2011 Missouri Revised Statutes
TITLE XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 376 Life, Health and Accident Insurance
Section 376.1367. Emergency services benefit determination, coverage required, when.

376.1367. When conducting utilization review or making a benefit determination for emergency services:

(1) A health carrier shall cover emergency services necessary to screen and stabilize an enrollee and shall not require prior authorization of such services;

(2) Coverage of emergency services shall be subject to applicable co-payments, coinsurance and deductibles;

(3) When an enrollee receives an emergency service that requires immediate post evaluation or post stabilization services, a health carrier shall provide an authorization decision within sixty minutes of receiving a request; if the authorization decision is not made within thirty minutes, such services shall be deemed approved.

(L. 1997 H.B. 335)

Annotation Copyright Missouri Joint Committee on Legislative Research