Missouri Senate Bill SB1147

Missouri 2026 Regular Session

• Introduced: 1/7/26
• Refer: 1/15/26

Caption

SB 1147

Summary

SB 1147 would add a new section to Missouri insurance law requiring health carriers to treat certain emergency behavioral and mental health care more like in-network care when a patient is admitted to, or transferred between, hospitals that are not participating providers for that condition. In those situations, the bill bars carriers from imposing cost-sharing that is greater than what the patient would pay for comparable care from a participating provider. The bill also requires the carrier to reimburse the nonparticipating hospital at the higher of the Missouri HealthNet or Medicare rate for treatment of the behavioral or mental health condition. In addition, it creates a new unlawful practice under Missouri consumer protection law if a health plan’s behavioral or mental health provider network is so inadequate that it threatens enrollees’ lives, and it establishes a rebuttable presumption of inadequacy if more than 15% of enrollees treated for such conditions are treated outside the network.

Impact

If enacted, SB 1147 would amend chapter 376, RSMo, by creating section 376.1553 and expanding state regulation of health benefit plans for mental health and behavioral health services. It would affect insurers, health carriers, hospitals, and enrollees by limiting out-of-network cost-sharing in emergency behavioral health situations, setting a minimum reimbursement benchmark tied to Medicaid and Medicare, and exposing carriers to enforcement under Missouri’s consumer protection statutes for inadequate mental health networks.

Sentiment

The available record shows no committee transcripts or recorded votes, so there is no direct evidence of debate or formal support/opposition in the materials provided. Based on the bill’s subject matter and structure, it appears aimed at improving access to emergency mental health care and reducing patient cost burdens, which suggests a consumer-protection and access-to-care rationale.

Contention

The main points of potential contention are likely to be the reimbursement mandate and the network-adequacy enforcement standard. Insurers may object to being required to pay nonparticipating hospitals at the higher of Medicaid or Medicare rates and to the presumption that a network is inadequate when more than 15% of treated enrollees go out of network. Hospitals and patient advocates would likely support the bill’s protections against high cost-sharing and limited access, especially in emergency behavioral health settings.