SB 103
Modifies provisions relating to health care services
LR Number:
Last Action:
5/17/2019 - H Informal Calendar Senate Bills for Third Reading (HCS)
Journal Page:
HCS SB 103
Calendar Position:
Effective Date:
August 28, 2019
House Handler:

Current Bill Summary

HCS/SB 103 - This act modifies provisions relating to health care services.


This act specifies that health carriers and managed care plans shall pay benefits directly to "ground and not-for-profit, hospital-based air ambulance services", rather than to "ambulance services" generally.

This provision is similar to a provision in SCS/SB 267 (2019), and to HB 493 (2019).


This act specifies that all short-term major medical policies delivered or issued for delivery in the state shall include on applications and fact pages a conspicuous and clearly labeled paragraph stating that the policy may not cover preexisting conditions or essential health benefits, and a recommendation to discuss the policy with the individual's insurance broker. (Section 376.008.1)

No short-term major medical policy shall be delivered or issued for delivery in this state until the prospective insured has confirmed receipt of a benefit summary statement, as defined in the act. (Section 376.008.2)

The act specifies that for short-term major medical policies with durations of less than one year, health carriers shall permit individuals to learn the amount of cost-sharing he or she would have to pay for a particular item or service from a participating provider. (Section 376.446)

This act exempts short-term major medical policies with durations of less than one year from the requirement to offer policy renewals. (Section 376.452 and 376.454)

The act requires the actuarial analysis undertaken by the Joint Committee on Legislative Research between September 1, 2013, and December 31, 2013, to assume that certain coverages do not apply short-term major medical policies with durations less than one year. (Section 376.1192)

This act also specifies that certain health insurance mandates shall not apply to short-term major medical policies with durations of less than one year. The act exempts the policies from mandates regarding:

• Human immunodeficiency virus infection (section 191.671);

• Diabetes (section 376.385);

• Clinical trial coverage (section 376.429);

• Alcoholism treatment (section 376.779);

• Speech and hearing disorders (section 376.781);

• Mammography screenings (section 376.782);

• Chemical dependency (section 376.811);

• Eating disorders (section 376.845);

• Obstetrical/gynocological services (section 376.1199);

• Breast cancer (section 376.1200);

• Mastectomy reconstruction and prosthetics (section 376.1209);

• Maternity (section 376.1210);

• Childhood immunizations (section 376.1215);

• First Steps for children eligible for Part C early intervention (section 376.1218);

• Phenylketonuria (PKU) testing and formula (section 376.1219);

• Newborn infant hearing screening (section 376.1220);

• Autism spectrum disorders (section 376.1224);

• Hospital dental procedures (section 376.1225);

• Chiropractic care (section 376.1230);

• Prosthetics (section 376.1232);

• Physical and occupational therapy (section 376.1235);

• Refills for prescription eyedrops (section 376.1237);

• Cancer screenings (section 376.1250);

• Second opinion for cancer diagnosis (section 376.1253);

• Oral chemotherapy (section 376.1257);

• Antigen testing for bone marrow transplants (section 376.1275);

• Lead testing (section 376.1290);

• Explanations of benefits (section 376.1400);

• Mental health parity (section 376.1550); and

• Telehealth services (section 376.1900).

These provisions are identical to provisions in the House perfected HB 83 (2019), and similar to SCS/SB 48 (2019), HB 582 (2019), HB 1020 (2019), the House perfected HCS/HB 1685 (2018), provisions in SS/SCS/SB 860 (2018), HB 708 (2017), and HCB 10 (2017).


This act specifies that health care professionals shall, rather than may, utilize the process outlined in statute for claims for unanticipated out-of-network care.

This provision is identical to a provision in the truly agreed to and finally passed SS/SCS/HCS/HB 399 (2019), provisions in the truly agreed to and finally passed SB 514 (2019), provisions in the perfected HB 83 (2019), provisions in SS#2/HB 219 (2019), the perfected HB 756 (2019), provisions in HCS/HB 1235 (2019), provisions in HCS/SS/SCS/SBs 70 & 128 (2019), provisions in HCS/SB 275 (2019).


This act prohibits health carriers and entities acting on their behalf from restricting methods of reimbursement to a method requiring health care providers to pay a fee to redeem the amount of their claim for reimbursement.

Health carriers initiating or changing the method used to reimburse a health care provider to a method of reimbursement requiring a fee shall "notify the health care, [sic] provider of the fee, discount, or other remuneration required to received [sic] reimbursement through a new or different reimbursement method". The notice shall provide clear instructions to the provider as to how to select a different reimbursement method, and upon request, the carrier shall use such method until the provider requests otherwise.

Health carriers shall allow providers to select to be reimbursed by an electronic funds transfer through the Automated Clearing House Network as required by federal law.

Violation of these provisions shall be deemed an unfair trade practice under the Unfair Trade Practice Act.

These provisions are similar to SB 302 (2019), HB 492 (2019), provisions in the truly agreed to and finally passed HB 514 (2019), provisions in the truly agreed to and finally passed SS/SCS/HCS/HB 399 (2019), provisions in SS#2/HB 219 (2019), provisions in HCS/HB 751 (2019), and provisions in SCS/SB 298 (2019).



No Amendments Found.