Missouri Revised Statutes
Chapter 191 - Health and Welfare
Section 191.875 - Citation--definitions--estimate of cost provided, when--statement--disclosure of costs without discounts.

Effective - 14 Oct 2016
*191.875. Citation--definitions--estimate of cost provided, when--statement--disclosure of costs without discounts. — 1. This section shall be known as the "Health Care Cost Reduction and Transparency Act".
2. As used in this section, the following terms shall mean:
(1) "Ambulatory surgical center", as such term is defined under section 197.200;
(2) "Estimate of cost", an estimate based on the information entered and assumptions about typical utilization and costs for health care services. Such estimates of cost shall encompass only those services within the direct control of the health care provider and shall include the amount that will be charged to a patient for the health services if all charges are paid in full without a public or private third party paying for any portion of the charges;
(3) "Health care provider", any ambulatory surgical center, assistant physician, chiropractor, clinical psychologist, dentist, hospital, imaging center, long-term care facility, nurse anesthetist, optometrist, pharmacist, physical therapist, physician, physician assistant, podiatrist, registered nurse, or other licensed health care facility or professional providing health care services in this state. "Health care provider" shall also include any provider located in a Kansas border county, as defined under section 135.1670, who participates in the MO HealthNet program;
(4) "Hospital", as such term is defined under section 197.020;
(5) "Imaging center", any facility at which diagnostic imaging services are provided including, but not limited to, magnetic resonance imaging;
(6) "Medical treatment plan", a patient-specific plan of medical treatment for a particular illness, injury, or condition determined by such patient's health care provider, which includes the applicable current procedural terminology code or codes;
(7) "Public or private third party", a state government, the federal government, employer, health carrier as such term is defined under section 376.1350, third-party administrator, or managed care organization.
3. Beginning July 1, 2017, upon written request by a patient, which shall include a medical treatment plan from the patient's health care provider, for an estimate of cost of a particular health care service or procedure, imaging procedure, or surgery procedure, a health care provider shall provide, in writing, the estimate of cost to the patient electronically, by mail, or in person within three business days after receiving the written request. Providing a patient a specific link to such estimates of cost and making such estimates of cost publicly available or posting such estimates of cost on a website of the health care provider shall constitute compliance with the provisions of this subsection.
4. Health care providers shall include with any estimate of cost the following: "Your estimated cost is based on the information entered and assumptions about typical utilization and costs. The actual amount billed to you may be different from the estimate of costs provided to you. Many factors affect the actual bill you will receive, and this estimate of costs does not account for all of them. Additionally, the estimate of costs is not a guarantee of insurance coverage. You will be billed at the health care provider's charge for any service provided to you that is not a covered benefit under your plan. Please check with your insurance company to receive an estimate of the amount you will owe under your plan or if you need help understanding your benefits for the service chosen.".
5. Beginning July 1, 2017, hospitals shall make available to the public the amount that would be charged without discounts for each of the one hundred most prevalent diagnosis-related groups as defined by the Medicare program, Title XVIII of the Social Security Act. The diagnosis-related groups shall be described in layperson's language suitable for use by reasonably informed patients. Disclosure of data under this subsection shall constitute compliance with subsection 3 of this section regarding any diagnosis-related group for which disclosure is required under this subsection.
6. It shall be a condition of participation in the MO HealthNet program for a health care provider located in a Kansas border county, as defined under section 135.1670, to comply with the provisions of this section.
7. No health care provider shall be required to report the information required by this section if the reporting of such information reasonably could lead to the identification of the person or persons receiving health care services or procedures in violation of the federal Health Insurance Portability and Accountability Act of 1996 or other federal law. This section shall not apply to emergency departments, which shall comply with requirements of the Emergency Medical Treatment and Active Labor Act, 42 U.S.C. Section 1395dd.
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(L. 2016 S.B. 608)
*Effective 10-14-16, see § 21.250. S.B. 608 was vetoed July 5, 2016. The veto was overridden on September 14, 2016.

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Structure Missouri Revised Statutes

Missouri Revised Statutes

Title XII - Public Health and Welfare

Chapter 191 - Health and Welfare

Section 191.005 - Information exchange between departments, rulemaking authority.

Section 191.025 - Health care compact.

Section 191.116 - Alzheimer's state plan task force established — members, appointment, duties — report — expiration date.

Section 191.127 - Land may be leased for farming or grazing — procedure.

Section 191.150 - Purchase of food limited to use of institution inmates.

Section 191.160 - Board and living quarters for employees of institutions.

Section 191.170 - Mistreatment of inmates — penalty.

Section 191.180 - Furnishing unfit food to institution — penalty.

Section 191.190 - Accessory to mistreatment of inmates or furnishing of unwholesome food — penalty.

Section 191.210 - Attendance of patient by private physician.

Section 191.211 - Funding of certain programs.

Section 191.213 - Additional funding sources for certain programs.

Section 191.226 - Costs of HIV testing for certain crime victims payable by department of health and senior services, when, conditions.

Section 191.227 - Medical records to be released to patient, when, exception — fee permitted, amount — liability of provider limited — annual handling fee adjustment — disclosure of deceased patient records, when.

Section 191.228 - Physician and pharmacist not subject to discipline for cooperation.

Section 191.229 - Accreditation of not-for-profit human services organizations deemed equivalent to licensure.

Section 191.231 - Community-based integrated delivery system, qualification, powers — organization, board of directors, powers — plans.

Section 191.235 - Mercury contained in immunizations, not to be administered to certain persons — insurance reimbursement for nonmercury immunizations — exemptions, when.

Section 191.237 - Failure to participate in health information organization, no fine or penalty may be imposed — no exchange of data, when — definitions.

Section 191.250 - Citation of law — definitions — DNR orders, requirements — revocation of consent — appointment of guardian, when — continuation of treatment not required, when.

Section 191.300 - Definitions.

Section 191.305 - Missouri genetic advisory committee created — purpose — appointment, terms — qualifications — expenses.

Section 191.310 - Duties of committee — liaison officers with mental health and education, appointment.

Section 191.315 - Genetics program to be established by department — rules authorized — procedure.

Section 191.317 - Confidentiality of all tests and personal information — exceptions — retention of specimens, procedure.

Section 191.320 - Genetic diagnostic and counseling services to be established — outreach centers, duties — referral for abortion, procedure, requirements.

Section 191.323 - Powers and duties of department of health and senior services in prevention and treatment of genetic diseases and birth defects.

Section 191.325 - Cost of services, how paid — free to persons financially unable to pay — residency requirement.

Section 191.331 - Infants to be tested for metabolic and genetic diseases — reports — exceptions — refusal to test — fee for screening test, department may impose by rule, use of fees — formula provided by department, when — assistance available, whe...

Section 191.332 - Supplemental newborn screening requirements — additional screenings — rulemaking authority.

Section 191.333 - Citation of law — screening for lysosomal storage diseases — rulemaking authority — fee increase authorized.

Section 191.334 - Chloe's Law — critical congenital heart disease screening, requirements — rulemaking authority.

Section 191.335 - Hemophilia program established — state assistance, when.

Section 191.340 - Hemophilia program — care and treatment — financial assistance — education — duties of department.

Section 191.360 - Trained employee of end-stage renal disease facility may initiate dialysis — not unlawful practice of medicine.

Section 191.362 - Appropriately trained employees to have completed course in dialysis techniques.

Section 191.365 - Sickle cell anemia — purposes of program — financial assistance, when.

Section 191.370 - Sickle cell anemia, development of program for care and treatment — duties of department.

Section 191.375 - Cystic fibrosis, program for care and treatment — financial assistance, when.

Section 191.380 - Cystic fibrosis, duties of department.

Section 191.400 - State board of health and senior services — appointment — terms — qualifications — limitation on other employment, exception — vacancies — compensation — meetings.

Section 191.411 - System of coordinated health care services — health access incentive fund created, purpose — enhanced Medicaid payments — rules — annual report.

Section 191.425 - Program established, eligibility — contracting authority — conditional on receipt of federal funding — sunset provision.

Section 191.480 - Manufacturers may make investigational drugs and devices available to eligible patients, when — definitions — requirements.

Section 191.500 - Definitions.

Section 191.505 - Department of health and senior services to administer — may make rules and regulations.

Section 191.510 - Contracts for loans to include terms.

Section 191.515 - Requirements for application.

Section 191.520 - Maximum amount of loans — source of funds.

Section 191.525 - Number of loans available — to whom — length of loans.

Section 191.530 - Interest on loans — repayment terms — temporary deferral.

Section 191.535 - Termination of course of study, effect.

Section 191.540 - Repayment schedules — breach of contract.

Section 191.545 - Recovery — actions for.

Section 191.550 - Approval of contracts.

Section 191.594 - Citation of law — prevalence of depression and suicide study — prohibited acts — definitions.

Section 191.596 - Research project authorized — committee established, members, duties — center study, contents — annual report.

Section 191.600 - Loan repayment program established — health professional student loan repayment program fund established — use.

Section 191.603 - Definitions.

Section 191.605 - Department to designate as areas of need — factors to be considered.

Section 191.607 - Qualifications for eligibility established by department.

Section 191.609 - Contract for repayment of loans, contents.

Section 191.611 - Loan repayment program to cover certain loans — amount paid per year of obligated service — schedule of payments — communities sharing costs to be given first consideration.

Section 191.614 - Termination of medical studies or failure to become licensed doctor, liability — breach of contract for service obligation, penalties — recovery of amount paid by contributing community.

Section 191.615 - Application for federal funds — insufficient funds, effect.

Section 191.630 - Definitions.

Section 191.631 - Testing for disease, consent deemed given, when — hospital to conduct testing, written policies and procedures required — notification for confirmed exposure, by whom — limitations on testing and duties of hospitals, coroners, and m...

Section 191.640 - Blood-borne pathogen standard required for occupational exposure of public employees to blood and other infectious materials — definitions — requirements of needleless system and sharps — violations, penalty.

Section 191.645 - Risk of exposure to Hepatitis C, information to be made available — website to be maintained, content.

Section 191.648 - Expedited partner therapy permitted, requirements for physicians utilizing — rulemaking authority.

Section 191.650 - Definitions.

Section 191.653 - HIV testing performed by whom, how — consultation with subject required, when.

Section 191.656 - Confidentiality of reports and records, exceptions — violation, civil action for injunction, damages, costs and attorney fees — health care provider participating in judicial proceeding, immune from civil liability.

Section 191.657 - Disclosure of confidential HIV information, by court order, only to certain persons, procedure, when.

Section 191.658 - HIV infection status disclosure by department of health and senior services to exposed health workers or law enforcement officers, when, violation, penalty.

Section 191.659 - Department of corrections, HIV and infectious diseases testing without right of refusal — exception — minors victim of sexual assault, testing, notice to parents or custodians required.

Section 191.662 - Department of mental health, permissive HIV testing without right of refusal, when — results of testing not to be reported to department of health and senior services, when.

Section 191.663 - HIV testing, defined — court order to test certain sexual offenders — costs — bond — disclosure of results of test — parents of unemancipated minor informed, when.

Section 191.665 - Discrimination prohibited, exceptions.

Section 191.668 - Department of health and senior services and department of elementary and secondary education to prepare education programs, contents.

Section 191.671 - Insurance companies, HMOs or health service corporations, HIV testing by, regulation by department — disclosure of test results, confidentiality.

Section 191.674 - Court-ordered HIV testing without right of refusal, department of health and senior services may seek, when — court record closed, proceeding to be in camera, when.

Section 191.677 - Serious infectious or communicable diseases, prohibited acts, criminal penalties — affirmative defense — use of pseudonym, when.

Section 191.680 - Maintaining a nuisance, abatement to be ordered, when.

Section 191.683 - Reports to general assembly by department of health and senior services.

Section 191.686 - Anonymous testing sites in central Missouri, Kansas City, Springfield and St. Louis — reports of results, use of coded system — contact notification required, when.

Section 191.689 - Schools to be given notice of identity of child with HIV infection, when, by whom — identity of infected child may be released to whom by school.

Section 191.692 - Premarital HIV testing, rulemaking authorized, when.

Section 191.694 - Infection control procedures — requirements and training for health care facilities and professionals.

Section 191.695 - Rulemaking authority, department of health and senior services — procedure.

Section 191.699 - Disciplinary action for health care professionals who discriminate or require HIV testing before treatment.

Section 191.700 - Testing of all health care professionals not justified — voluntary and confidential evaluation of infected professional, procedure — expert review panel qualifications, powers and duties, practice restrictions, when — health care fa...

Section 191.703 - Death of patient with infectious or contagious disease, notification to funeral director or coroner.

Section 191.710 - MO HealthNet program and SCHIPS to focus on premature infant health care.

Section 191.711 - Education publications to be prepared, contents — distribution.

Section 191.724 - Discrimination based on religious beliefs or moral convictions prohibited, health plan coverage of abortion — no mandatory employee coverage of certain procedures — attorney general to enforce — sterilization defined.

Section 191.725 - Physician to counsel pregnant patients on effects of cigarettes, alcohol and controlled substances — certifying form to be signed by patient on counseling — educational materials to be furnished to physicians.

Section 191.729 - School districts to be furnished information on prenatal and postnatal effects of substances, when.

Section 191.731 - Pregnant woman referred for substance abuse to have priority for treatment — confidentiality of records.

Section 191.737 - Children exposed to substance abuse, referral by physician to children's division — physician making referral immune from civil liability — confidentiality of report.

Section 191.739 - Protective and preventive services to be provided by department of social services, duties.

Section 191.748 - Shaken baby syndrome video, required viewing, when.

Section 191.755 - Department to post resources on website, content.

Section 191.756 - Grants awarded by board of health and senior services — eligibility criteria.

Section 191.758 - Information to be made available by physician to pregnant women, when.

Section 191.761 - Umbilical cord blood samples, department to provide courier service to nonprofit umbilical cord blood bank — rulemaking authority.

Section 191.765 - Definitions.

Section 191.767 - Persons not to smoke in public places or meetings, except in designated smoking areas — designation of space for smoking area, requirements.

Section 191.769 - Areas not considered public places.

Section 191.771 - Person in control of public places or public meetings, duties.

Section 191.773 - Violators, guilty of infraction.

Section 191.775 - Public schools and school buses — smoking, or tobacco or vapor product use prohibited — permissible use of tobacco, where.

Section 191.776 - Child day care facilities, smoking or tobacco use when children are present, prohibited, penalty.

Section 191.777 - More stringent ordinances or rules may be adopted by governing bodies or school boards.

Section 191.800 - Definitions.

Section 191.803 - Boards of education to establish breakfast program — rules — waiver, procedure.

Section 191.805 - Hardship grant program, distribution of, rules.

Section 191.807 - Supplemental funding, women, infants and children supplemental food program — funding of certain county health offices, use, maximum amount of grants — rules and regulations.

Section 191.810 - Department of health and senior services to establish standards for summer food service program — where established — order of priority — waiver, filing required.

Section 191.813 - Agencies to coordinate outreach programs — specific programs — public service announcements to be designed.

Section 191.815 - Administrative rules, procedure.

Section 191.828 - Evaluations, effect of initiatives.

Section 191.831 - Health initiatives fund established, use — Alt-care pilot program, components — participation may be required.

Section 191.835 - Community 2000 grants program — local commissions, members — goals, objectives — evaluations, funding.

Section 191.839 - Education programs for persons with no or inadequate health insurance.

Section 191.843 - Authorizes grants for regional research consortia in a distressed community.

Section 191.875 - Citation--definitions--estimate of cost provided, when--statement--disclosure of costs without discounts.

Section 191.900 - Definitions.

Section 191.905 - False statement to receive health care payment prohibited — kickback, bribe, purpose, prohibited, exceptions — abuse prohibited — penalty — prosecution, procedure — Medicaid fraud reimbursement fund created — restitution — civil pen...

Section 191.907 - Original source of information to receive a portion of any recovery.

Section 191.908 - Whistleblower protections — violations, penalty.

Section 191.910 - Attorney general may investigate violations, powers — service authorized — prosecuting attorney, report, prosecution — provision of records — no limitation of other actions.

Section 191.914 - False report or claim, penalty.

Section 191.915 - Breast-feeding information provided, when, by whom.

Section 191.918 - Breast-feeding in public permitted — not sexual conduct, public indecency, or obscenity — no municipal ordinances to prohibit or restrict.

Section 191.923 - Prenatally diagnosed conditions, patient to be provided information — definitions — clearinghouse of information to be established.

Section 191.925 - Screening for hearing loss, infants, when — procedures used — exemptions — information provided, by whom — no liability, when.

Section 191.928 - Surveillance and monitoring system for certain newborns — standards and follow-up procedure — confidentiality of information.

Section 191.931 - Early intervention services available — report, content.

Section 191.937 - Rulemaking authority, procedure.

Section 191.940 - Citation of law — definitions — hospitals and ambulatory surgical centers to provide information about postpartum depression.

Section 191.950 - Prostate cancer pilot programs — definitions — eligibility — services provided — grants — rulemaking authority — sunset provision.

Section 191.975 - Adoption awareness, department duties — advertising campaign authorized — rulemaking authority.

Section 191.980 - Missouri area health education centers program established — authority of director — duties.

Section 191.990 - Diabetes goals and benchmarks — report, contents.

Section 191.1050 - Definitions.

Section 191.1053 - Designation of areas — re-evaluation of designations, when — rulemaking authority.

Section 191.1056 - Fund created, use of moneys.

Section 191.1075 - Definitions.

Section 191.1080 - Council created, purpose, members, terms, duties — report — expiration date.

Section 191.1085 - Program established, purpose — website information — rulemaking authority.

Section 191.1100 - Citation of law — definitions.

Section 191.1102 - Additional licensure not required, when — inapplicability.

Section 191.1104 - Display of license or certificate, how satisfied.

Section 191.1106 - Registration with department required, fee, contents — quarterly reports — list of providers — recordkeeping requirements — rulemaking authority.

Section 191.1110 - Immunity from liability, when — no compensation to be received — certain military personnel deemed licensed.

Section 191.1112 - Volunteer crisis response teams — definitions — immunity from liability, inapplicability of.

Section 191.1140 - Treatment of chronic, common, and complex diseases, program authorized, purpose.

Section 191.1145 - Definitions — telehealth services authorized, when.

Section 191.1146 - Physician-patient relationship required, how established.

Section 191.1150 - Citation of law — definitions — designation of caregiver, when — requirements.

Section 191.1164 - Citation of law — definitions.

Section 191.1165 - Medication-assisted treatment — formulary medications and requirements — disclosure of MAT services provided — incarcerated persons and diversion program participants, assessment for substance use disorders.

Section 191.1167 - Contracts, policies, or procedures in violation of act deemed null and void.

Section 191.1168 - Severability clause.

Section 191.1400 - Citation of law — definitions — compassionate care visits to be permitted, policy — limitations — informational materials — violations may be reported — immunity from liability, when.

Section 191.1601 - Citation of law.

Section 191.1603 - Definitions.

Section 191.1604 - Long-term dignity savings account, use, requirements.

Section 191.1605 - Accounts, use of moneys — withdrawals, recapture — death of account holder, effect of.

Section 191.1606 - Reporting, forms — rulemaking authority.

Section 191.1607 - Financial institutions, requirements — no responsibility or liability, when.

Section 191.2290 - Citation of law — definitions — state of emergency, designated essential caregiver designation — requirements.