Bill > HB502

This bill enacts the "Honest Billing Act", which focuses on how healthcare facilities bill for services provided at off-campus outpatient departments. The bill requires such departments to obtain and use a unique National Provider Identifier (NPI) that is distinct from the main hospital campus when submitting claims for reimbursement. Starting January 1, 2026, off-campus outpatient departments must use this specific NPI when billing health carriers and must submit claims using a CMS 1500 form or HIPAA X12 837P electronic claims transaction. If a facility does not bill using the correct NPI, they cannot hold patients financially responsible for the services. The bill allows the Department of Health and Senior Services to impose penalties for non-compliance, including administrative fines up to $1,000 per violation, license suspension or revocation, and potential referral to the Attorney General. Health carriers are not required to reimburse claims that do not follow these billing requirements. The legislation applies to all facilities licensed in Missouri and health carriers doing business in the state, with the goal of increasing transparency and accuracy in healthcare billing practices.

https://house.mo.gov/Bill.aspx?bill=HB502&year=2025&code=R