reglab/housing_qa huggingface dataset:
MO Rev Stat § 376.1209 (2021)
2021 Missouri Revised Statutes|Title XXIV - Business and Financial Institutions|Chapter 376 - Life, Health and Accident Insurance|Section 376.1209 - Mastectomy — mandatory insurance coverage for prosthetic devices and reconstructive surgery — no time limit to be imposed.

Effective - 28 Aug 2001   376.1209. Mastectomy — mandatory insurance coverage for prosthetic devices and reconstructive surgery — no time limit to be imposed. — 1. Each entity offering individual and group health insurance policies providing coverage on an expense-incurred basis, individual and group service or indemnity type contracts issued by a nonprofit corporation, individual and group service contracts issued by a health maintenance organization, all self-insured group arrangements to the extent not preempted by federal law, and all managed health care delivery entities of any type or description, that provide coverage for the surgical procedure known as a mastectomy, and which are delivered, issued for delivery, continued or renewed in this state on or after January 1, 1998, shall provide coverage for prosthetic devices or reconstructive surgery necessary to restore symmetry as recommended by the oncologist or primary care physician for the patient incident to the mastectomy. Coverage for prosthetic devices and reconstructive surgery shall be subject to the same deductible and coinsurance conditions applied to the mastectomy and all other terms and conditions applicable to other benefits with the exception that no time limit shall be imposed on an individual for the receipt of prosthetic devices or reconstructive surgery and if such individual changes his or her insurer, then the new policy subject to the federal Women's Health and Cancer Rights Act (Sections 901-903 of P.L. 105-277), as amended, shall provide coverage consistent with the federal Women's Health and Cancer Rights Act (Sections 901-903 of P.L. 105-277), as amended, and any regulations promulgated pursuant to such act.  2. As used in this section, the term "mastectomy" means the removal of all or part of the breast for medically necessary reasons, as determined by a physician licensed pursuant to chapter 334.  3. The provisions of this section shall not apply to a supplemental insurance policy, including a life care contract, accident-only policy, specified disease policy, hospital policy providing a fixed daily benefit only, Medicare supplement policy or long-term care policy. ­­-------- (L. 1997 H.B. 129, A.L. 2001 H.B. 762)
MO Rev Stat § 376.1215 (2021)
2021 Missouri Revised Statutes|Title XXIV - Business and Financial Institutions|Chapter 376 - Life, Health and Accident Insurance|Section 376.1215 - Immunizations, mandated coverage, exceptions, rulemaking.

Effective - 28 Aug 1996   376.1215. Immunizations, mandated coverage, exceptions, rulemaking. — 1. All individual and group health insurance policies providing coverage on an expense-incurred basis, individual and group service or indemnity type contracts issued by a health services corporation, individual and group service contracts issued by a health maintenance organization and all self-insured group arrangements to the extent not preempted by federal law and all managed health care delivery entities of any type or description shall provide coverage for immunizations of a child from birth to five years of age as provided by department of health and senior services regulations.  2. Such coverage shall not be subject to any deductible or co-payment limits.  3. The contract issued by a health maintenance organization may provide that the benefits required pursuant to this section shall be covered benefits only if the services are rendered by a provider who is designated by and affiliated with the health maintenance organization, except that the health maintenance organization shall, as a condition of participation, comply with the immunization requirements of state or federally funded health programs.  4. This section shall not apply to supplemental insurance policies, including life care contracts, accident-only policies, specified disease policies, hospital policies providing a fixed daily benefit only, Medicare supplement policies, long-term care policies, coverage issued as a supplement to liability insurance, short-term major medical policies of six months or less duration and other supplemental policies as determined by the department of commerce and insurance.  5. The department of health and senior services shall promulgate rules and regulations to determine which immunizations shall be covered by policies, plans or contracts described in this section. No rule or portion of a rule promulgated under the authority of this section shall become effective unless it has been promulgated pursuant to the provisions of section 536.024.  6. No health care provider shall charge more than one hundred percent of the reasonable and customary charges for providing any immunization. ­­-------- (L. 1996 H.B. 904, et al. § 1)
MO Rev Stat § 376.1219 (2021)
2021 Missouri Revised Statutes|Title XXIV - Business and Financial Institutions|Chapter 376 - Life, Health and Accident Insurance|Section 376.1219 - PKU formula and low protein modified food products covered by insurance, when — exceptions.

Effective - 28 Aug 2002   376.1219. PKU formula and low protein modified food products covered by insurance, when — exceptions. — 1. Each policy issued by an entity offering individual and group health insurance which provides coverage on an expense-incurred basis, individual and group health service or indemnity type contracts issued by a nonprofit corporation, individual and group service contracts issued by a health maintenance organization, all self-insured group health arrangements to the extent not preempted by federal law, and all health care plans provided by managed health care delivery entities of any type or description, that are delivered, issued for delivery, continued or renewed in this state on or after September 1, 1997, shall provide coverage for formula and low protein modified food products recommended by a physician for the treatment of a patient with phenylketonuria or any inherited disease of amino and organic acids who is covered under the policy, contract, or plan and who is less than six years of age.  2. For purposes of this section, "low protein modified food products" means foods that are specifically formulated to have less than one gram of protein per serving and are intended to be used under the direction of a physician for the dietary treatment of any inherited metabolic disease. Low protein modified food products do not include foods that are naturally low in protein.  3. The coverage required by this section may be subject to the same deductible for similar health care services provided by the policy, contract, or plan as well as a reasonable coinsurance or co-payment on the part of the insured, which shall not be greater than fifty percent of the cost of the formula and food products, and may be subject to an annual benefit maximum of not less than five thousand dollars per covered child. Nothing in this section shall prohibit a carrier from using individual case management or from contracting with vendors of the formula and food products.  4. This section shall not apply to a supplemental insurance policy, including a life care contract, accident-only policy, specified disease policy, hospital policy providing a fixed daily benefit only, Medicare supplement policy, long-term care policy, or any other supplemental policy as determined by the director of the department of commerce and insurance. ­­-------- (L. 1997 H.B. 600 & 388, A.L. 2002 S.B. 1026)
MO Rev Stat § 376.1220 (2021)
2021 Missouri Revised Statutes|Title XXIV - Business and Financial Institutions|Chapter 376 - Life, Health and Accident Insurance|Section 376.1220 - Insurance coverage for newborn hearing screenings mandated.

Effective - 28 Aug 1999   376.1220. Insurance coverage for newborn hearing screenings mandated. — 1. Each policy issued by an entity offering individual and group health insurance which provides coverage on an expense-incurred basis, individual or group health service, or indemnity contracts issued by a nonprofit corporation, individual and group service contracts issued by a health maintenance organization, all self-insured group health arrangements to the extent not preempted by federal law, and all health care plans provided by managed health care delivery entities of any type or description that are delivered, issued for delivery, continued or renewed in this state shall provide coverage for newborn hearing screening, necessary rescreening, audiological assessment and follow-up, and initial amplification.  2. The health care service required by this section shall not be subject to any greater deductible or co-payment than other similar health care services provided by the policy, contract or plan.  3. This section shall not apply to a supplemental insurance policy, including a life care contract, accident-only policy, specified disease policy, hospital policy providing a fixed daily benefit only, Medicare supplement policy, long-term care policy, short-term major medical policies of six months or less duration, or any other supplemental policy as determined by the director of the department of commerce and insurance.  4. Coverage for newborn hearing screening and any necessary rescreening and audiological assessment shall be provided to newborns eligible for medical assistance pursuant to section 208.151, and the children's health program pursuant to sections 208.631 to 208.660, with payment for the newborn hearing screening required in section 191.925, and any necessary rescreening, audiological assessment and follow-up, and amplification as described in section 191.928. ­­-------- (L. 1999 H.B. 401 § 376.685)  CROSS REFERENCE: Rulemaking authority, 191.937
MO Rev Stat § 376.1222 (2021)
2021 Missouri Revised Statutes|Title XXIV - Business and Financial Institutions|Chapter 376 - Life, Health and Accident Insurance|Section 376.1222 - Prostheses and scalp prostheses to be provided for children under eighteen by Medicaid, children's health insurance and the consolidated plan — no additional insurance cost — amount allowable.

Effective - 28 Aug 2003   376.1222. Prostheses and scalp prostheses to be provided for children under eighteen by Medicaid, children's health insurance and the consolidated plan — no additional insurance cost — amount allowable. — 1. Any health insurance policy through the Medicaid program pursuant to chapter 208, the children's health insurance program pursuant to sections 208.631 to 208.660, and any health care plans issued to employees under the Missouri consolidated health care plan established pursuant to chapter 103 that are delivered, issued for delivery, continued or renewed in this state on or after January 1, 2004, shall provide coverage for prostheses and expenses for scalp hair prostheses worn for hair loss suffered as a result of alopecia areata or alopecia totalis for persons eighteen years of age or younger who are covered under a policy, program or plan pursuant to this section.  2. For purposes of this section, the following terms mean:  (1) "Prostheses", artificial appliances used to replace lost natural structures;  (2) "Scalp hair prostheses", artificial substitutes for scalp hair that are made specifically for a particular individual.  3. The coverage required by this section shall not be more than a maximum benefit amount of two hundred dollars per calendar year or exceed a lifetime maximum benefit amount of three thousand two hundred dollars for those persons who select a more permanent scalp hair prosthesis. A person may request a one-time expenditure of up to three thousand two hundred dollars. The benefits required by this section shall expire when total benefits paid reach three thousand two hundred dollars or when such person listed in subsection 1 of this section reaches eighteen years of age.  4. The health care service required by this section shall not be subject to any greater deductible or co-payment than other similar health care services provided by the policy, program, or plan.  5. Nothing in this section shall prohibit a health insurer or health benefit plan from providing coverage that is greater than or more favorable to persons than the coverage provided by this section. ­­-------- (L. 2003 H.B. 455)
MO Rev Stat § 376.1225 (2021)
2021 Missouri Revised Statutes|Title XXIV - Business and Financial Institutions|Chapter 376 - Life, Health and Accident Insurance|Section 376.1225 - Mandated coverage for general anesthesia and hospital charges for dental care, when — prior authorization required, when — exceptions.

Effective - 28 Aug 1998   376.1225. Mandated coverage for general anesthesia and hospital charges for dental care, when — prior authorization required, when — exceptions. — 1. All individual and group health insurance policies providing coverage on an expense-incurred basis, individual and group service or indemnity type contracts issued by a nonprofit corporation, individual and group service contracts issued by a health maintenance organization, all self-insured group arrangements to the extent not preempted by federal law and all managed health care delivery entities of any type or description, that are delivered, issued for delivery, continued or renewed on or after August 28, 1998, shall provide coverage for administration of general anesthesia and hospital charges for dental care provided to the following covered persons:  (1) A child under the age of five;  (2) A person who is severely disabled; or  (3) A person who has a medical or behavioral condition which requires hospitalization or general anesthesia when dental care is provided.  2. Each plan as described in this section must provide coverage for administration of general anesthesia and hospital or office charges for treatment rendered by a dentist, regardless of whether the services are provided in a participating hospital or surgical center or office.  3. Nothing in this section shall prevent a health carrier from requiring prior authorization for hospitalization for dental care procedures in the same manner that prior authorization is required for hospitalization for other covered diseases or conditions.  4. Nothing in this section shall apply to accident-only, dental-only plans or other specified disease, hospital indemnity, Medicare supplement or long-term care policies, or short-term major medical policies of six months or less in duration. ­­-------- (L. 1998 H.B. 1302 § 8)
MO Rev Stat § 376.1226 (2021)
2021 Missouri Revised Statutes|Title XXIV - Business and Financial Institutions|Chapter 376 - Life, Health and Accident Insurance|Section 376.1226 - Fee schedule for services not covered under health benefit plans — definitions.

Effective - 28 Aug 2013   376.1226. Fee schedule for services not covered under health benefit plans — definitions. — 1. No contract between a health carrier or health benefit plan and a dentist for the provision of dental services under a dental plan shall require that the dentist provide dental services to insureds in the dental plan at a fee established by the health carrier or health benefit plan if such dental services are not covered services under the dental plan.  2. For purposes of this section, the following terms shall mean:  (1) "Covered services", services reimbursable by a health carrier or health benefit plan under an applicable dental plan, subject to such contractual limitations on benefits as may apply, including but not limited to deductibles, waiting periods, or frequency limitations;  (2) "Dental plan", any policy or contract of insurance which provides for coverage of dental services;  (3) "Health benefit plan", the same meaning as such term is defined in section 376.1350;  (4) "Health carrier", the same meaning as such term is defined in section 376.1350. ­­-------- (L. 2013 H.B. 315)
MO Rev Stat § 376.1228 (2021)
2021 Missouri Revised Statutes|Title XXIV - Business and Financial Institutions|Chapter 376 - Life, Health and Accident Insurance|Section 376.1228 - Hearing aids coverage for children required — amount of coverage — exclusions — additional state costs subject to appropriations.

Effective - 28 Aug 2021   376.1228. Hearing aids coverage for children required — amount of coverage — exclusions — additional state costs subject to appropriations. — 1. For purposes of this section, the terms "health carrier" and "health benefit plan" shall have the same meanings given to the terms under section 376.1350, and the term "hearing aid" shall have the same meaning given to the term under section 345.015.  2. Each health carrier or health benefit plan that offers or issues health benefit plans that are delivered, issued for delivery, continued, or renewed in this state on or after January 1, 2022, shall, at a minimum, provide coverage to children under eighteen years of age for all hearing aids covered for children who receive MO HealthNet benefits under section 208.151.  3. The provisions of this section shall not apply to a supplemental insurance policy, including a life care contract, accident-only policy, specified disease policy, hospital policy providing a fixed daily benefit only, Medicare supplement policy, long-term care policy, short-term major medical policies of six months' or less duration, or any other supplemental policy as determined by the director of the department of commerce and insurance.  4. Any additional costs to the state created under the provisions of this section shall be subject to appropriation. If any agency of the federal government determines that this section violates 42 U.S.C. Section 18116 relating to nondiscrimination, the provisions of this section shall be null and void. ­­-------- (L. 2021 H.B. 432)
MO Rev Stat § 376.1230 (2021)
2021 Missouri Revised Statutes|Title XXIV - Business and Financial Institutions|Chapter 376 - Life, Health and Accident Insurance|Section 376.1230 - Chiropractic care coverage, rates, terms, conditions, limits, and exclusions.

Effective - 28 Aug 2003   376.1230. Chiropractic care coverage, rates, terms, conditions, limits, and exclusions. — 1. Every policy issued by a health carrier, as defined in section 376.1350, shall provide coverage for chiropractic care delivered by a licensed chiropractor acting within the scope of his or her practice as defined in chapter 331. The coverage shall include initial diagnosis and clinically appropriate and medically necessary services and supplies required to treat the diagnosed disorder, subject to the terms and conditions of the policy. The coverage may be limited to chiropractors within the health carrier's network, and nothing in this section shall be construed to require a health carrier to contract with a chiropractor not in the carrier's network nor shall a carrier be required to reimburse for services rendered by a nonnetwork chiropractor unless prior approval has been obtained from the carrier by the enrollee. An enrollee may access chiropractic care within the network for a total of twenty-six chiropractic physician office visits per policy period, but may be required to provide the health carrier with notice prior to any additional visit as a condition of coverage. A health carrier may require prior authorization or notification before any follow-up diagnostic tests are ordered by a chiropractor or for any office visits for treatment in excess of twenty-six in any policy period. The certificate of coverage for any health benefit plan issued by a health carrier shall clearly state the availability of chiropractic coverage under the policy and any limitations, conditions, and exclusions.  2. A health benefit plan shall provide coverage for treatment of a chiropractic care condition and shall not establish any rate, term, or condition that places a greater financial burden on an insured for access to treatment for a chiropractic care condition than for access to treatment for another physical health condition.  3. The provisions of this section shall not apply to any health plan or contract that is individually underwritten.  4. The provisions of this section shall not apply to benefits provided under the Medicaid program.  5. The provisions of this section shall not apply to a supplemental insurance policy, including a life care contract, accident-only policy, specified disease policy, hospital policy providing a fixed daily benefit only, Medicare supplement policy, long-term care policy, short-term major medical policy of six months' or less duration, or any other similar supplemental policy. ­­-------- (L. 2003 H.B. 121 §§ 376.1230 and 376.1231)
MO Rev Stat § 376.1232 (2021)
2021 Missouri Revised Statutes|Title XXIV - Business and Financial Institutions|Chapter 376 - Life, Health and Accident Insurance|Section 376.1232 - Insurers to offer coverage for prosthetics.

Effective - 28 Aug 2009   376.1232. Insurers to offer coverage for prosthetics. — 1. Each health carrier or health benefit plan that offers or issues health benefit plans which are delivered, issued for delivery, continued, or renewed in this state on or after January 1, 2010, shall offer coverage for prosthetic devices and services, including original and replacement devices, as prescribed by a physician acting within the scope of his or her practice.  2. For the purposes of this section, "health carrier" and "health benefit plan" shall have the same meaning as defined in section 376.1350.  3. The amount of the benefit for prosthetic devices and services under this section shall be no less than the annual and lifetime benefit maximums applicable to the basic health care services required to be provided under the health benefit plan. If the health benefit plan does not include any annual or lifetime maximums applicable to basic health care services, the amount of the benefit for prosthetic devices and services shall not be subject to an annual or lifetime maximum benefit level. Any co-payment, coinsurance, deductible, and maximum out-of-pocket amount applied to the benefit for prosthetic devices and services shall be no more than the most common amounts applied to the basic health care services required to be provided under the health benefit plan.  4. The provisions of this section shall not apply to a supplemental insurance policy, including a life care contract, accident-only policy, specified disease policy, hospital policy providing a fixed daily benefit only, Medicare supplement policy, long-term care policy, short-term major medical policies of six months or less duration, or any other supplemental policy as determined by the director of the department of commerce and insurance. ­­-------- (L. 2009 H.B. 577)