AN ACT TO AMEND SECTION 43-13-117, MISSISSIPPI CODE OF 1972, TO REQUIRE EACH ORGANIZATION PARTICIPATING IN A MANAGED CARE PROGRAM OR COORDINATED CARE PROGRAM IMPLEMENTED BY THE DIVISION OF MEDICAID TO PROVIDE TO EACH HEALTH CARE PROVIDER FOR WHOM THE ORGANIZATION HAS DENIED THE COVERAGE OF A PROCEDURE THAT WAS ORDERED OR REQUESTED BY THE HEALTH CARE PROVIDER FOR A PATIENT, A LETTER THAT PROVIDES A DETAILED EXPLANATION OF THE REASONS FOR THE DENIAL OF COVERAGE OF THE PROCEDURE AND THE NAME AND THE CREDENTIALS OF THE PERSON WHO DENIED THE COVERAGE; TO PROVIDE THAT THE LETTER SHALL BE SENT TO THE HEALTH CARE PROVIDER IN BOTH PHYSICAL AND ELECTRONIC FORMAT AND SHALL BE SIGNED BY THE PERSON WHO DENIED THE COVERAGE; AND FOR RELATED PURPOSES.

Statutes affected:
As Introduced: 43-13-117