§ 43-13-101. Title of article
This article shall be entitled and cited as the “Mississippi Medicaid Law.”
§ 43-13-103. Purpose
For the purpose of affording health care and remedial and institutional services in accordance with the requirements for federal grants and other assistance under Titles XVIII, XIX and XXI of the Social Security Act, as amended, a statewide system of medical assistance is established and shall be in effect in all political subdivisions of the […]
§ 43-13-105. Definitions
When used in this article, the following definitions shall apply, unless the context requires otherwise: “Administering agency” means the Division of Medicaid in the Office of the Governor as created by this article. “Division” or “Division of Medicaid” means the Division of Medicaid in the Office of the Governor. “Medical assistance” means payment of part […]
§ 43-13-107. Division of Medicaid created; director and other personnel; Medical Care Advisory Committee; Drug Use Review Board; Pharmacy and Therapeutics Committee
The Division of Medicaid is created in the Office of the Governor and established to administer this article and perform such other duties as are prescribed by law. The Governor shall appoint a full-time executive director, with the advice and consent of the Senate, who shall be either (i) a physician with administrative experience in […]
§ 43-13-109. Rules and regulations for procurement of employees
The director, with the approval of the governor and pursuant to the rules and regulations of the state personnel board, may adopt reasonable rules and regulations to provide for an open, competitive or qualifying examination for all employees of the division other than the director, part-time consultants and professional staff members.
§ 43-13-111. Budgets of state health agencies
Every state health agency, as defined in Section 43-13-105, shall obtain an appropriation of state funds from the state Legislature for all medical assistance programs rendered by the agency and shall organize its programs and budgets in such a manner as to secure maximum federal funding through the Division of Medicaid under Title XIX or […]
§ 43-13-113. Receipt and disbursement of funds; contingency plan; contracting for donated dental services program
The State Treasurer shall receive on behalf of the state, and execute all instruments incidental thereto, federal and other funds to be used for financing the medical assistance plan or program adopted pursuant to this article, and place all such funds in a special account to the credit of the Governor’s Office-Division of Medicaid, which […]
§ 43-13-115. Persons entitled to receive Medicaid
Recipients of Medicaid shall be the following persons only: Those who are qualified for public assistance grants under provisions of Title IV-A and E of the federal Social Security Act, as amended, including those statutorily deemed to be IV-A and low income families and children under Section 1931 of the federal Social Security Act. For […]
§ 43-13-116. Authority to determine Medicaid eligibility; agreements with state and federal agencies; administrative hearings; authority to hire employees
It shall be the duty of the Division of Medicaid to fully implement and carry out the administrative functions of determining the eligibility of those persons who qualify for medical assistance under Section 43-13-115. In determining Medicaid eligibility, the Division of Medicaid is authorized to enter into an agreement with the Secretary of the Department […]
§ 43-13-116.1. Asset verification program; data match system with financial institutions; authority of division to request and financial institution to provide additional financial information as needed to verify eligibility
For purposes of this section: “Financial institution” has the meaning given by Sections 81-3-1 and 81-12-3, and shall include, but not be limited to, credit unions, stock brokerages, public or private entities administering retirement, savings, annuities, life insurance and/or pension funds. “Account” means a demand deposit account, checking or negotiable withdrawal order account, savings account, […]
§ 43-13-117. Types of care and services for which financial assistance furnished
Medicaid as authorized by this article shall include payment of part or all of the costs, at the discretion of the division, with approval of the Governor and the Centers for Medicare and Medicaid Services, of the following types of care and services rendered to eligible applicants who have been determined to be eligible for […]
§ 43-13-117.1. Nursing facility services funds for certain nursing facility residents may be transferred to cover costs of services available through home- and community-based waiver programs
It is the intent of the Legislature to expand access to Medicaid-funded home- and community-based services for eligible nursing facility residents who choose those services. The Executive Director of the Division of Medicaid is authorized to transfer funds allocated for nursing facility services for eligible residents to cover the cost of services available through the […]
§ 43-13-117.2. Study on implementation of pilot program to provide chronic disease management of chronic obstructive pulmonary disease
The Division of Medicaid is authorized and directed to study the feasibility of implementing a pilot program to provide chronic disease management of chronic obstructive pulmonary disease (COPD) using private sources of funding in an effort to reduce the financial and clinical burden of COPD illness upon the Medicaid program and the citizens of Mississippi. […]
§ 43-13-117.4. Payment by Division of Medicaid of costs of care and services rendered by an entity that performs nontherapeutic abortions or maintains or operates or is affiliated with an entity that maintains or operates a facility where nontherapeutic abortions are performed prohibited
Notwithstanding any other provision of Section 43-13-117, the division shall not authorize payment of part or all of the costs of care and services rendered by any entity that performs nontherapeutic abortions, maintains or operates a facility where nontherapeutic abortions are performed, or is affiliated with such an entity. For purposes of this provision, “nontherapeutic […]
§ 43-13-117.5. Reimbursement for services provided eligible beneficiaries by licensed freestanding psychiatric hospital authorized
The Division of Medicaid is authorized to reimburse for services provided to eligible Medicaid beneficiaries by a licensed freestanding psychiatric hospital in a method and manner to be determined by the division in accordance with federal law and federal regulations. The division may seek any necessary waivers, make any required amendments to its State Plan, […]
§ 43-13-118. Records of provider participating in Medicaid program
It shall be the duty of each provider participating in the medical assistance program to keep and maintain books, documents, and other records as prescribed by the division of Medicaid in substantiation of its claim for services rendered Medicaid recipients, and such books, documents, and other records shall be kept and maintained for a period […]
§ 43-13-120. Division of Medicaid deemed beneficiary of certain recipients who die intestate and without heirs
Any person who is a Medicaid recipient and is receiving medical assistance for services provided in a long-term care facility under the provisions of Section 43-13-117 from the Division of Medicaid in the Office of the Governor, who dies intestate and leaves no known heirs, shall have deemed, through his acceptance of such medical assistance, […]
§ 43-13-121. Authority to administer article
The division shall administer the Medicaid program under the provisions of this article, and may do the following: Adopt and promulgate reasonable rules, regulations and standards, with approval of the Governor, and in accordance with the Administrative Procedures Law, Section 25-43-1.101 et seq.: Establishing methods and procedures as may be necessary for the proper and […]
§ 43-13-122. Division authorized to apply for federal, private and public waivers, grants and contributions; implementation of integrated case-mix payment and quality monitoring system
The division is authorize to apply to the Center for Medicare and Medicaid Services of the United States Department of Health and Human Services for waivers and research and demonstration grants. The division is further authorized to accept and expend any grants, donations or contributions from any public or private organization together with any additional […]
§ 43-13-123. Methods of providing for payment of claims
The determination of the method of providing payment of claims under this article shall be made by the division, with approval of the Governor, which methods may be: By contract with insurance companies licensed to do business in the State of Mississippi or with nonprofit hospital service corporations, medical or dental service corporations, authorized to […]