| 1 | 1 | | FIRSTREGULARSESSION |
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| 2 | 2 | | HOUSEBILLNO.626 |
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| 3 | 3 | | 103RDGENERALASSEMBLY |
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| 4 | 4 | | INTRODUCEDBYREPRESENTATIVEKELLEY. |
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| 5 | 5 | | 1811H.01I DANARADEMANMILLER,ChiefClerk |
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| 6 | 6 | | ANACT |
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| 7 | 7 | | Torepealsection376.446,RSMo,andtoenactinlieuthereofonenewsectionrelatingto |
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| 8 | 8 | | healthinsurancereimbursement. |
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| 9 | 9 | | BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows: |
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| 10 | 10 | | SectionA.Section376.446,RSMo,isrepealedandonenewsectionenactedinlieu |
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| 11 | 11 | | 2thereof,tobeknownassection376.446,toreadasfollows: |
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| 12 | 12 | | 376.446.1.Immediatelyuponthewrittenororalrequestofanenrollee,ahealth |
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| 13 | 13 | | 2[carriers] carriershallpermit[individuals] anenrolleetolearn: |
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| 14 | 14 | | 3 (1)Theamountofcost-sharing,includingdeductibles,copayments,andcoinsurance, |
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| 15 | 15 | | 4underthe[individual's] enrollee'shealthbenefitplanorcoveragethatthe[individual] |
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| 16 | 16 | | 5enrolleewouldberesponsibleforpayingwithrespecttothefurnishingofaspecificitemor |
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| 17 | 17 | | 6servicebyaparticipatingprovider[inatimelymannerupontherequestoftheindividual]; |
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| 18 | 18 | | 7and |
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| 19 | 19 | | 8 (2)Iftheenrolleeprovidesaspecificbillingcodeforahealthcareservice: |
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| 20 | 20 | | 9 (a)Thereimbursementamount,expressedindollarsandnotasapercentage, |
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| 21 | 21 | | 10thatthehealthcarrierwillpayaparticipatingproviderforthehealthcareservice;and |
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| 22 | 22 | | 11 (b)Thereimbursementamount,expressedindollarsandnotasapercentage, |
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| 23 | 23 | | 12thatthehealthcarrierwillpaytheenrolleeforthehealthcareserviceifthehealthcare |
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| 24 | 24 | | 13serviceisnotdeliveredbyaparticipatingprovider. |
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| 25 | 25 | | 14 2.Ataminimum,[such] theinformationdescribedinsubsection1ofthissection |
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| 26 | 26 | | 15shallbemadeavailableto[suchindividual] theenrolleethroughaninternetwebsiteandsuch |
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| 27 | 27 | | 16othermeansfor[individuals] enrolleeswithoutaccesstotheinternet. |
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| 28 | 28 | | EXPLANATION—Matterenclosedinbold-facedbrackets[thus] intheabovebillisnotenactedandis |
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| 29 | 29 | | intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 17 3.Asusedinthissection,theterms"enrollee","healthcarrier"[and],"healthbenefit |
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| 30 | 30 | | 18[plans"] plan","healthcareservice",and"participatingprovider"shallhavethesame |
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| 31 | 31 | | 19meaningsassignedtotheminsection376.1350. |
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| 32 | 32 | | 20 [2.]4.Thissectionshallnotapplytoasupplementalinsurancepolicy,includingalife |
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| 33 | 33 | | 21carecontract,accident-onlypolicy,specifieddiseasepolicy,hospitalpolicyprovidingafixed |
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| 34 | 34 | | 22dailybenefitonly,Medicaresupplementpolicy,long-termcarepolicy,hospitalization- |
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| 35 | 35 | | 23surgicalcarepolicy,short-termmajormedicalpolicyofsixmonthsorlessduration,orany |
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| 36 | 36 | | 24othersupplementalpolicy. |
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| 37 | 37 | | 25 [3.Theprovisionsofsubsections1and2shallbecomeeffectiveonJanuary1,2014.] |
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| 38 | 38 | | âś” |
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| 39 | 39 | | HB626 2 |
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