FIRSTREGULARSESSION
HOUSECOMMITTEESUBSTITUTEFOR
HOUSEBILLNO.530
103RDGENERALASSEMBLY
1688H.02C JOSEPHENGLER,ChiefClerk
ANACT
Toamendchapter376,RSMo,byaddingtheretoonenewsectionrelatingtohealthcare
providerparticipationinhealthinsuranceplans.
BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows:
SectionA.Chapter376,RSMo,isamendedbyaddingtheretoonenewsection,tobe
2knownassection376.1583,toreadasfollows:
376.1583.1.Theprovisionsofthissectionshallbeknownandmaybecitedas
2the"PatientsFirstAct".
3 2.Thedepartmentofcommerceandinsuranceshallimplementandenforcethe
4nondiscriminationprotectionsinSection2706ofthefederalPublicHealthServiceAct,
542U.S.C.Section300gg-5,byensuringthatnogrouphealthplanorhealthinsurance
6issuerofferinggrouporindividualhealthinsurancecoverageshalldiscriminatewith
7respecttoparticipationundertheplanorcoverageagainstanyhealthcareprovider
8whoisactingwithinthescopeofthatprovider'slicenseorcertificationunderstatelaw.
9 3.(1)Ahealthbenefitplan,asdefinedinsection376.1350,shallnotdiscriminate
10againstahealthcareproviderbasedontheprovider'slicensurewithrespectto
11reimbursementorparticipationinanyplanorinsuranceprogram.
12 (2)Allhealthcareprovidersshallbereimbursedatthesamerateforthesame
13serviceaslongassuchserviceiswithintheprovider'sscopeofpractice.
14 (3)Nothinginthissectionshallbeconstruedtopreventagrouphealthplanora
15healthinsuranceissuerfromestablishingvaryingreimbursementratesbasedonquality
16orperformancemeasures.
17 4.Nothinginthissectionshallapplytophysicianslicensedunderchapter334.
EXPLANATION—Matterenclosedinbold-facedbrackets[thus] intheabovebillisnotenactedandis
intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 18 5.Thedepartmentofcommerceandinsurancemaypromulgateallnecessary
19rulesandregulationsfortheadministrationofthissection.Anyruleorportionofa
20rule,asthattermisdefinedinsection536.010,thatiscreatedundertheauthority
21delegatedinthissectionshallbecomeeffectiveonlyifitcomplieswithandissubjectto
22alloftheprovisionsofchapter536and,ifapplicable,section536.028.Thissectionand
23chapter536arenonseverableandifanyofthepowersvestedwiththegeneralassembly
24pursuanttochapter536toreview,todelaytheeffectivedate,ortodisapproveandannul
25arulearesubsequentlyheldunconstitutional,thenthegrantofrulemakingauthority
26andanyruleproposedoradoptedafterAugust28,2025,shallbeinvalidandvoid.
âś”
HCSHB530 2