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Resource Use (Cost/Utilization) Measurement and Reporting in Missouri

        Hospitals are required to report certain financial data to the Department of Health annually.1  The law also allows health insurers who provide group insurance to employers to provide the employer with the total amount of claims paid under the plan for each year, if the information is requested by the employer.2  Interestingly, the law also allows hospitals that have provided uncompensated care to uninsured patients, who are not eligible for medical assistance, to file a claim to be reimbursed for the care by the Department.3

 

Footnotes

  • 1. 19 CSR 10-33.030
  • 2. V.A.M.S. 376.435
  • 3. V.A.M.S. 143.790

 

Resource Use (Cost/Utilization) Measurement and Reporting in Missouri

Subtopic Statute/Regulation Description
Resource Use (Cost/Utilization) Measurement and Reporting Hospital Requirements for Reporting Financial Data - Mo. Code Regs. Ann. tit. 19, § 10-33.030 Hospitals are required to report specific financial information to the Department of Health each year.  The Department may use this data in the...
Reporting Requirements for Claim Information - Mo. Rev. Stat. §376.435 A health insurer providing a group health benefit plan to an employer must provide the employer with the total amount of claims paid under the plan...
Requirements for Submitting Claims for Unpaid Services - Mo. Rev. Stat. §143.790 Hospitals or health care providers who have provided health care services to an individual who is uninsured or not eligible for Medicaid or CHIP...