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SECOND REGULAR SESSION
SENATE BILL NO. 1705
103RD GENERAL ASSEMBLY
INTRODUCED BY SENATOR LEWIS.
6182S.02I KRISTINA MARTIN, Secretary
AN ACT
To amend chapter 376, RSMo, by adding thereto one new section relating to insurance coverage
of preventative health care services.
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 376.1180, to read as 2
follows:3
376.1180. 1. As used in this section, the following 1
terms mean: 2
(1) "Cost-sharing requirement", the same meaning as in 3
section 376.1183; 4
(2) "Health benefit plan", the same meaning as in 5
section 376.1350; 6
(3) "Health carrier", the same meaning as in section 7
376.1350. 8
2. Each health carrier or health benefit plan that 9
offers or issues health benefit plans that are delivered, 10
issued for delivery, continued, or renewed in this state on 11
or after January 1, 2026, shall provide coverage, and shall 12
not impose any cost-sharing requirement for: 13
(1) Evidence-based items or services that have in 14
effect a rating of A or B in the recommendations of the U.S. 15
Preventative Services Task Force with respect to the 16
individual involved; 17
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(2) Immunizations that have in effect a recommendation 18
from the Advisory Committee on Immunization Practices of the 19
Centers for Disease Control and Prevention with respect to 20
the individual involved; and 21
(3) Preventative care and screening provided for in 22
comprehensive guidelines supported by the Health Resources 23
and Services Administration. 24
3. To the extent otherwise permissible under federal 25
or state law, a health carrier or health benefit plan that 26
uses a network of providers may impose cost-sharing 27
requirements on the coverage described in subsection 2 of 28
this section for items or services delivered by an out-of- 29
network provider. 30
4. If an insured or enrollee is covered under a high 31
deductible health plan, as such term is defined in 26 U.S.C. 32
Section 223 (c)(2), a health carrier or health benefit plan 33
may apply the deductible requirement of the high deductible 34
health plan to the coverage required under subsection 2 of 35
this section, unless the director of the department of 36
commerce and insurance determines that the coverage is 37
included in the safe harbor provisions for preventative care 38
under 26 U.S.C. Section 223 (c)(2)(c). 39
5. The provisions of this section shall not be 40
construed to prohibit a health carrier or health benefit 41
plan from providing coverage for services in addition to 42
those recommended by the U.S. Preventative Services Task 43
Force or to deny coverage for services that are not 44
recommended by the Task Force. 45
6. The director of the department of commerce and 46
insurance shall enforce the provisions of this section 47
consistent with the recommendations and guidelines in effect 48
on December 31, 2025, set by the U.S. Preventative Services 49
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Task Force, the Advisory Committee on Immunization Practices 50
of the Centers for Disease Control and Prevention, or the 51
Health Resources and Services Administration, and related 52
federal rules or guidance. 53
7. The director shall, by rule, adopt regulations to 54
require health carriers and health benefit plans to provide 55
coverage without cost-sharing requirement for any 56
preventative health care services recommendations and 57
guidelines issued after December 31, 2025, by the U.S. 58
Preventative Services Task Force, the Advisory Committee on 59
Immunization Practices of the Centers for Disease Control 60
and Prevention, or the Health Resources and Services 61
Administration, and relating federal rules or guidance. 62
8. (1) The department of commerce and insurance shall 63
create an advisory committee to be known as the "Health 64
Insurance Preventative Health Care Services Advisory 65
Committee". This committee shall be comprised of five 66
members, with three representatives of health care providers 67
and two representatives of health carriers and health 68
benefit plans. All members of the committee shall be 69
appointed by, and serve at the pleasure of, the director of 70
the department. The committee members shall serve without 71
compensation and shall not be reimbursed for their expenses. 72
(2) The committee shall meet at least once a year to 73
make recommendations to the department, the general 74
assembly, and the governor regarding any updates or 75
modifications, as necessary, to the preventative health care 76
services described in subsection 2 of this section. The 77
committee shall provide any recommendations for updates or 78
modifications no later than November first each year to the 79
department, the general assembly, and the governor. 80
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9. Any rule or portion of a rule, as that term is 81
defined in section 536.010, that is created under the 82
authority delegated in this section shall become effective 83
only if it complies with and is subject to all of the 84
provisions of chapter 536 and, if applicable, section 85
536.028. This section and chapter 536 are nonseverable and 86
if any of the powers vested with the general assembly 87
pursuant to chapter 536 to review, to delay the effective 88
date, or to disapprove and annul a rule are subsequently 89
held unconstitutional, then the grant of rulemaking 90
authority and any rule proposed or adopted after August 28, 91
2026, shall be invalid and void. 92
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