HB 2394 -- Transparency of Health Care Services

Sponsor:  Ervin

This bill establishes guidelines for transparency in pricing and
quality of health care services.  In its main provisions, the
bill:

(1)  Specifies that a patient or consumer who has requested an
estimated cost of health care services will not be required to
pay for the services until an estimate has been provided.  This
provision does not apply to emergency services;

(2)  Requires health care providers to issue a disclaimer
regarding possible differences between the estimated and the
actual billed costs of services;

(3)  Requires health care providers to provide patients or
consumers with quality of care data.  Failure to comply will be
basis for licensure sanction;

(4)  Requires all contracts between health care providers and
insurers to include quality of care data disclosure requirements;

(5)  Specifies the requirements that insurers must use in
programs to evaluate and compare the performance and efficiency
of health care providers; and

(6)  Prohibits a provider from declining to enter into a contract
with an insurer due to quality of care data disclosure
requirements or programs to evaluate and compare performance and
efficiency.

Requirements are established for a person who sells or
distributes quality of care data that is not included in the
quality measures used by the federal Centers for Medicare and
Medicaid Services.  This provision does not apply to articles or
research studies that are published in peer-reviewed academic
journals.  The Department of Health and Senior Services is
required to investigate complaints of alleged violations and is
authorized to impose a penalty of up to $1,000.

Alleged violations by health insurers will be investigated and
enforced by the Department of Insurance, Financial Institutions,
and Professional Registration.

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