SB1504 • 2026

Modifies payments to ambulance providers

Passed Legislature

This bill passed both chambers and reached final enrollment, even if later executive action is not shown here.

Sponsor: Henderson, Mike; House handler: N/A
Last action: 2026-02-05
Official status: Second Read and Referred S Insurance and Banking Committee
Effective date: 2026-08-28

Plain English Breakdown

Using official source text because the generated explanation was unavailable or could not be confirmed against the official bill text.

Modifies payments to ambulance providers

The following summaries of this bill are available: Print All Summaries Introduced Print SB 1504 - This act sets the minimum allowable reimbursement rate to an out-of-network ambulance provider for services provided to enrollees and limits co-payment, coinsurance, deductibles, and other cost sharing amounts to the in-network payment amount for covered services.

What This Bill Does

The following summaries of this bill are available: Print All Summaries Introduced Print SB 1504 - This act sets the minimum allowable reimbursement rate to an out-of-network ambulance provider for services provided to enrollees and limits co-payment, coinsurance, deductibles, and other cost sharing amounts to the in-network payment amount for covered services.
Ambulance providers are prohibited from billing enrollees any additional amounts for paid covered services.
Health carriers are required to remit payment for ambulance services directly to the ambulance provider rather than the enrollee within thirty days of receipt of a clean claim, as such term is defined in the act.
Upon receipt of a claim that is not clean, health carriers are required to specify the reason for declining payment in whole or in part and the additional information necessary to determine if the claim is payable in whole or part.

Limits and Unknowns

This entry is temporarily using official source text because the generated explanation could not be confirmed against the official bill text during the last sync.

Bill History

2026-02-05 S307
Second Read and Referred S Insurance and Banking Committee
2026-01-07 S98
S First Read
2026-01-06 Missouri House of Representatives and Missouri Senate
Prefiled

Official Summary Text

The following summaries of this bill are available:

Print All Summaries

Introduced

Print

SB 1504 - This act sets the minimum allowable reimbursement rate to an out-of-network ambulance provider for services provided to enrollees and limits co-payment, coinsurance, deductibles, and other cost sharing amounts to the in-network payment amount for covered services. Ambulance providers are prohibited from billing enrollees any additional amounts for paid covered services.

Health carriers are required to remit payment for ambulance services directly to the ambulance provider rather than the enrollee within thirty days of receipt of a clean claim, as such term is defined in the act.

Upon receipt of a claim that is not clean, health carriers are required to specify the reason for declining payment in whole or in part and the additional information necessary to determine if the claim is payable in whole or part.

This act is identical to HB 2597 (2026).
TAYLOR MIDDLETON

Current Bill Text

Read the full stored bill text

SECOND REGULAR SESSION
SENATE BILL NO. 1504
103RD GENERAL ASSEMBLY
INTRODUCED BY SENATOR HENDERSON.
6485S.01I KRISTINA MARTIN, Secretary
AN ACT
To amend chapter 376, RSMo, by adding thereto one new section relating to payments to
ambulance providers.
Be it enacted by the General Assembly of the State of Missouri, as follows:
Section A. Chapter 376, RSMo, is amended by adding thereto 1
one new section, to be known as section 376.684, to read as 2
follows:3
376.684. 1. As used in this section, unless the 1
context indicates otherwise, the following terms mean: 2
(1) "Ambulance provider", any ambulance service, as 3
defined in section 190.100. The term "ambulance provider" 4
shall not include an air ambulance provider; 5
(2) "Clean claim", a claim that has no defect or 6
impropriety, including any lack of required substantiating 7
documentation or particular circumstance requiring special 8
treatment that prevents timely payment from being made on 9
the claim; 10
(3) "Covered services", those emergency ambulance 11
services that an enrollee is entitled to receive under the 12
terms of a health benefit plan; 13
(4) "Enrollee", the same meaning given to the term in 14
section 376.1350; 15
(5) "Health benefit plan", the same meaning given to 16
the term in section 376.1350; 17
SB 1504 2
(6) "Health carrier", the same meaning given to the 18
term in section 376.1350; 19
(7) "Out-of-network ambulance provider", an ambulance 20
provider that does not contract with the health carrier of 21
the enrollee receiving the covered services. 22
2. The minimum allowable reimbursement rate under any 23
health benefit plan issued by any health carrier to an out- 24
of-network ambulance provider for providing emergency 25
services shall be: 26
(1) At the rates set or approved, whether in contract 27
or ordinance, by a local governmental entity in the 28
jurisdiction in which the covered services originate, or as 29
provided for in section 190.105; or 30
(2) In the absence of rates as provided in subdivision 31
(1) of this subsection, three hundred twenty-five percent of 32
the current published rate for ambulance services, as 33
established by the Centers for Medicare and Medicaid 34
Services under Title XVIII of the Social Security Act for 35
the same service provided in the same geographic area, or 36
the ambulance provider's billed charges, whichever is less. 37
3. Payment made in compliance with this section shall 38
be considered payment in full for the covered services 39
provided, except for any co-payment, coinsurance, 40
deductible, and other cost-sharing amounts required to be 41
paid by the enrollee. An ambulance provider is prohibited 42
from billing the enrollee for any additional amounts for 43
paid covered services. 44
4. All co-payment, coinsurance, deductible, and other 45
cost-sharing amounts provided by subsection 3 of this 46
section shall not exceed the in-network co-payment, 47
coinsurance, deductible, and other cost-sharing amounts for 48
the covered services received by the enrollee. 49
SB 1504 3
5. A health carrier shall, within thirty days after 50
receipt of a clean claim for covered services, promptly 51
remit payment for ambulance services directly to the 52
ambulance provider and shall not send payment to an enrollee. 53
6. If the claim is not a clean claim, the health 54
carrier shall, within thirty days after receipt of the 55
claim, send a written notice acknowledging the date of the 56
receipt of the claim and shall specify: 57
(1) That the health carrier is declining to pay all or 58
part of the claim and the specific reason or reasons for the 59
denial; or 60
(2) That additional information is necessary to 61
determine if all or part of the claim is payable and the 62
specific additional information that is required. 63
7. To the extent that this section conflicts with 64
section 376.690 or any other provision of law, this section 65
shall prevail. 66
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