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SB 1504

SB 1504 - This act sets the minimum allowable reimbursement rate to an out-of-network ambulance provider for services provided to enrollees and limits co-payment, coinsurance, deductibles, and other cost sharing amounts to the in-network payment amount for covered services. Ambulance providers are prohibited from billing enrollees any additional amounts for paid covered services. Health carriers are required to remit payment for ambulance services directly to the ambulance provider rather than the enrollee within thirty days of receipt of a clean claim, as such term is defined in the act. Upon receipt of a claim that is not clean, health carriers are required to specify the reason for declining payment in whole or in part and the additional information necessary to determine if the claim is payable in whole or part. This act is identical to HB 2597 (2026). TAYLOR MIDDLETON

2026 Regular Session Introduced by Mike Henderson

SB 1504 adjusts ambulance provider payment rates in Missouri, potentially affecting service availability and financial viability across regions.

Second Read and Referred S Insurance and Banking Committee
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Bill Summary · SB 1504

Legislative bill overview

SB 1504 modifies the payment structure and rates for ambulance service providers in Missouri. The bill appears to adjust how ambulance providers are compensated, though specific payment mechanism changes are not detailed in the available information.

Why is this important

Ambulance services are critical emergency infrastructure, and payment rates directly affect provider viability, service availability, and response times in rural and urban areas. Changes to reimbursement can influence whether ambulance services remain operational or expand to underserved regions.

Potential points of contention

  • Rural vs. urban equity: Payment modifications may disproportionately affect rural ambulance services that operate with thinner margins and serve lower-call-volume areas
  • Provider financial sustainability: Rate changes could impact whether independent and volunteer ambulance services can maintain operations or recruit trained personnel
  • Cost-shifting concerns: Modified payments might shift costs to patients, insurance companies, or local government budgets depending on the direction and magnitude of changes

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

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