AN ACT TO AMEND SECTION 43-13-115, MISSISSIPPI CODE OF 1972, TO ALLOW THE FAMILY PLANNING WAIVER PROGRAM UNDER THE MEDICAID PROGRAM TO BE CONDUCTED UNDER A WAIVER OR THE STATE PLAN; TO PROVIDE THAT MEN OF REPRODUCTIVE AGE ARE ELIGIBLE UNDER THE FAMILY PLANNING PROGRAM; TO PROVIDE THAT CHILDREN IN STATE CUSTODY WHO ARE IN FOSTER CARE ON THEIR EIGHTEENTH BIRTHDAY SHALL BE MEDICAID ELIGIBLE UNTIL THEIR TWENTY SIXTH BIRTHDAY; TO PROVIDE THAT CHILDREN WHO HAVE AGED OUT OF FOSTER CARE WHILE ON MEDICAID IN OTHER STATES SHALL QUALIFY UNTIL THEIR TWENTY SIXTH BIRTHDAY; TO DELETE THE AUTHORITY FOR A WAIVER PROGRAM TO PROVIDE SERVICES TO CERTAIN INDIVIDUALS WHO ARE END STAGE RENAL DISEASE PATIENTS ON DIALYSIS, CANCER PATIENTS ON CHEMOTHERAPY OR ORGAN TRANSPLANT RECIPIENTS ON ANTIREJECTION DRUGS; TO AMEND SECTION 43-13-117, MISSISSIPPI CODE OF 1972, TO DELETE THE OPTION FOR CERTAIN RURAL HOSPITALS TO NOT BE REIMBURSED FOR OUTPATIENT HOSPITAL SERVICES USING THE APC METHODOLOGY; TO DIRECT THE DIVISION OF MEDICAID TO UPDATE THE CASE MIX PAYMENT SYSTEM FAIR RENTAL REIMBURSEMENT SYSTEM FOR NURSING FACILITY SERVICES AS NECESSARY TO MAINTAIN COMPLIANCE WITH FEDERAL LAW; TO AUTHORIZE THE DIVISION TO IMPLEMENT A QUALITY OR VALUE-BASED COMPONENT TO THE NURSING FACILITY PAYMENT SYSTEM; TO DELETE THE LEGISLATIVE INTENT FOR THE DIVISION TO ENCOURAGE THE USE OF ALPHA HYDROXYPROGESTERONE CAPROATE TO PREVENT RECURRENT PRETERM BIRTHS; TO AUTHORIZE ORAL CONTRACEPTIVES TO BE PRESCRIBED AND DISPENSED IN TWELVE MONTH SUPPLY INCREMENTS UNDER FAMILY PLANNING SERVICES; TO UPDATE AND CLARIFY LANGUAGE ABOUT THE DIVISION'S TRANSITION FROM THE MEDICARE UPPER PAYMENTS LIMITS (UPL) PROGRAM TO THE MISSISSIPPI HOSPITAL ACCESS PROGRAM (MHAP); TO PROVIDE THAT THE DIVISION SHALL MAXIMIZE TOTAL FEDERAL FUNDING FOR MHAP, UPL AND OTHER SUPPLEMENTAL PAYMENT PROGRAMS IN EFFECT FOR STATE FISCAL YEAR 2024 AND SHALL NOT CHANGE THE METHODOLOGIES, FORMULAS, MODELS OR PREPRINTS USED TO CALCULATE THE DISTRIBUTION OF SUPPLEMENTAL PAYMENTS TO HOSPITALS FROM THOSE METHODOLOGIES, FORMULAS, MODELS OR PREPRINTS IN EFFECT AND AS APPROVED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES FOR STATE FISCAL YEAR 2024; TO REQUIRE THAT POPULATIONS ELIGIBLE FOR RECEIVING PERINATAL RISK MANAGEMENT SERVICES FROM MANAGED CARE ORGANIZATIONS RECEIVE THE SERVICES FROM THE MANAGED CARE ORGANIZATIONS OR CONTRACT WITH THE STATE DEPARTMENT OF HEALTH FOR THOSE SERVICES; TO REINSTATE THE AUTHORITY TO PROVIDE MEDICAID REIMBURSEMENT FOR A BORDER CITY UNIVERSITY AFFILIATED PEDIATRIC TEACHING HOSPITAL; TO LIMIT THE PAYMENT FOR PROVIDING SERVICES TO MISSISSIPPI MEDICAID BENEFICIARIES UNDER THE AGE OF TWENTY ONE YEARS WHO ARE TREATED BY A BORDER CITY UNIVERSITY AFFILIATED PEDIATRIC TEACHING HOSPITAL; TO EXTEND THE DATE OF THE REPEALER ON PROVIDING MEDICAID REIMBURSEMENT FOR A BORDER CITY UNIVERSITY AFFILIATED PEDIATRIC TEACHING HOSPITAL; TO AUTHORIZE THE DIVISION TO EXPEDITE NOTICE TO THE CHAIRMEN OF THE MEDICAID COMMITTEES WHEN THE DIVISION PROPOSES A RATE CHANGE; AMEND SECTION 43-13-121, MISSISSIPPI CODE OF 1972, TO AUTHORIZE THE DIVISION TO EXPEDITE NOTICE TO THE CHAIRMEN OF THE MEDICAID COMMITTEES WHEN THE DIVISION PROPOSES A STATE PLAN AMENDMENT; TO AMEND SECTION 43-13-305, MISSISSIPPI CODE OF 1972, TO PROVIDE THAT WHEN A THIRD PARTY PAYOR REQUIRES PRIOR AUTHORIZATION FOR AN ITEM OR SERVICE FURNISHED TO A MEDICAID RECIPIENT, THE PAYOR SHALL ACCEPT AUTHORIZATION PROVIDED BY THE DIVISION OF MEDICAID THAT THE ITEM OR SERVICE IS COVERED UNDER THE STATE PLAN AS IF SUCH AUTHORIZATION WERE THE PRIOR AUTHORIZATION MADE BY THE THIRD PARTY PAYOR FOR SUCH ITEM OR SERVICE; AND FOR RELATED PURPOSES.

Statutes affected:
As Introduced: 43-13-115, 43-13-117, 43-13-121, 43-13-305
Committee Substitute: 43-13-115, 43-13-117, 43-13-121, 43-13-305, 43-13-107