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SECOND REGULAR SESSION
HOUSE COMMITTEE SUBSTITUTE FOR
HOUSE BILL NO. 1894
103RD GENERAL ASSEMBL Y
5004H.02C JOSEPH ENGLER, Chief Clerk
AN ACT
T o amend chapter 376, RSMo, by adding thereto one new section relating to health care
provider participation in health insurance plans.
Be it enacted by the General Assembly of the state of Missouri, as follows:
Section A. Chapter 376, RSMo, is amended by adding thereto one new section, to be
2 known as section 376.1583, to read as follows:
376.1583. 1. The provi sions of this section shall be known and may be cited as
2 the "Patients First Act".
3 2. The department of commer ce and insurance shall implement and enfor ce the
4 nondiscrimination pr otections in Section 2706 of the federal Public Health Service Act,
5 42 U.S.C. Section 300gg-5, by ensuring that no grou p health plan or health insurance
6 issuer offering group or individual health insurance coverage shall discriminate with
7 r espect to participation under the plan or coverage against any health car e provi der
8 who is acting within the scope of that prov ider's license or certification under state law .
9 3. (1) A health benefit plan, as defined in section 376.1350, shall not discriminate
10 against a health care pro vider based on the pr ovider's licensur e with res pect to
11 r eimbursement or participation in any plan or insurance prog ram.
12 (2) All health car e pr oviders shall be reim bursed at the same rate for the same
13 service as long as such service is within the prov ider's scope of practice under state law .
14 (3) Nothing in this section shall be construed to pr event a gr oup health plan or a
15 health insurance issuer fr om establishing varying rei mbursement rates based on quality
16 or performance measur es.
17 (4) Nothing in this section shall be construed to requ ire a grou p health plan or
18 health insurance issuer to accept any willing prov ider into a network.
EXPLANA TION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is
intended to be omitted from the law . Matter in bold-face type in the above bill is proposed language.
19 4. Nothing in this section shall apply to physicians licensed under chapter 334.
20 5. The department of commer ce and insurance may pro mulgate all necessary
21 rules and reg ulations for the administration of this section. Any rule or portion of a
22 rule, as that term is defined in section 536.010, that is crea ted under the authority
23 delegated in this section shall become effective only if it complies with and is subject to
24 all of the pr ovisions of chapter 536 and, if applicable, section 536.028. This section and
25 chapter 536 are nonseverable and if any of the powers vested with the general assembly
26 pursuant to chapter 536 to revi ew , to delay the effective date, or to disappr ove and annul
27 a rule are subsequently held unconstitutional, then the grant of rulemaking authority
28 and any rule prop osed or adopted after August 28, 2026, shall be invalid and void.
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HCS HB 1894 2