers within parentheses: () indicate costs or losses. L.R. No. 1688H.01I
Bill No. HB 530
Page 2 of
February 21, 2025
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ESTIMATED NET EFFECT ON FEDERAL FUNDSFUND AFFECTEDFY 2026FY 2027FY 2028
Federal Funds
(Unknown, greater
than $6,600,000)
(Unknown, greater
than $6,600,000)
(Unknown, greater
than $6,600,000)
Total Estimated Net
Effect on All Federal
Funds
(Unknown, greater
than $6,600,000)
(Unknown, greater
than $6,600,000)
(Unknown, greater
than $6,600,000)
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*(Unknown)(Unknown)(Unknown)
*Oversight assumes this proposal could have an unknown fiscal impact to local political
subdivisions’ health insurance plans. L.R. No. 1688H.01I
Bill No. HB 530
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February 21, 2025
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FISCAL ANALYSIS
ASSUMPTION
§376.1583 – Health Care Provider Participation in Health Insurance Plans
Officials from the Missouri Consolidated Health Care Plan (MCHCP) assume this proposal
creates provisions relating to health care provider participation in health insurance plans.
MCHCP assumes this legislation requires a health benefit plan to not discriminate against
providers, letting any provider participate in any plan and receive the same amount of
reimbursement for the same service. In consultation with MCHCP’s third party administrator,
MCHCP is estimating that medical claims costs would increase by 7% to 12% primarily driven
by the erosion of provider discounts.
MCHCP medical claims costs for FY 24 were just over $434 million. Using the lessor of the
amounts estimated (7%), the fiscal impact would be unknown, but greater than $30 million.
While most of the cost increase would be borne by the state, there would also be an unknown
impact to member’s costs from increased out of pocket costs and any resulting increase
in premiums.
Oversight does not have any information to the contrary. Therefore, Oversight will reflect the
cost estimate as provided by MCHCP, broken out as the following:
(63%) GR – Unknown, Greater than $18,900,000
(22%) Federal - Unknown, Greater than $6,600,000
(15%) Other State Funds - Unknown, Greater than $4,500,000
TOTAL $30,000,000
Officials from the Missouri Department of Transportation (MoDOT) state that while the
MoDOT/MSHP medical plan does not fall under the definition of “health benefit plan” under
376.1350, this may apply to third party administrators that administer the plan’s benefits. This
will increase the costs for the health plan administrators which will likely be passed on as a self-
insured plan.
MoDOT expects an increased plan cost between 7 and 9 percent, based on FTC studies. This
equates to an estimated negative fiscal impact of $8,000,000 to $12,000,000.
Oversight does not have any information to the contrary. Therefore, Oversight will reflect the
cost estimate as provided by MoDOT to the State Road Fund. L.R. No. 1688H.01I
Bill No. HB 530
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February 21, 2025
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Oversight assumes this proposal could have an unknown fiscal impact to local political
subdivisions’ health insurance plans.
Officials from the Department of Commerce and Insurance, the Department of Social
ServicesMissouri Department of Conservation each assume the proposal will have
no fiscal impact on their respective organizations. Oversight does not have any information to
the contrary. Therefore, Oversight will reflect a zero impact in the fiscal note for these agencies.
Officials from the Department of Public Safety - Missouri Highway Patrol defer to the
Missouri Department of Transportation for the potential fiscal impact of this proposal.
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. 1688H.01I
Bill No. HB 530
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February 21, 2025
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FISCAL IMPACT – State GovernmentFY 2026
(10 Mo.)
FY 2027FY 2028GENERAL REVENUE FUNDCost – MCHCP
Increased Medical Claims Cost
§376.1583 p. 3
(Unknown,
greater than
$18,900,000)
(Unknown,
greater than
$18,900,000)
(Unknown,
greater than
$18,900,000)
ESTIMATED NET EFFECT TO
THE GENERAL REVENUE FUND
(Unknown,
greater than
$18,900,000)
(Unknown,
greater than
$18,900,000)
(Unknown,
greater than
$18,900,000)
OTHER STATE FUNDSCost – MCHCP
Increased Medical Claims Cost
§376.1583 p. 3
(Unknown,
greater than
$4,500,000)
(Unknown,
greater than
$4,500,000)
(Unknown,
greater than
$4,500,000)
ESTIMATED NET EFFECT TO
OTHER STATE FUNDS
(Unknown,
greater than
$4,500,000)
(Unknown,
greater than
$4,500,000)
(Unknown,
greater than
$4,500,000)
STATE ROAD FUND (0320)Cost – MoDOT
Increased Medical Claims Cost
§376.1583 p. 3
($8,000,000 to
$12,000,000)
($8,000,000 to
$12,000,000)
($8,000,000 to
$12,000,000)
ESTIMATED NET EFFECT TO
THE STATE ROAD FUND
($8,000,000 to
$12,000,000)
($8,000,000 to
$12,000,000)
($8,000,000 to
$12,000,000)
FEDERAL FUNDSCost – MCHCP
Increased Medical Claims Cost
§376.1583 p. 3
(Unknown,
greater than
$6,600,000)
(Unknown,
greater than
$6,600,000)
(Unknown,
greater than
$6,600,000)
ESTIMATED NET EFFECT TO
FEDERAL FUNDS
(Unknown,
greater than
$6,600,000)
(Unknown,
greater than
$6,600,000)
(Unknown,
greater than
$6,600,000) L.R. No. 1688H.01I
Bill No. HB 530
Page 6 of
February 21, 2025
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FISCAL IMPACT – Local GovernmentFY 2026
(10 Mo.)
FY 2027FY 2028LOCAL POLITCAL
SUBDIVISIONS
Cost
Increased Medical Claims Cost*(Unknown)(Unknown)(Unknown)
ESTIMATED NET EFFECT TO
LOCAL POLITICAL
SUBDIVISIONS(Unknown)(Unknown)(Unknown)
*Oversight assumes this proposal could have an unknown fiscal impact to local political
subdivisions’ health insurance plans.
FISCAL IMPACT – Small Business
A direct fiscal impact to small businesses offering group or individual health insurance coverage
could be expected as a result of this proposal.
FISCAL DESCRIPTION
This bill establishes the "Patients First Act".
This bill prohibits a group health plan or health issuance issuer offering group or individual
health insurance coverage from discriminating with respect to participation under the plan or
coverage against any health care provider who is acting within the scope of the provider's license
or certificate.
The health benefit plan cannot discriminate against a health care provider based on the provider's
licensure with respect to reimbursement or participation in any plan or insurance program.
The bill requires a health care provider to be reimbursed at the same rate for the same service as
long as the service is within the provider's scope of practice, but these provisions should not be
construed to prevent a group health plan or a health insurance issuer from establishing varying
reimbursement rates based on quality or performance measures.
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. 1688H.01I
Bill No. HB 530
Page 7 of
February 21, 2025
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SOURCES OF INFORMATION
Department of Commerce and Insurance
Department of Public Safety - Missouri Highway Patrol
Department of Social Services
Missouri Department of Conservation
Missouri Department of Transportation
Office of the Secretary of State
Joint Committee on Administrative Rules
Missouri Consolidated Health Care Plan
Julie MorffJessica HarrisDirectorAssistant DirectorFebruary 21, 2025February 21, 2025