Read the full stored bill text
7075S.02C
1
SENATE COMMITTEE SUBSTITUTE
FOR
SENATE BILL NO. 1635
AN ACT
To repeal section 376.1190, RSMo, and to enact in
lieu thereof two new sections relating to state health
plans.
Be it enacted by the General Assembly of the State of Missouri, as follows:
Section A. Section 376.1190, RSMo, is repealed and two
new sections enacted in lieu thereof, to be known as sections
103.180 and 376.1190, to read as follows:
103.180. 1. Beginning January 1, 2027, pursuant to
the provisions of section 376.1190, the board of the
Missouri consolidated health care plan shall implement any
new health care benefit mandate enacted by the general
assembly. Such mandates shall include requirements for the
provision of specific health care services, specific
diseases, or for certain health care providers. Coverage of
a new health care benefit mandate under the Missouri
consolidated health care plan shall be effective for a
period of thirty-six consecutive months.
2. No later than July first of the year following the
first full calendar year of coverage for a new health care
benefit mandate and quarterly thereafter, the board of the
Missouri consolidated health care plan shall submit to the
director of the department of commerce and insurance data
outlining the impact of the new health care benefit
mandate. Such data shall not include personal health
information of any enrollee and shall be given confidential
treatment and not be subject to subpoena, nor be made
publicly available by the director or any other person. The
2
contents of the report shall include, but not be limited to
the following data:
(1) Number of covered individuals utilizing the
benefit mandate;
(2) Overall cost to the plan to provide the services
required by the benefit mandate;
(3) The operational costs to the plan associated with
the implementation of the benefit mandate;
(4) The cost to provide the services required by the
benefit mandate on a per insured per month basis, and on the
basis of the total average cost of such coverage per insured
per month.
3. No later than March first of the year following the
second full calendar year of coverage for a new health
benefit mandate, the director of the department of commerce
and insurance shall submit to the president pro tempore of
the senate and the speaker of the house of representatives a
final report outlining the impact of the new health care
benefit mandate on the Missouri consolidated health care
plan, including data on utilization and costs of such new
mandate, containing the same set of data elements required
by subsection 2 of this section.
376.1190. 1. Any new health care benefit mandate
[proposed] enacted after August 28, [2011,] 2026, which
would require a health carrier to provide coverage under a
health benefit plan for specific health care services,
specific diseases, or for certain health care providers
shall [be subject to review by the oversight division of the
joint committee on legislative research. The oversight
division shall perform an actuarial analysis of the cost
impact to private and public payers of any new or revised
mandated health care benefit proposed by the general
assembly after August 28, 2011, and a recommendation shall
3
be delivered to the speaker and the president pro tem prior
to mandate being enacted] only apply to the Missouri
consolidated health care plan established in chapter 103.
Such coverage under the Missouri consolidated health care
plan shall be effective for a period of thirty-six
consecutive months and shall remain in effect until the
general assembly takes action pursuant to subsection 2 of
this section or expires pursuant to subsection 3 of this
section.
2. Prior to continuing the mandate for the Missouri
consolidated health care plan or extending the applicability
of any new health care benefit mandate to health benefit
plans offered by health carriers in this state pursuant to
the provisions of this chapter, the general assembly shall
conduct a thorough review of the report prepared pursuant to
section 103.180 and take legislative action. Any such
legislation to extend the applicability of a new mandate
shall include whether to extend the new health care benefit
mandate to health benefit plans as defined in section
376.1350, the health care plan as defined in section
103.003, or both.
3. Absent legislative action taken by the general
assembly to extend the new mandate to health benefit plans
offered by health carriers in this state or continuation of
the mandate for the health care plan as defined in section
103.003, the new health care benefit mandate shall
automatically expire.