☰ Revisor of Missouri


Chapter 354

< > Effective - 28 Aug 1997    bottom

  354.560.  Payment arrangements, department to adopt rules — disclosure of financial arrangements — confidentiality. — 1.  The director of the department of commerce and insurance shall adopt rules governing the use of payment arrangements by community-based health maintenance organizations which use payment withholding arrangements that place a physician at substantial financial risk.  The standards for determining substantial financial risk and determining which payment arrangements are subject to rules shall be the same as provided for health maintenance organizations and competitive medical plans contracting with the Medicare program, as provided in 42 CFR 417.479, or its successor regulation.

  2.  The department of commerce and insurance may require that community-based health maintenance organizations disclose to the department financial arrangements or contractual provisions that place a physician at substantial financial risk.  Such financial arrangements and contractual provisions which constitute substantial financial risk for the physician shall be reviewed by the department and shall be deemed approved if not disapproved by the director of the department within thirty days from the date that they are filed with the department.

  3.  The department of commerce and insurance shall promulgate rules governing the confidentiality of proprietary information disclosed to the department pursuant to this section.  Proprietary information disclosed pursuant to this section shall not be construed to be a public record as defined in chapter 610.


(L. 1997 H.B. 335 § 6)

---- end of effective  28 Aug 1997 ----

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