Mo. Rev. Stat. § 354.554

Current with changes from the 2023 Legislative Session
Section 354.554 - Standing referrals for certain members of community-based health maintenance organizations, when

Each community-based health maintenance organization shall offer coverage that allows an enrollee who suffers from a life-threatening condition or a degenerative, disabling condition requiring a regimen of specialized medical treatment lasting for six months or more to receive a standing referral for specialty care case management by a physician or specialty care center with expertise in treating the condition. Under such specialty care case management, the provider shall coordinate primary and specialty care for the enrollee under a treatment plan approved by the health maintenance organization in consultation with the enrollee's primary care provider and the specialist physician or specialty care center.

§ 354.554, RSMo

L. 1997 H.B. 335 § 2