Missouri Code of State Regulations
Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE
Division 400 - Life, Annuities and Health
Chapter 2 - Accident and Health Insurance in General
Section 20 CSR 400-2.180 - Offer of Coverage for Prosthetic Devices and Services
Current through Register Vol. 49, No. 6, March 15, 2024
PURPOSE: This rule defines "prosthetic devices and services" for purposes of the mandated offer of coverage required under section 376.1232, RSMo, and clarifies the related obligations for health carriers and health benefit plans.
(1) As used in this rule and section 376.1232, RSMo, the term "prosthetic devices" shall have the same meaning as described in the federal Medicare program definitions under 42 U.S.C. section 1395x(s)(8) and (9).
(2) As used in this rule and section 376.1232, RSMo, the term "services" means-
(3) A health carrier may offer coverage more generous than the coverage described in this rule or in section 376.1232, RSMo.
(4) If the offer of coverage described in this rule and in section 376.1232, RSMo, is not accepted by the purchaser of the health benefit plan, nothing in this rule or in section 376.1232, RSMo, shall be construed to prevent the health carrier from offering alternative coverage for prosthetic devices and services or from using alternative definitions of these terms.
*Original authority: 374.045, RSMo 1967, amended 1993, 1995, 2008 and 376.1232, RSMo 2009.