AN ACT RELATING TO THE MISSISSIPPI MEDICAID PROGRAM; TO AMEND SECTION 43-13-117, MISSISSIPPI CODE OF 1972, RELATING TO REIMBURSEMENT FOR CARE AND SERVICES UNDER THE MEDICAID PROGRAM; TO DELETE CERTAIN OUTDATED PROVISIONS RELATING TO REIMBURSEMENT OF INPATIENT HOSPITAL SERVICES; TO PROVIDE FOR REIMBURSEMENT FOR FEES FOR PHYSICIAN SERVICES COVERED ONLY BY MEDICAID; TO AUTHORIZE THE DIVISION TO REIMBURSE OBSTETRICIANS AND GYNECOLOGISTS FOR CERTAIN PRIMARY CARE SERVICES AT 100% OF THE MEDICARE RATE; TO DELETE THE PROVISION THAT REQUIRES THE DIVISION TO ALLOW PHYSICIAN-ADMINISTERED DRUGS TO BE BILLED AND REIMBURSED AS A MEDICAL CLAIM OR PHARMACY POINT-OF-SALE; TO PROVIDE FOR A REIMBURSEMENT RATE INCREASE TO DENTAL PREVENTION SERVICES; TO DEFINE CLINIC SERVICES FOR PURPOSES OF THE REIMBURSEMENTS BY MEDICAID FOR THOSE SERVICES; TO DELETE AUTHORITY FOR ADULT DAY CARE REIMBURSEMENT; TO PROVIDE THAT MEDICAID MAY ESTABLISH AN UPPER PAYMENT LIMITS PROGRAM FOR AMBULANCE TRANSPORTATION AND ASSESS PROVIDERS OF SUCH SERVICE; TO AUTHORIZE CERTAIN SUPPLEMENTAL REIMBURSEMENTS TO PROVIDERS SUBJECT TO CMS APPROVAL AND TO REQUIRE CONSULTATION WITH THE HOSPITAL INDUSTRY; TO REQUIRE THE DIVISION OF MEDICAID TO RECOGNIZE FEDERALLY QUALIFIED HEALTH CENTERS (FQHC), RURAL HEALTH CLINICS (RHC) AND COMMUNITY MENTAL HEALTH CENTERS (CMHC) AS BOTH AN ORIGINATING AND DISTANT SITE PROVIDER FOR THE PURPOSES OF TELEHEALTH REIMBURSEMENT; TO AUTHORIZE REIMBURSEMENT FOR CERTAIN PSYCHIATRIC SERVICES; TO CLARIFY THE REIMBURSEMENT OF PEDIATRIC SKILLED NURSING SERVICES, INPATIENT PSYCHIATRIST SERVICES AND NONEMERGENCY TRANSPORTATION SERVICES; TO PROVIDE THAT THE DIVISION MAY ESTABLISH COPAYMENTS AND COINSURANCE FOR ANY MEDICAID SERVICES; TO ALLOW THE DIVISION TO USE ENHANCED REIMBURSEMENTS AND UPPER PAYMENT LIMIT PROGRAMS FOR ITS REIMBURSEMENT PROGRAM; TO PROVIDE THAT THE VACCINES FOR CHILDREN ARE AVAILABLE FREE OF CHARGE; TO DELETE THE PROVISION THAT REQUIRES MEDICAID TO REDUCE THE RATE OF REIMBURSEMENT TO CERTAIN PROVIDERS FOR SERVICES BY 5% OF THE ALLOWED AMOUNT FOR THAT SERVICE; TO REQUIRE PROVIDERS TO MAINTAIN RECORDS AS (a) PRESCRIBED BY THE DIVISION AND IN ACCORDANCE WITH FEDERAL LAW; TO DELETE CERTAIN ENROLLMENT LIMITATIONS AND PROVISIONS RELATING TO MANAGED CARE PROGRAMS; TO ALLOW THE DIVISION OF MEDICAID TO APPROVE THE USE OF ALTERNATIVE PAYMENT MODELS FOR REIMBURSEMENT RATES FOR MANAGED CARE PROGRAMS; TO CLARIFY LIMITATIONS ON MEDICAID ELIGIBILITY FOR ENROLLMENT IN MANAGED CARE PROGRAMS; TO DELETE THE PROVISIONS THAT PROVIDE FOR THE COMMISSION ON EXPANDING MEDICAID MANAGED CARE; TO REQUIRE CONTRACTORS RECEIVING PAYMENTS UNDER A MANAGED CARE DELIVERY SYSTEM TO DISCLOSE TO THE CHAIRMEN OF THE SENATE AND HOUSE MEDICAID COMMITTEES THE ADMINISTRATIVE EXPENSES FOR THE PRIOR YEAR, AND THE NUMBER OF EMPLOYEES IN MISSISSIPPI WHO ARE DEDICATED TO MEDICAID AND CHIP LINES OF BUSINESS AS OF JUNE 30 OF EACH YEAR; TO PROVIDE FOR REVIEWS OF THE MANAGED CARE PROGRAMS BY THE STATE AUDITOR; TO REQUIRE ALL MANAGED CARE CONTRACTORS TO DEVELOP AND IMPLEMENT, NOT LATER THAN DECEMBER 1, 2021, A UNIFORM CREDENTIALING PROCESS UNDER WHICH ALL PROVIDERS WHO MEET THE CRITERIA FOR CREDENTIALING WILL BE CREDENTIALED WITH ALL CONTRACTORS; TO PROVIDE THAT IF THE CONTRACTORS HAVE NOT IMPLEMENTED A UNIFORM CREDENTIALING PROCESS BY THAT DATE, THE DIVISION SHALL DEVELOP AND IMPLEMENT, NOT LATER THAN JULY 1, 2022, A SINGLE, CONSOLIDATED CREDENTIALING PROCESS BY WHICH ALL PROVIDERS WILL BE CREDENTIALED; TO DELETE THE PROVISION THAT THERE SHALL NOT BE CUTS TO INPATIENT AND OUTPATIENT HOSPITAL PAYMENTS; TO DIRECT THE DIVISION TO EVALUATE THE FEASIBILITY OF ADMINISTERING PHARMACY BENEFITS AND DENTAL BENEFITS UNDER MANAGED CARE; TO DIRECT MANAGED CARE CONTRACTORS TO IMPLEMENT INNOVATIVE PROGRAMS FOR MEMBERS WITH PREDIABETES AND DIABETES; TO AUTHORIZE THE DIVISION TO NEGOTIATE A LIMITATION ON LIABILITY TO THE STATE OF CERTAIN PROSPECTIVE CONTRACTORS; TO AUTHORIZE MANAGED CARE CONTRACTORS TO IMPROVE UTILIZATION OF LONG-ACTING REVERSABLE CONTRACEPTIVES (LARCS); TO AUTHORIZE THE DIVISION TO MAKE ONE MANAGED CARE CONTRACT EXTENSION; TO PROHIBIT THE DIVISION FROM MAKING CERTAIN CHANGES TO THE SERVICES AUTHORIZED UNDER THIS SECTION WITHOUT AN AMENDMENT TO THIS SECTION BY THE LEGISLATURE; TO EXTEND THE AUTOMATIC REPEALER ON THIS SECTION; TO AMEND SECTION 43-13-145, MISSISSIPPI CODE OF 1972, TO PROVIDE THAT NURSING FACILITIES OPERATED BY THE UNIVERSITY OF MISSISSIPPI MEDICAL CENTER ARE NOT EXEMPT FROM THE ANNUAL ASSESSMENT FOR THE SUPPORT OF THE MEDICAID PROGRAM, TO DELETE CERTAIN TECHNICAL PROVISIONS RELATING TO THE ASSESSMENT AND COLLECTION OF THE HOSPITAL ASSESSMENT, TO CLARIFY THE PROCEDURE FOR PAYMENT OF THE HOSPITAL ASSESSMENT FOR THE NONFEDERAL SHARE NECESSARY FOR THE MEDICARE UPPER PAYMENT LIMITS (UPL) PROGRAM AND THE DISPROPORTIONATE SHARE HOSPITAL (DSH) PROGRAM; TO EXTEND THE AUTOMATIC REPEALER ON THIS SECTION; TO AMEND SECTION 41-75-5, MISSISSIPPI CODE OF 1972, TO DELETE THE RESTRICTION ON POST-ACUTE RESIDENTIAL BRAIN INJURY REHABILITATION FACILITIES PARTICIPATION IN THE MEDICAID PROGRAM; AND FOR RELATED PURPOSES.

Statutes affected:
As Introduced: 43-13-115, 43-13-117, 43-13-145, 41-7-191, 41-75-5, 83-9-353
Committee Substitute: 43-13-117, 43-13-145, 41-7-191, 41-75-5, 83-9-353
As Passed by the Senate: 43-13-117, 43-13-145, 41-7-191, 41-75-5, 83-9-353
Approved by the Governor: 43-13-117, 43-13-145, 41-75-5