Bill > HB626

This bill modifies requirements for health carriers regarding the information they must provide to enrollees. Specifically, when an enrollee makes a written or oral request, health carriers must now provide two key pieces of information: (1) the exact amount of cost-sharing (like deductibles, copayments, and coinsurance) the enrollee would be responsible for a specific healthcare service from a participating provider, and (2) if the enrollee provides a specific billing code, the carrier must disclose the exact dollar amount they will reimburse a participating provider for the service, as well as the reimbursement amount they will pay the enrollee if the service is provided by a non-participating provider. The information must be made available through an internet website and alternative methods for those without internet access. The bill explicitly excludes supplemental insurance policies from these requirements, such as accident-only policies, specified disease policies, and short-term major medical policies. The terms used in the bill, like "enrollee", "health carrier", and "participating provider", are defined according to existing state law in section 376.1350.

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https://house.mo.gov/Bill.aspx?bill=HB626&year=2025&code=R