summary
Introduced
01/08/2025
01/08/2025
In Committee
05/15/2025
05/15/2025
Crossed Over
Passed
Dead
05/16/2025
05/16/2025
Introduced Session
2025 Regular Session
Bill Summary
Enacts provisions relating to payment for health care services
AI Summary
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.
Sponsors (1)
Last Action
Referred: Emerging Issues(H) (on 05/15/2025)
Official Document
bill text
bill summary
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bill summary
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bill summary
Document Type | Source Location |
---|---|
State Bill Page | https://house.mo.gov/Bill.aspx?bill=HB502&year=2025&code=R |
Analysis - Summary: Introduced | https://documents.house.mo.gov/billtracking/bills251/sumpdf/HB0502I.pdf |
BillText | https://documents.house.mo.gov/billtracking/bills251/hlrbillspdf/0787H.01I.pdf |
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