HCS/SS/SB 817 - This act modifies provisions relating to anatomic pathology and vision services.
ANATOMIC PATHOLOGY SERVICES
This act provides that no licensed health care professional shall charge, bill, or solicit payment for anatomic pathology services, unless the services are rendered personally by the health care professional or under the health care professional's direct supervision. However, this act does not prohibit billing of a referring laboratory for services when samples must be sent to another specialist, nor is it prohibited to bill a referring physician who has provided a written confirmation that the patient is not covered under a health benefit program, which is defined under the act. A referring physician shall not be prohibited from sending a patient's specimen to any laboratory providing anatomic pathology services.
The provisions of the act do not prohibit the billing of anatomic pathology services:
- To a referring laboratory, or by a referring laboratory, in instances where a sample or samples must be sent to another specialist;
- By a hospital, public health clinic, or non-profit health clinic;
- To a referring physician, or by a referring physician, who has provided written confirmation to the physician or laboratory providing the anatomic pathology service that the patient is not covered under a health care benefit program; or
- By any governmental agency or their specified public or private agent.
A clinical laboratory or physician who sends a bill to a patient who is not covered by a healthcare benefit program shall provide the name and address of the physician or laboratory performing the anatomic pathology service and the net amount to be paid to the physician or laboratory for each anatomic pathology service.
No patient, insurer, third-party payor, hospital, public health clinic, or nonprofit health clinic shall be required to reimburse any licensed health care professional for charges or claims submitted in violation of this act. The licenses of health care professionals violating the provisions of this act may be subject to disciplinary action.
Nothing in this section shall be construed to prohibit a referring physician from sending a patient's specimen to any laboratory providing anatomic pathology services. It shall also not be prohibited to mandate the billing of any patient not covered under a health care benefit program.
This provision is similar to SB 467 (2007).
INCREASED FEES FOR MEDICAL RECORDS
This act increases the fee to health care providers for copies of medical records from $17.05 plus 40 cents per page for the cost of supplies and labor, to $19.31 plus 46 cents per page. Current law previously prohibited notary fees for medical records from exceeding $2. This act increases the fee to provide that the combination of the notary and certification fee, if certification is requested, cannot exceed $8. SECTION 191.227
This provision is identical to HB 1815 (2008).
EYE CARE PROVIDERS
This act also provides that a health carrier shall be prohibited either directly or indirectly from discriminating between eye care providers when:
-selecting among providers of health care services for enrollment in the network;
-referring enrollees for health care services provided within the scope of those professional licenses and
-reimbursing amounts for covered services among persons unduly licensed to provide such services.
A health carrier shall not directly or indirectly refuse to select an eye care provider for the network solely on the grounds that not all eye care providers in a group practice agree to participate in the health carrier's provider network or that the provider is not a retailer of frames and corrective lenses.
If optometric services are being provided in connection to a treatment plan for corrective surgery, a health carrier shall not directly or indirectly act on issue of selecting an eye care provider for the network, referring enrollees for health services or reimbursing covered services in a discriminatory manner.
A health carrier shall not require a licensed optometrist who provides basic medical eye care to participate solely through an intermediary if such health carrier permits ophthalmologists to contract directly with the health carrier.