Medicaid recipients could be charged copays and fined for repeatedly missing medical appointments under a measure sponsored by Sen. David Sater, R-Cassville.
Given first-round approval Feb. 10 by the Missouri Senate,
Senate Bill 608 comes after Gov. Jay Nixon called for more funding to Medicaid this year.
If the bill becomes law, a health care provider could charge a Medicaid recipient an escalating fee for repeatedly missing doctors’ appointments starting at up to $5 for missing the second appointment within three years. The maximum fee that could be charged would rise to $10 for missing the third and up to $20 for every missed appointment after that within a three-year period.
In addition, there would be a mandatory $8 fee if a Medicaid recipient sought emergency room care for a condition that was not an emergency.
Supporters argued missed appointments currently discourage some health care providers from seeing Medicaid patients.
"The reason that providers won't sign on is that they know that MO HealthNet [Medicaid] patients are notorious for making appointments and then not keeping them because Mo HealthNet patients have no incentive," said Sen. Rob Schaaf, R-St. Joseph, one of the Senate’s two physicians.
The measure would require hospitals to report the costs of the 140 most common procedures.
In addition, a health care provider would be required to provide a patient with an estimated cost of treatment within five days of a request about the potential costs.
Democrats argued against the bill.
"I understand that $8 or $5 might be minor to somebody, but to many of my constituents, they don't have the $5 to go out and buy groceries," said Sen. Gina Walsh, D-St. Louis County.
During the debate, Schaaf urged critics to come up with a compromise.
"What I'm asking you to do is, if you don't like the language, come up with a compromise," Schaaf said. "How about instead of $5, make it $3."
Opponents then introduced amendments to the bill that would allow patients to miss their first appointment without charge.
Also added to the bill was a measure requiring greater financial disclosure by health care providers.
