197.240. Accident and health insurers to cover care in an ambulatory surgical center, exceptions. - Missouri Statutes

Accident and health insurers to cover care in an ambulatory surgicalcenter, exceptions.

197.240. After September 28, 1975, no individual or grouphealth insurance policy of insurance providing coverage on anexpense incurred basis, nor individual or group service orindemnity type contract issued by a nonprofit corporation, norany self-insured group health benefit plan or trust, of any kindor description, shall be issued or payment accepted therefor inrenewal or continuation thereof unless coverage for any serviceperformed in an ambulatory surgical center is provided fortherein if such service would have been covered under the termsof the policy or contract as an eligible inpatient service,except as provided in section 376.805, RSMo. Nothing in thissection shall apply to a group contract, plan or trust whichprovides health care and surgical care directly to its membersand their dependents. Nothing in this section shall be construedto mandate coverage under an individual or group health insurancepolicy of insurance providing coverage on an expense incurredbasis, or an individual or group service or indemnity typecontract issued by a nonprofit corporation, or any self-insuredgroup health benefit plan or trust, of any kind or description,to provide health insurance for services which are usuallyperformed in a physician's office.

(L. 1975 S.B. 1 § 9, A.L. 1986 H.B. 1162)