Overview

Missouri has long recognized the benefits of telehealth in increasing access to healthcare. To encourage providers to adopt telehealth services, the state has passed parity laws requiring health plans to provide coverage and reimbursement for telehealth services at the same basis and rate as they would for in-person services. Access to telehealth services was further expanded for Medicaid enrollees in recent sessions where the Medicaid program would reimburse providers for telehealth services if the providers can ensure that the services meet the same standard of care as those provided in person.

Missouri state law provides protection against surprise medical bills by prohibiting balance billing for services provided by an out-of-network physician at an in-network emergency room. The law also outlines a specific process for arbitration between insurers and providers to settle costs owed in cases where emergency out-of-network bills arise. Although there is no consumer website available to facilitate price comparisons between providers and facilities, Missouri has collected inpatient and outpatient charge and utilization data since 1993. In another demonstrated effort to increase transparency, the state proposed the Missouri Right to Shop Act, which would allow patients to compare the prices of non-emergency procedures. Insurance companies would provide financial incentives to enrollees who “shop” for cheaper services.

To ensure market competition, Missouri’s merger review statute requires nonprofit entities to provide pre-transaction notice to the state’s attorney general. Additionally, as part of a system-wide cost containment strategy, legislators have sought to establish a state-based single payer healthcare system. The proposal outlined plans to establish the “Missouri Health Assurance Program,” a publicly financed, statewide program to provide comprehensive necessary health, mental health, and dental care services and preventive screenings for Missouri residents.

In 2024, Missouri passed legislation prohibiting pharmaceutical manufacturers from denying, restricting, or prohibiting the acquisition or delivery of 340B drugs to pharmacies that are authorized by covered entities (such as certain healthcare providers) to receive these drugs.

See below for an overview of existing Missouri state mandates. Click on citation tab for detailed information of specific statutes (click link to download statute text).

State Action

Additional Resources

STATE BUDGET

Missouri’s fiscal year begins on July 1 and ends on June 30 of the following year.  State agencies submit their budget requests to the governor by October 1.  Agency hearings are held from January through April. Public hearings are held in January and February.  The governor submits a proposed budget to the state legislature no later than 30 days after the legislature convenes.  The legislature is required to adopt a budget by the first Friday after the first Monday in May.  The governor is legally required to submit a balanced budget. The legislature is not required to pass a balanced budget, but the governor is required to sign one.

STATE LEGISLATURE

The Missouri General Assembly has a 34-member Senate, who are term limited to two four-year terms, and a 163-member House of Representatives, who are limited to four two-year terms.  The Assembly convenes on the first Wednesday after the first Monday in January and adjourns on May 30.  Bills do not carry over from year-to-year.

KEY RESOURCES