Missouri State Senate

Senate Committee Substitute

SCS/SB 197 – This act requires a physician who orders an anatomic pathology service for a patient and does not supervise or perform a component of the service to disclose in any bill presented to the patient, insurer, or other third party payor the name and address of the physician or laboratory that provided the service and the actual amount paid or to be paid for each service by the physician or laboratory that performed the service.

The disclosure is not required when the anatomic pathology service has been ordered by a hospital, nonprofit or public health clinic, or a state or federal agency on behalf of the patient. Any physician subject to the disclosure requirement shall not charge a markup, commission, or profit on the actual amount paid for each anatomic pathology service by the physician or laboratory that performed the service. However, a physician taking a patient specimen may make an acquisition charge or processing charge that is coded distinctly from the pathology service.

No patient, insurer, or third party payor is required to reimburse a licensed health care professional for charges submitted for pathology services that are not in accordance with this act. The licenses of health care professionals violating the provisions of this act may be subject to disciplinary action.

This act is similar to SB 817 (2008), SB 467 (2007) and SB 1076 (2006).