Off-campus hospital departments would use separate billing numbers

Each covered off-campus department would have to get and use its own provider number on claims. This covers hospital-affiliated outpatient departments located more than 250 yards from the hospital's main campus that provide integrated outpatient care. The number must differ from the one used by the hospital's main campus and its other off-campus locations. The separate number would be required on claims submitted after December 31, 2026.

Facilities would have to use the separate number and a required claim form or electronic format when billing insurers. These rules cover health care given to an enrollee at a covered off-campus outpatient department. Insurers would not have to pay claims that do not follow these rules. A facility could not make the patient pay if it failed to follow them; violations would be subject to enforcement under Missouri's consumer protection law. The section would apply to claims submitted after December 31, 2026.

The health department could penalize licensees that violate the section, and state insurance officials and the attorney general could refer or enforce violations. Facilities applying for or renewing a state license would have to show they obtained the required provider numbers and use them on every claim. Possible penalties include a $1,000 fine for each violation, investigation costs, license action, probation, referral to the attorney general, or a requirement to post penalty information on the facility's website. The proof requirement would apply when a facility applies for or renews its state license.