(a) If cost-effective, the executive commissioner by rule shall establish a physician incentive program designed to reduce recipients’ use of hospital emergency room services for non-emergent conditions.
(b) In establishing the physician incentive program, the executive commissioner may include only the program components identified as cost-effective in the study conducted under former Section 531.086 before that section expired September 1, 2014.

(c) If the physician incentive program includes the payment of an enhanced reimbursement rate for routine after-hours appointments, the executive commissioner shall implement controls to ensure that the after-hours services billed are actually provided outside of normal business hours.

Text of section effective on April 01, 2025