Bill > HB1599

This bill creates a new section in Missouri state law (208.149) that establishes specific provisions for MO HealthNet reimbursement of professional clinical pathology services. The bill defines key terms such as "clinical pathology services" (medical services provided by a pathologist for examining and interpreting laboratory tests), "hospital-based pathologist" (a licensed physician specializing in pathology within a hospital), and "professional component" (the pathologist's expertise in interpreting and supervising laboratory tests). The legislation mandates that MO HealthNet will pay for professional clinical pathology services provided to patients, with the reimbursement set at 30% of the approved outpatient fee schedule based on Medicare's clinical laboratory fee schedule. The bill specifies that if the pathologist is employed by the hospital, the professional fee will be paid directly to the hospital, and if the pathologist is not employed by the hospital, the fee will be paid to the third-party service provider. The Missouri Department of Social Services is required to create rules and regulations to implement this section, with specific guidelines about rule-making authority and compliance with existing state legislative procedures.

Government Affairs, Labor and Employment

https://house.mo.gov/Bill.aspx?bill=HB1599&year=2025&code=R