Missouri Laws 376.2020 – Contracts prohibiting disclosure of certain payments and costs are ..
1. For purposes of this section, the following terms shall mean:
(1) “Contractual payment amount” or “payment amount”, shall mean the total amount a health care provider is to be paid for providing a given health care service pursuant to a contract with a health carrier, and includes both the portions to be paid by the patient and by the health carrier. It is commonly referred to as the allowable amount;
Terms Used In Missouri Laws 376.2020
- Contract: A legal written agreement that becomes binding when signed.
- following: when used by way of reference to any section of the statutes, mean the section next preceding or next following that in which the reference is made, unless some other section is expressly designated in the reference. See Missouri Laws 1.020
- Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
- Guardian: if used in a section in a context relating to property rights or obligations, means conservator of the estate as defined in chapter 475. See Missouri Laws 1.020
- person: may extend and be applied to bodies politic and corporate, and to partnerships and other unincorporated associations. See Missouri Laws 1.020
(2) “Enrollee”, shall have the same meaning ascribed to it in section 376.1350;
(3) “Health care provider”, shall have the same meaning ascribed to it in section 376.1350;
(4) “Health care service”, shall have the same meaning ascribed to it in section 376.1350;
(5) “Health carrier”, shall have the same meaning ascribed to it in section 376.1350.
2. No provision in a contract in existence or entered into, amended, or renewed on or after August 28, 2016, between a health carrier and a health care provider shall be enforceable if such contractual provision prohibits, conditions, or in any way restricts any party to such contract from disclosing to an enrollee, or such person‘s parent or legal guardian, the contractual payment amount for a health care service if such payment amount is less than the health care provider’s usual charge for the health care service, and if such contractual provision prevents the determination of the potential out-of-pocket cost for the health care service by the enrollee, parent, or legal guardian.