Section 376.2020

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS

Chapter 376

Effective - 14 Oct 2016, see footnote   

  *376.2020.  Contracts prohibiting disclosure of certain payments and costs are unenforceable. — 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;

  (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.

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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.