FIRST REGULAR SESSION
SENATE BILL NO. 724
103RD GENERAL ASSEMBLY
INTRODUCED BY SENATOR COLEMAN.
2919S.01I KRISTINA MARTIN, Secretary
AN ACT
To amend chapter 197, RSMo, by adding thereto three new sections relating to hospital pricing
practices.
Be it enacted by the General Assembly of the State of Missouri, as follows:
Section A. Chapter 197, RSMo, is amended by adding there to 1
three new sections, to be known as sections 197.1040, 197.1045, 2
and 197.1050, to read as follows:3
197.1040. For purposes of sections 197.1040 to 1
197.1050, unless the context otherwise requires, the 2
following terms mean: 3
(1) "Centers for Medicare and Medicaid Services", the 4
Centers for Medicare and Medicaid Services in the United 5
States Department of Health and Human Services; 6
(2) "Collection action", any of the following actions 7
taken with respect to a debt for items and services that 8
were provided to a patient by or purchased from a hospital 9
on a date during which the hospital was not in material 10
compliance with hospital price transparency laws: 11
(a) Attempting to collect a debt from a patient or 12
patient guarantor by refe rring the debt, directly or 13
indirectly, to a debt collector, a collection agency, or 14
other third party retained by or on behalf of the hospital; 15
(b) Suing the patient or patient guarantor or 16
enforcing an arbitration or mediation clause in any hosp ital 17 SB 724 2
documents, including contracts, agreements, statements, or 18
bills; or 19
(c) Directly or indirectly causing a report to be made 20
to a consumer reporting agency; 21
(3) "Collection agency": 22
(a) Any: 23
a. Person who engages in a busines s, the principal 24
purpose of which is the collection of debts; or 25
b. Person who: 26
(i) Regularly collects or attempts to collect, 27
directly or indirectly, debts owed or due or asserted to be 28
owed or due to another; 29
(ii) Takes assignment of debts for collection purposes; 30
(iii) Directly or indirectly solicits for collection 31
debts owed or due or asserted to be owed or due to another; 32
or 33
(iv) Collects debts for the office of administration; 34
(b) Does not include: 35
a. Any officer or employee of a creditor while, in the 36
name of the creditor, collecting debts for such creditor; 37
b. Any person while acting as a collection agency for 38
another person, both of whom are related by common ownership 39
or affiliated by corporat e control, if the person acting as 40
a collection agency does so only for creditors to whom it is 41
so related or affiliated and if the principal business of 42
the person is not the collection of debts; 43
c. Any officer or employee of the United States or any 44
state to the extent that collecting or attempting to collect 45
any debt is in the performance of the officer's or 46
employee's official duties; 47 SB 724 3
d. Any person while serving or attempting to serve 48
legal process on any other person in connection wi th the 49
judicial enforcement of any debt; 50
e. Any person collecting or attempting to collect any 51
debt owed or due or asserted to be owed or due another to 52
the extent that: 53
(i) The activity is incidental to a bona fide 54
fiduciary obligation or a bona fide escrow arrangement; 55
(ii) The activity concerns a debt that was extended by 56
the person; 57
(iii) The activity concerns a debt that was not in 58
default at the time it was obtained by the person; or 59
(iv) The activity concerns a deb t obtained by the 60
person as a secured party in a commercial credit transaction 61
involving the creditor; or 62
f. Any person whose principal business is the making 63
of loans or the servicing of debt not in default and who 64
acts as a loan correspondent, seller, and servicer for the 65
owner, or holder of a debt that is secured by a deed of 66
trust on real property, regardless of whether the debt is 67
also secured by an interest in personal property; 68
(c) Notwithstanding the provisions of paragraph (b) of 69
this subdivision to the contrary, the term "collection 70
agency" includes any person who, in the process of 71
collecting the person's own debts, uses another name that 72
would indicate that a third person is collecting or 73
attempting to collect such debts; 74
(4) "Consumer reporting agency", any person who, for 75
monetary fees or dues or on a cooperative nonprofit basis, 76
regularly engages, in whole or in part, in the practice of 77
assembling or evaluating consumer credit information or 78
other information on consumers for the purpose of furnishing 79 SB 724 4
consumer reports to third parties. The term "consumer 80
reporting agency" includes any person defined in 15 U.S.C. 81
Section 1681a(f) and any consumer credit reporting agency 82
defined in section 407.1380. The term "consumer reporting 83
agency" does not include any business entity that provides 84
only check verification or check guarantee services; 85
(5) "Debt", any obligation or alleged obligation of a 86
consumer to pay moneys arising out of a transaction, 87
regardless of whether the obligation has been reduced to 88
judgment. The term "debt" does not include a debt for 89
business, investment, commercial, or agricultural purposes 90
or a debt incurred by a business; 91
(6) "Debt collector", any person employed or eng aged 92
by a collection agency to perform the collection of debts 93
owed or due or asserted to be owed or due to another; 94
(7) "Hospital", a hospital: 95
(a) Licensed under this chapter; or 96
(b) Approved by the department of health and senior 97
services as meeting the standards established for licensing 98
a hospital in this state; 99
(8) "Hospital price transparency laws", Section 100
2718(e) of the Public Health Service Act, as amended, and 101
rules adopted by the United States Department of Health a nd 102
Human Services implementing Section 2718(e); 103
(9) "Items and services" or "items or services", items 104
and services as defined in 45 CFR 180.20. 105
197.1045. 1. On and after August 28, 2025, a hospital 1
that is not in material com pliance with hospital price 2
transparency laws on the date that items or services are 3
provided to a patient by or purchased from the hospital 4
shall not initiate or pursue a collection action against the 5 SB 724 5
patient or patient guarantor for a debt owed for t he items 6
or services. 7
2. If a patient believes that a hospital was not in 8
material compliance with hospital price transparency laws on 9
a date on or after August 28, 2025, that items or services 10
were purchased by or provided to the patient, and th e 11
hospital takes a collection action against the patient or 12
patient guarantor, the patient or patient guarantor may file 13
suit to determine if the hospital was materially out of 14
compliance with the hospital price transparency laws and 15
rules and regulations on the date of service and if the 16
noncompliance is related to the items or services. The 17
hospital shall not take a collection action against the 18
patient or patient guarantor while the lawsuit is pending. 19
3. A hospital that has been found by a judge or jury, 20
considering compliance standards issued by the Centers for 21
Medicare and Medicaid Services, to be materially out of 22
compliance with hospital price transparency laws and rules 23
and regulations: 24
(1) Shall refund the payer any amount of the debt the 25
payer has paid and shall pay a penalty to the patient or 26
patient guarantor in an amount equal to the total amount of 27
the debt or five thousand dollars for each violation, 28
whichever is greater, and an amount equal to one percent 29
interest per day from the date of occurrence; 30
(2) Shall dismiss or cause to be dismissed any court 31
action with prejudice and pay any costs incurred by the 32
patient or patient guarantor relating to the action; and 33
(3) Shall remove or cause to be remov ed from the 34
patient's or patient guarantor's credit report any report 35
made to a consumer reporting agency relating to the debt. 36
4. Nothing in this section: 37 SB 724 6
(1) Prohibits a hospital from billing a patient, 38
patient guarantor, or third -party payer, including a health 39
insurer, for items or services provided to the patient; or 40
(2) Requires a hospital to refund any payment made to 41
the hospital for items or services provided to the patient, 42
so long as no collection action is taken in violat ion of 43
this section. 44
197.1050. Any patient who pays a bill received from a 1
hospital charging the patient for items or services in an 2
amount that exceeds the price of the items or services 3
published by the hospital in accordance with hospital price 4
transparency laws may bring a civil action in circuit court 5
against the hospital and recover the difference between the 6
amount paid by the patient and the price of the items or 7
services published by the hospital in accordance with 8
hospital price transparency laws or five thousand dollars, 9
whichever is lower, and an amount equal to one percent 10
interest per day from the date of occurrence. 11