HCS SS SB 817 -- HEALTH CARE SERVICES

SPONSOR:  Goodman (Wilson, 130)

COMMITTEE ACTION:  Voted "do pass" by the Special Committee on
Health Insurance by a vote of 5 to 2.

This substitute changes the laws regarding medical record fees
and anatomic pathology and vision services.  In its main
provisions, the substitute:

(1)  Increases the fee for the copying of medical records from
not more than $17 plus 40 cents per page for the cost of supplies
and labor to $19 plus 46 cents per page.  The combination of the
notary and certification fee, if certification is requested, is
increased from not to exceed $2 to $8;

(2)  Prohibits a licensed health care professional from charging,
billing, or soliciting payment for anatomic pathology services,
unless the services are rendered personally by the licensed
health care professional or under his or her direct supervision.
No patient, insurer, third-party payor, hospital, public health
clinic, or nonprofit health clinic will be required to reimburse
any licensed health care professional for charges or claims
submitted in violation of this provision.  Nothing will prohibit
the billing of a referring laboratory for services when samples
must be sent to another specialist.  The state licensing board
having jurisdiction over the licensed health care professional
who requests or provides these services may revoke, suspend, or
deny the license of anyone who violates these provisions; and

(3)  Prohibits health insurance carriers from discriminating
between eye care providers when selecting, referring, or
reimbursing duly licensed providers for their services; prohibits
carriers from refusing to select an eye care provider for their
network if not all of the optometrists in the group practice
agree to participate in the network or if the provider does not
sell eye glass frames or corrective lenses; and prohibits
carriers from requiring optometrists to participate in the
network through an intermediary if the carrier allows
ophthalmologists to contract directly with the carrier.  When eye
care services are being provided in connection with a treatment
plan for corrective surgery, carriers cannot:

(a)  Refuse to select an eye care provider for their network;

(b)  Refuse to refer an enrollee for services needed; or

(c)  Reimburse the provider for covered services in a
discriminatory manner.

FISCAL NOTE:  Estimated Cost on General Revenue Fund of $207,377
in FY 2009, $232,771 in FY 2010, and $236,754 in FY 2011.  No
impact on Other State Funds in FY 2009, FY 2010, and FY 2011.

PROPONENTS:  Supporters say that Medicaid and Medicare doctors
cannot charge a brokerage fee for anatomic pathology services but
private physicians can.  The bill requires private physicians to
follow the same standards of the Centers for Medicaid and
Medicare Services.  Disallowing a brokerage fee will protect
patients from markups in charges for pathology services, and the
statement for services will go directly to the patient and not to
the treating physician.

Testifying for the bill were Senator Goodman; and Dr. Jeffrey
Cramer.

OPPONENTS:  Those who oppose the bill say that a family practice
is a one-stop-shop for consumers, and the bill interferes with
previously negotiated rates for provided services.  The bill will
negatively impact rural health care providers and patients
without insurance.  Passing the bill will not support capitalism
by prohibiting profit-making.

Testifying against the bill were Missouri Academy of Family
Physicians; Missouri Association of Osteopathic Physicians and
Surgeons; and Mark Tucker, American Academy of Dermatology.

Missouri House of Representatives
94th General Assembly, 2nd Regular Session
Last Updated October 15, 2008 at 3:12 pm