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Bill

HB 1875

Creates provisions relating to notification of out-of-network status by health care providers

2026 Regular Session Introduced by Renee Reuter

HB 1875 requires health providers to notify patients upfront about out-of-network status, estimate costs, and outline in-network options to prevent surprise bills.

Referred: Emerging Issues(H)
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Bill Summary · HB 1875

Bill overview

HB 1875 (2026 Missouri) aims to regulate the notification requirements for health care providers regarding out-of-network status. The bill specifies when and how providers must inform patients about a service being out-of-network, what information must be included, and potential consequences for non-compliance. It is sponsored in part by Co-sponsor Renee Reuter and has progressed through committee and floor readings during the 2026 session.

Main purpose and intent

  • Improve transparency for patients by ensuring timely and clear notice when a health care service is provided by an out-of-network provider or facility.
  • Help patients anticipate potential balance bills or higher out-of-pocket costs by clarifying network status before or at the point of care.
  • Align provider notification practices with consumer protection goals related to health care billing and cost-shifting.

Key provisions and changes

  • Notification requirements: Health care providers must notify patients if a service, procedure, or admission is being performed on an out-of-network basis. The bill outlines the timing (e.g., prior to service, at the time of scheduling, or at point of care) and the manner of notification.
  • Required content: Notifications must include:
    • The out-of-network status of the provider or facility
    • An estimate of potential patient financial responsibility, including expected balance bill risk
    • A comparison or explanation of network coverage options, if available
    • Any reasonable alternative in-network options and how to pursue them
  • Timing and delivery mechanisms: The bill may mandate specific windows for notice (e.g., before services are rendered) and acceptable modes of delivery (written, electronic, or verbal with documentation).
  • Patient protections: Provisions to minimize surprise bills, inform patients about rights to seek in-network care where feasible, and provide information about disputes or appeal processes related to charges.
  • Compliance and enforcement: Expectations for health care providers to maintain records of notices and to comply with the statute, with potential penalties or remedies for non-compliance as defined in the bill.
  • Priority language: Emphasis on patient awareness and informed consent in situations where network status affects costs.

Who and what is affected

  • Health care providers and facilities that bill for professional or facility services, including out-of-network practitioners.
  • Patients and prospective patients receiving care from out-of-network providers, particularly those who may incur higher charges.
  • Health plans and payers may indirectly be impacted by increased clarity around network status and potential shifts in billing disputes or patient inquiries.
  • Administrative and compliance personnel within provider organizations responsible for issuing notices and maintaining documentation.

Procedural and timeline aspects

  • Prefiled in December 2025, introduced and read in January 2026.
  • Referred to Emerging Issues (H) on May 15, 2026, indicating initial committee consideration focused on broad implications and cross-cutting impacts.
  • The bill has undergone standard readings (First and Second) and is moving through the legislative process with sponsor and co-sponsor involvement.

Potential impact

  • Enhanced transparency may reduce surprise medical billing by ensuring patients understand out-of-network risks before or at the time of care.
  • Providers may incur administrative workload to implement or revise notification processes and record-keeping.
  • Payers and patients could see increased clarity in cost expectations, potentially affecting negotiations over balance bills and dispute processes.
  • The exact scope, enforcement mechanisms, and penalties (if any) will influence the practical effect on provider behavior and patient financial protection.

If you’d like, I can tailor this summary to emphasize sections most relevant to policymakers, health care providers, or consumer advocates, or compare it to related Missouri statutes on balance billing and network transparency.

Compiled from official sources — confirm details with the bill’s official record.

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