354.559. Disclosure to members, restrictions and prohibitions. - Missouri Statutes

Disclosure to members, restrictions and prohibitions.

354.559. No community-based health maintenance organization shallprohibit or restrict any provider from disclosing to any subscriber,enrollee or member any information that such provider deems appropriateregarding the nature of treatment, risks or alternatives thereto, theavailability of other therapy, consultation or test, the decision of anyplan to authorize or deny services, or to process the plan or any person toauthorize or deny services, or to process the plan or any personcontracting with the plan uses or proposes to use, to authorize or denyhealth care services or benefits. Any such prohibition or restrictioncontained in a contract with a provider entered into after August 28, 1997,shall be void and unenforceable. The standards used to determine if acommunity-based health maintenance organization has prohibited orrestricted a provider's disclosure in violation of this section shall bethose established by federal regulation of the Health Care FinancingAdministration for use in regulating managed care plans serving Medicareenrollees.

(L. 1997 H.B. 335 § 5)