HCSHB530--HEALTHCAREPROVIDERPARTICIPATIONINHEALTH
INSURANCEPLANS
SPONSOR: Hausman
COMMITTEEACTION:Voted"DoPasswithHCS"bytheStanding
CommitteeonInsurancebyavoteof10to2with1votingpresent.
ThefollowingisasummaryoftheHouseCommitteeSubstituteforHB
530.
Thisbillestablishesthe"PatientsFirstAct".
Thisbillprohibitsagrouphealthplanorhealthissuanceissuer
offeringgrouporindividualhealthinsurancecoveragefrom
discriminating withrespecttoparticipationundertheplanor
coverageagainstanyhealthcareproviderwhoisactingwithinthe
scopeoftheprovider'slicenseorcertificatewithanexclusion
forphysicianslicensedunderchapter334.
Thehealthbenefitplancannotdiscriminateagainstahealthcare
providerbasedontheprovider'slicensurewithrespectto
reimbursementorparticipationinanyplanorinsuranceprogram.
Thebillrequiresahealthcareprovidertobereimbursedatthe
samerateforthesameserviceaslongastheserviceiswithinthe
provider'sscopeofpractice,buttheseprovisionsshouldnotbe
construedtopreventagrouphealthplanorahealthinsurance
issuerfromestablishingvaryingreimbursementratesbasedon
qualityorperformancemeasures.
ThisbillissimilartoHCSHB2733(2024).
Thefollowingisasummaryofthepublictestimonyfromthe
committeehearing. Thetestimonywasbasedontheintroduced
versionofthebill.
PROPONENTS: Supporterssaythathealthcarecostswillgodownif
patientscangetproceduresinanoutpatientsettingthesameasin
ahospital. Thisbillwillleveltheplayingfieldforthehealth
careservicesprovidedbyallhealthcareproviders. Healthcare
providersshouldbepaidthesameandnotlessforservicesthat
areequaltootherproviders.
TestifyinginpersonforthebillwereRepresentative Hausman;Jill
Nelson,BackToHealth;MissouriPodiatricMedicalAssociation;Dr.
QuinnJames,MissouriChiropracticPhysiciansAssociates;REACH
HealthcareFoundation;ArnieDienoff;MissouriAssociationofNurse Anesthetists;MissouriRuralHealthAssociation;andMissouri
NursesAssociation.
OPPONENTS: Thosewhoopposethebillsaythatnotallhealthcare
providersarethesame.Somehavebetterequipmentandtraining.
Ahigherlevelofserviceshouldbereimbursedmore.
TestifyinginpersonagainstthebillwerePCMA;MissouriState
MedicalAssociation;MissouriAssociationofOsteopathicPhysicians
andSurgeons;America'sHealthInsurancePlans;MissouriInsurance
Coalition.
Writtentestimonyhasbeensubmittedforthisbill.Thefull
writtentestimonyandwitnessestestifyingonlinecanbefound
underTestimonyonthebillpageontheHousewebsite.