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SECOND REGULAR SESSION
SENATE BILL NO. 1267
103RD GENERAL ASSEMBLY
INTRODUCED BY SENATOR MOON.
5413S.01I KRISTINA MARTIN, Secretary
AN ACT
To amend chapter 197, RSMo, by adding thereto two new sections relating to hospital price
transparency laws.
Be it enacted by the General Assembly of the State of Missouri, as follows:
Section A. Chapter 197, RSMo, is amended by adding thereto 1
two new sections, to be known as sections 197.1040 and 197.1045, 2
to read as follows:3
197.1040. For purposes of this section, unless the 1
context otherwise requires, the following terms mean: 2
(1) "Centers for Medicare and Medicaid Services", the 3
Centers for Medicare and Medicaid Services in the United 4
States Department of Health and Human Services; 5
(2) "Collection action", any of the following actions 6
taken with respect to a debt for items and services that 7
were purchased from or provided to a patient by a hospital 8
on a date during which the hospital was not in material 9
compliance with hospital price transparency laws: 10
(a) Attempting to collect a debt from a patient or 11
patient guarantor by referring the debt, directly or 12
indirectly, to a debt collector, a collection agency, or 13
other third party retained by or on behalf of the hospital; 14
(b) Suing the patient or patient guarantor or 15
enforcing an arbitration or mediation clause in any hospital 16
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documents, including contracts, agreements, statements, or 17
bills; or 18
(c) Directly or indirectly causing a report to be made 19
to a consumer reporting agency; 20
(3) "Collection agency": 21
(a) Any: 22
a. Person who engages in a business, the principal 23
purpose of which is the collection of debts; or 24
b. Person who: 25
(i) Regularly collects or attempts to collect, 26
directly or indirectly, debts owed or due or asserted to be 27
owed or due to another; 28
(ii) Takes assignment of debts for collection purposes; 29
(iii) Directly or indirectly solicits for collection 30
debts owed or due or asserted to be owed or due to another; 31
or 32
(iv) Collects debts for the office of administration; 33
(b) Does not include: 34
a. Any officer or employee of a creditor while, in the 35
name of the creditor, collecting debts for such creditor; 36
b. Any person while acting as a collection agency for 37
another person, both of whom are related by common ownership 38
or affiliated by corporate control, if the person acting as 39
a collection agency does so only for creditors to whom it is 40
so related or affiliated and if the principal business of 41
the person is not the collection of debts; 42
c. Any officer or employee of the United States or any 43
state to the extent that collecting or attempting to collect 44
any debt is in the performance of the officer's or 45
employee's official duties; 46
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d. Any person while serving or attempting to serve 47
legal process on any other person in connection with the 48
judicial enforcement of any debt; 49
e. Any person collecting or attempting to collect any 50
debt owed or due or asserted to be owed or due to another to 51
the extent that: 52
(i) The activity is incidental to a bona fide 53
fiduciary obligation or a bona fide escrow arrangement; 54
(ii) The activity concerns a debt that was extended by 55
the person; 56
(iii) The activity concerns a debt that was not in 57
default at the time it was obtained by the person; or 58
(iv) The activity concerns a debt obtained by the 59
person as a secured party in a commercial credit transaction 60
involving the creditor; or 61
f. Any person whose principal business is the making 62
of loans or the servicing of debt not in default and who 63
acts as a loan correspondent, seller, and servicer for the 64
owner, or holder of a debt that is secured by a deed of 65
trust on real property, regardless of whether the debt is 66
also secured by an interest in personal property; 67
(c) Notwithstanding the provisions of paragraph (b) of 68
this subdivision to the contrary, the term "collection 69
agency" includes any person who, in the process of 70
collecting the person's own debts, uses another name that 71
would indicate that a third person is collecting or 72
attempting to collect such debts; 73
(4) "Consumer reporting agency", any person who, for 74
monetary fees or dues or on a cooperative nonprofit basis, 75
regularly engages, in whole or in part, in the practice of 76
assembling or evaluating consumer credit information or 77
other information on consumers for the purpose of furnishing 78
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consumer reports to third parties. The term "consumer 79
reporting agency" includes any person defined in 15 U.S.C. 80
Section 1681a(f) and any consumer credit reporting agency 81
defined in section 407.1380. The term "consumer reporting 82
agency" does not include any business entity that provides 83
only check verification or check guarantee services; 84
(5) "Debt", any obligation or alleged obligation of a 85
consumer to pay moneys arising out of a transaction, 86
regardless of whether the obligation has been reduced to 87
judgment. The term "debt" does not include a debt for 88
business, investment, commercial, or agricultural purposes 89
or a debt incurred by a business; 90
(6) "Debt collector", any person employed or engaged 91
by a collection agency to perform the collection of debts 92
owed or due or asserted to be owed or due to another; 93
(7) "Hospital", a hospital: 94
(a) Licensed under this chapter; or 95
(b) Approved by the department of health and senior 96
services as meeting the standards established for licensing 97
a hospital in this state; 98
(8) "Hospital price transparency laws", Section 99
2718(e) of the Public Health Service Act, as amended, and 100
rules adopted by the United States Department of Health and 101
Human Services implementing Section 2718(e); 102
(9) "Items and services" or "items or services", items 103
and services as defined in 45 CFR 180.20. 104
197.1045. 1. On and after August 28, 2026, a hospital 1
that is not in material compliance with hospital price 2
transparency laws on the date that items or services are 3
purchased from, or provided to a patient by, the hospital 4
shall not initiate or pursue a collection action against the 5
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patient or patient guarantor for a debt owed for the items 6
or services. 7
2. If a patient believes that a hospital was not in 8
material compliance with hospital price transparency laws on 9
a date on or after August 28, 2026, that items or services 10
were purchased by or provided to the patient, and the 11
hospital takes a collection action against the patient or 12
patient guarantor, the patient or patient guarantor may file 13
suit to determine if the hospital was materially out of 14
compliance with the hospital price transparency laws and 15
rules and regulations on the date of service and if the 16
noncompliance is related to the items or services. The 17
hospital shall not take a collection action against the 18
patient or patient guarantor while the lawsuit is pending. 19
3. A hospital that has been found by a judge or jury, 20
considering compliance standards issued by the Centers for 21
Medicare and Medicaid Services, to be materially out of 22
compliance with hospital price transparency laws and rules 23
and regulations: 24
(1) Shall refund the payer any amount of the debt the 25
payer has paid and shall pay a penalty to the patient or 26
patient guarantor in an amount equal to the total amount of 27
the debt; 28
(2) Shall dismiss or cause to be dismissed any court 29
action with prejudice and pay any attorney's fees and costs 30
incurred by the patient or patient guarantor relating to the 31
action; and 32
(3) Remove or cause to be removed from the patient's 33
or patient guarantor's credit report any report made to a 34
consumer reporting agency relating to the debt. 35
4. Nothing in this section: 36
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(1) Prohibits a hospital from billing a patient, 37
patient guarantor, or third-party payer, including a health 38
insurer, for items or services provided to the patient; or 39
(2) Requires a hospital to refund any payment made to 40
the hospital for items or services provided to the patient, 41
so long as no collection action is taken in violation of 42
this section. 43
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