tci Medicare Compliance & Reimbursement - 2018 Issue 11

Industry Note: Missouri Lawmakers Take Action

On May 18, Missouri state legislators approved a law barring insurers from denying emergency department claims based solely on the final diagnosis that the physician assigns to the visit. This move is intended to help those in the state face fewer denials. The legislation defines "emergency medical condition" as "the sudden and, at the time, unexpected onset of a health condition that manifests itself by symptoms of sufficient severity, regardless of the final diagnosis that is given, that would lead a prudent layperson, possessing an average knowledge of medicine and health, to believe that immediate medical care is required...

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