Quarterly Rate and Charge Reporting Requirements

PURPOSE: This rule specifies the quarterly rate and charge reporting requirements of a supplemental health care services agency in Missouri. (1) Any registered supplemental health care services agency that contracts with a health care facility that participates in Medicare or Medicaid shall submit the following report every quarter to the department: (A) A detailed list of each health care facility participating in Medicare or Medicaid with whom the agency has contracted over the prior quarter; (B) A detailed list of the average amount charged by the agency to the health care facility over the prior quarter, broken down by health care facility and each individual health care personnel within each job classification (including but not limited to nursing, therapy, dietary/nutrition, lab, and radiology); and (C) A detailed list of the average amount paid by the agency to health care personnel over the prior quarter, broken down by health care facility and each individual health care personnel within each job classification, including but not limited to nursing, therapy, dietary/nutrition, lab, and radiology. (2) The required submission dates shall be as follows: (A) The quarterly report containing data from January 1 through March 31 shall be submitted no later than April 30; (B) The quarterly report containing data from April 1 through June 30 shall be submitted no later than July 31; (C) The quarterly report containing data from July 1 through September 30 shall be submitted no later than October 31; and (D) The quarterly report containing data from October 1 through December 31 shall be submitted no later than January 31. (3) Health care personnel to be reported shall include all positions that are licensed, accredited, or certified by the state of Missouri to perform specified health services consistent with state law. (4) Failure of the agency to provide any of this information to the department shall result in revocation or nonrenewal of its registration. AUTHORITY: section 198.648, RSMo Supp. 2022* Original rule filed Feb. 8, 2023, effective Sept. 30, 2023. *Original authority: 198.648, RSMo 2022.