Bill > HB2597

This bill creates new regulations for reimbursing out-of-network ambulance providers by health insurance carriers, establishing detailed guidelines for payment rates and claims processing. The bill defines key terms like "ambulance provider", "clean claim", and "out-of-network ambulance provider", and specifies that reimbursement rates for emergency ambulance services shall be either the rates set by local government jurisdictions or 325% of Medicare rates, whichever is less. The legislation mandates that health carriers must pay ambulance providers directly within 30 days of receiving a clean claim, and provides specific requirements for handling claims that are not clean, such as sending a written notice explaining any denial or requesting additional information. The bill also prohibits ambulance providers from billing patients for additional amounts beyond their standard co-payments, coinsurance, and deductibles, and ensures that these patient costs do not exceed in-network rates. Importantly, the bill specifies that its provisions will take precedence over any conflicting existing laws, providing a clear standard for ambulance service reimbursement.

https://house.mo.gov/Bill.aspx?bill=HB2597&year=2026&code=R