HB 3450

                                 SECOND REGULAR SESSION
                    HOUSE BILL NO. 3450
                           103RD GENERAL ASSEMBLY
                          INTRODUCED BY REPRESENTATIVE MANSUR.
 7361H.01I  JOSEPH ENGLER, Chief Clerk
                                            AN ACT
 To amend chapter 376, RSMo, by adding thereto one new section relating to insurance
       coverage of preventive health care services.
 Be it enacted by the General Assembly of the state of Missouri, as follows:
        Section A. Chapter 376, RSMo, is amended by adding thereto one new section, to be
2  known as section 376.1180, to read as follows:
        376.1180. 1. As used in this section, the following terms mean:
2(1) "Cost-sharing requirement", the same meaning as in section 376.1183;
3(2) "Health benefit plan", the same meaning as in section 376.1350;
4(3) "Health carrier", the same meaning as in section 376.1350.
52. Each health carrier or health benefit plan that offers or issues health benefit
6 plans that are delivered, issued for delivery, continued, or renewed in this state on or
7 after January 1, 2026, shall provide coverage and shall not impose any cost-sharing
8 requirement for:
9(1) Evidence-based items or services that have in effect a rating of A or B in the
10 recommendations of the United States Preventive Services Task Force with respect to
11 the individual involved;
12(2) Immunizations that have in effect a recommendation from the Advisory
13 Committee on Immunization Practices of the Centers for Disease Control and
14 Prevention with respect to the individual involved; and
15(3) Preventive care and screening provided for in comprehensive guidelines
16 supported by the federal Health Resources and Services Administration.
 EXPLANATION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is
 intended to be omitted from the law. Matter in bold-face type in the above bill is proposed language.
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173. To the extent otherwise permissible under federal or state law, a health carrier
18 or health benefit plan that uses a network of providers may impose cost-sharing
19 requirements on the coverage described in subsection 2 of this section for items or
20 services delivered by an out-of-network provider.
214. If an insured or enrollee is covered under a high deductible health plan, as
22 such term is defined in 26 U.S.C. Section 223(c)(2), a health carrier or health benefit
23 plan may apply the deductible requirement of the high deductible health plan to the
24 coverage required under subsection 2 of this section unless the director of the
25 department of commerce and insurance determines that the coverage is included in the
26 safe harbor provisions for preventive care under 26 U.S.C. Section 223(c)(2)(c).
275. The provisions of this section shall not be construed to prohibit a health
28 carrier or health benefit plan from providing coverage for services in addition to those
29 recommended by the United States Preventive Services Task Force or to deny coverage
30 for services that are not recommended by the United States Preventive Services Task
31 Force.
326. The director of the department of commerce and insurance shall enforce the
33 provisions of this section consistent with the recommendations and guidelines in effect
34 on December 31, 2025, set by the United States Preventive Services Task Force, the
35 Advisory Committee on Immunization Practices of the Centers for Disease Control and
36 Prevention, or the federal Health Resources and Services Administration, and related
37 federal rules or guidance.
387. The director shall, by rule, adopt regulations to require health carriers and
39 health benefit plans to provide coverage without cost-sharing requirements for any
40 preventive health care services recommendations and guidelines issued after December
41 31, 2025, by the United States Preventive Services Task Force, the Advisory Committee
42 on Immunization Practices of the Centers for Disease Control and Prevention, or the
43 federal Health Resources and Services Administration, and related federal rules or
44 guidance.
458. (1) The department of commerce and insurance shall create an advisory
46 committee to be known as the "Health Insurance Preventive Health Care Services
47 Advisory Committee". This committee shall be composed of five members, with three
48 representatives of health care providers and two representatives of health carriers and
49 health benefit plans. All members of the committee shall be appointed by, and serve at
50 the pleasure of, the director of the department. The committee members shall serve
51 without compensation and shall not be reimbursed for their expenses.
52(2) The committee shall meet at least once each year to make recommendations
53 to the department, the general assembly, and the governor regarding any updates or
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54 modifications, as necessary, to the preventive health care services described in
55 subsection 2 of this section. The committee shall provide any recommendations for
56 updates or modifications no later than November first each year to the department, the
57 general assembly, and the governor.
589. Any rule or portion of a rule, as that term is defined in section 536.010, that is
59 created under the authority delegated in this section shall become effective only if it
60 complies with and is subject to all of the provisions of chapter 536 and, if applicable,
61 section 536.028. This section and chapter 536 are nonseverable and if any of the powers
62 vested with the general assembly pursuant to chapter 536 to review, to delay the
63 effective date, or to disapprove and annul a rule are subsequently held unconstitutional,
64 then the grant of rulemaking authority and any rule proposed or adopted after August
65 28, 2026, shall be invalid and void.
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