PURPOSE: This rule establishes procedures for the State Cancer Center to utilize payments by third-party sources and responsible parties to offset the cost of care.

1. (1) The State Cancer Center, through its director or his/her designee, such as the patient accounts manager, shall apply toward the costs incurred for providing the patient’s services payments received on behalf of the patient from third-party sources, including public and private health insurance, to the extent and limits of the coverage of the patient by the third-party sources.

   1. (A) If a federal program requires the hospital to accept federal reimbursement as full payment as a condition of participation in the program, the hospital shall not charge the patient any additional fee or amount for the services or care except for any permitted deductible or coinsurance.
   2. (B) The hospital shall charge the patient or responsible party for any deductible or coinsurance permitted by the third-party source.
   3. (C) If payment by a parent or spouse under this rule would result in a reduction of government benefits to the patient, then the parent or spouse shall not be charged unless required by the third-party source.
   4. (2) The following are jointly liable for payment for the services rendered by the State Cancer Center:
   5. (A) The patient;
   6. (B) The patient’s estate;
   7. (C) The patient’s spouse;
   8. (D) The parents of an emancipated patient under the age of eighteen (18) years or the stepparent of an unemancipated patient under the age of eighteen (18) years who resides in the home of the stepparent;
   9. (E) The parents of a patient age eighteen

2. (18) years or over who is not a resident of this state and who is insolvent or incapacitated;

   1. (F) Any fiduciary, such as a trustee, only to the extent of the assets the fiduciary is holding on behalf of or for the patient and which are assets that may be used according to law; and
   2. (G) Any representative of the patient to the extent of the benefits and assets under the law governing and permitting payment of benefits and assets for the patients.

AUTHORITY: sections 192.005.2. and 200.030, RSMo 1986.* This rule was previously filed as 19 CSR 80-1.020. Original rule filed May 15, 1990, effective Sept. 28, 1990. *Original authority: 192.005, RSMo 1985.