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# Mississippi Division of Medicaid

## Sitemaps

- [XML Sitemap](https://medicaid.ms.gov/sitemap.xml): Contains all public & indexable URLs for this website.

## Posts

- [MS SPA 23-CHIP-0015 for Coverage Required by the American Rescue Plan Act](https://medicaid.ms.gov/ms-spa-23-chip-0015-for-coverage-required-by-the-american-rescue-plan-act-2/) - CMS approved MS SPA 23-CHIP-0015 on June 22, 2023. The purpose of this SPA is to demonstrate compliance with the American Rescue Plan Act which includes coverage of treatment, testing, and vaccinations for COVID-19 without cost sharing in CHIP, effective July 1, 2022. For more information, read the approved SPA pages.
- [MS SPA 23-0010 Private Duty Nursing (PDN) Rate Updates submitted to CMS](https://medicaid.ms.gov/ms-spa-23-0010-private-duty-nursing-pdn-rate-updates-submitted-to-cms/) - State Plan Amendment (SPA) 23-0010 is being submitted to allow the Division of Medicaid to continue the same PDN rates in effect January 1, 2023, for dates of service beginning May 1, 2023. For more information, read the proposed SPA pages.
- [MS SPA 23-0011 Copay submitted to CMS](https://medicaid.ms.gov/ms-spa-23-0011-copay-submitted-to-cms/) - State Plan Amendment (SPA) 23-0011 is being submitted to allow the Division of Medicaid (DOM) to remove copays from Medicaid services, effective May 1, 2023. For more information, read the proposed SPA pages.
- [MS SPA 23-0019 Prescribed Pediatric Extended Care (PPEC) submitted to CMS](https://medicaid.ms.gov/ms-spa-23-0019-prescribed-pediatric-extended-care-ppec-submitted-to-cms/) - State Plan Amendment (SPA) 23-0019 is being submitted to allow the Division of Medicaid (DOM) to continue the fifteen percent (15%) increase for Prescribed Pediatric Extended Care (PPEC) facilities that were made effective October 1, 2022, beyond the end of the federal Public Health Emergency. For more information, read the proposed SPA pages.
- [Public Notice of Annual Post-Award Forum for 1115(a) Healthier Mississippi Waiver](https://medicaid.ms.gov/public-notice-of-annual-post-award-forum-for-1115a-healthier-mississippi-waiver-4/) - Pursuant to 42 C.F.R. Section 431.420(c), public notice is hereby given to the annual Post-Award Forum on the Division of Medicaid’s Healthier Mississippi Waiver. The annual Post-Award Forum provides stakeholders and the general public the opportunity to provide meaningful comment on the progress of the Healthier Mississippi Waiver. The Healthier Mississippi Waiver operates under the
- [Public Notice of Annual Public Forum for 1115(a) Family Planning Waiver](https://medicaid.ms.gov/public-notice-of-annual-public-forum-for-1115a-family-planning-waiver-5/) - Pursuant to 42 C.F.R. Section 431.420©, a Public Forum is required annually after the implementation of the Division of Medicaid’s Family Planning Waiver. This Public Forum provides stakeholders the opportunity to provide meaningful comments on the progress of the Family Planning Waiver. The Family Planning Waiver operates under the authority of an 1115(a) wavier approved
- [Value-Based Incentives](https://medicaid.ms.gov/value-based-incentives/) - Comprehensive Quality Strategy In accordance with 42 C.F.R. § 438.340, the Mississippi Division of Medicaid (DOM) has developed a Comprehensive Quality Strategy. The Comprehensive Quality Strategy reflects many ongoing and planned quality improvement efforts within the managed care and fee-for-delivery systems. MS DOM 2026 Managed Care Quality Strategy – Draft posted June 23, 2026
- [Public Notice for State Plan Amendment (SPA) 26-0011 Inpatient Upper Payment Limit (UPL)](https://medicaid.ms.gov/public-notice-for-state-plan-amendment-state-plan-amendment-spa-26-0011-inpatient-upper-payment-limit-upl/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 26-0011 Inpatient Upper Payment Limit (UPL). The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2026,
- [Procedure Code PA Requirement](https://medicaid.ms.gov/procedure-code-pa-requirement/) - Procedure Code Prior Authorization Required Click here to find Procedure code list requiring PA by Service Area.
- [Public Notice for State Plan Amendment (SPA) 26-0013 Inpatient Single Case Agreement](https://medicaid.ms.gov/public-notice-for-state-plan-amendment-spa-26-0013-inpatient-single-case-agreement/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 26-0013 Inpatient Single Case Agreement. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective August 1, 2026, contingent
- [Public Notice for State Plan Amendment (SPA) 26-0009 340B Drugs Ceiling Price](https://medicaid.ms.gov/public-notice-for-state-plan-amendment-spa-26-0009-340b-drugs-ceiling-price/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 26-0009 340B Drugs Ceiling Price. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective August 1, 2026, contingent
- [BAC/MAC meetings to be held July 10, 2026](https://medicaid.ms.gov/bac-mac-meetings-to-be-held-july-10-2026/) - The Mississippi Beneficiary Advisory Council (BAC) will meet at 10 a.m. on July 10, 2026, in the Cobb Conference Center at 550 High Street, Jackson, MS. This meeting may be viewed virtually by clicking on the following link (the link will be live shortly before the meeting begins): BAC July 10, 2026 Meeting Learn more about
- [Public Forum for Mississippi Section 1115(a) Family Planning Waiver](https://medicaid.ms.gov/public-forum-for-mississippi-section-1115a-family-planning-waiver/) - Pursuant to 42 C.F.R. § 431.420(c), a public forum is required annually after the implementation of the Division of Medicaid’s Family Planning Waiver. This public forum provides stakeholders the opportunity to provide meaningful comments on the progress of the Family Planning Waiver. The Family Planning Waiver operates under the authority of an 1115(a) wavier approved
- [Pharmacy News and Notices Archive](https://medicaid.ms.gov/prn-updates-for-pharmacy-providers-oct-3-2022/) - Archived Documents 340B Frequently Asked Questions - effective 9/23/2022-12/31/2024 Flat rate price of generics being offered in Mississippi 72-hour emergency prescription - effective October 1, 2022 Pharmacy contact and plan billing information (PCN/BIN) State of Emergency & Medicaid Pharmacy Billing Guidance - 1/23/26 The Governor has declared a State of Emergency in advance of
- [MS SPA 26-0002 Federally Qualified Health Center (FQHC) Submitted to CMS](https://medicaid.ms.gov/ms-spa-26-0002-federally-qualified-health-center-fqhc-submitted-to-cms/) - State Plan Amendment (SPA) 26-0002 is being submitted to allow Federally Qualified Health Center (FQHC) mobile units to operate under the same Medicaid provider number as the affiliated FQHC, remove the requirement that FQHC mobile units be surveyed by the Mississippi Department of Health, and no longer require a separate approval letter from the Centers
- [MS SPA 26-0020-CHIP submitted to CMS](https://medicaid.ms.gov/ms-spa-26-0020-chip-submitted-to-cms/) - State Plan Amendment (SPA) 26-0020-CHIP is being submitted to update the CHIP State Plan to align with the most recent CHIP contract, effective July 1, 2025. For more information, read the proposed SPA pages.
- [MS SPA 26-0007 Recovery Audit Contractors (RAC) Exemption Submitted to CMS](https://medicaid.ms.gov/ms-spa-26-0007-recovery-audit-contractors-rac-exemption-submitted-to-cms/) - State Plan Amendment (SPA) 26-0007 is being submitted to allow the Division of Medicaid (DOM) to request an exemption under 42 CFR § 455.516 from the federal requirement to contract with a Recovery Audit Contractor (RAC), effective July 1, 2026. For more information, read the proposed SPA pages.
- [MS SPA 26-0001 Ventilator Dependent Care (VDC)](https://medicaid.ms.gov/ms-spa-26-0001-ventilator-dependent-care-vdc/) - MS SPA 26-0001 Ventilator Dependent Care (VDC) will not be submitted at this time. An updated notice will be shared when the submission process resumes. For more information, read the public notice and draft pages.
- [Presumptive Eligibility for Pregnant Women](https://medicaid.ms.gov/presumptive-eligibility-for-pregnant-women/) - Presumptive Eligibility for Pregnant Women House Bill 539, approved by the Mississippi Legislature during the 2024 regular session, authorized the Mississippi Division of Medicaid to offer presumptive eligibility for pregnant women (PEPW) to provide coverage for ambulatory prenatal care. What is Presumptive Eligibility for Pregnant Women? The PEPW provision permits qualified providers to immediately
- [Magnolia Health - Mental Health Information Archive](https://medicaid.ms.gov/magnolia-health-mental-health-information-archive/) - Magnolia Health Electroconvulsive Therapy (ECT) OTR form Magnolia Health Injectable Antipsychotic Authorization form Magnolia Health Intensive Outpatient Program (IOP) Authorization form Magnolia Health mental health provider directory
- [Providers Archive](https://medicaid.ms.gov/providers-archive/) - Provider survey letter Provider survey feedback Magnolia Health prior authorization form for non-mental health service Magnolia Health Electroconvulsive Therapy (ECT) OTR form Magnolia Health Injectable Antipsychotic Authorization form Magnolia Health Intensive Outpatient Program (IOP) Authorization form Magnolia Health mental health provider directory UnitedHealth Community Plan Authorization Request Form
- [Beneficiaries Archive](https://medicaid.ms.gov/beneficiaries-archive/) - Magnolia Health provider directory - access the provider directory for Magnolia Health to find a doctor clinic or hospital UnitedHealthcare Community Plan provider directory - access the provider directory for UnitedHealthcare Community Plan to find a doctor clinic or hospital Magnolia Health Plan website Molina Healthcare of Mississippi website TrueCare website UnitedHealthcare Community Plan website Magnolia Health brochure
- [Medicaid Vital Signs – January-March 2026](https://medicaid.ms.gov/medicaid-vital-signs-january-march-2026/) - This update of the Medicaid Vital Signs dashboard contains enrollment and expenditure data from the first quarter of 2026. Launched in early 2019, Vital Signs displays key Mississippi Medicaid metrics allowing anyone to quickly check certain Medicaid statistics and follow recent program trends. View previous reports at the Medicaid Vital Signs Archive. Enrollment Enrollment
- [Public Notice for State Plan Amendment SPA 26-0010 All Patient Refined Diagnosis Related Groups (APR-DRG) Grouper Version Update](https://medicaid.ms.gov/public-notice-for-state-plan-amendment-spa-26-0010-all-patient-refined-diagnosis-related-groups-apr-drg-grouper-version-update/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 26-0010 All Patient Refined Diagnosis Related Groups (APR-DRG) Grouper Version Update. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services
- [Post Award Public Forum for Mississippi Section 1115(a) Healthier Mississippi Waiver](https://medicaid.ms.gov/post-award-public-forum-for-mississippi-section-1115a-healthier-mississippi-waiver/) - Pursuant to 42 C.F.R. Section 431.420(c), public notice is hereby given for the Post Award Public Forum on the Division of Medicaid’s Healthier Mississippi Waiver. The Post Award Public Forum provides stakeholders and the general public the opportunity to provide meaningful comments on the progress of the Healthier Mississippi Waiver. The Healthier Mississippi Waiver operates
- [Medicaid Vital Signs – October-December 2025](https://medicaid.ms.gov/medicaid-vital-signs-october-december-2025/) - This update of the Medicaid Vital Signs dashboard contains enrollment and expenditure data from the fourth quarter of 2025. Launched in early 2019, Vital Signs displays key Mississippi Medicaid metrics allowing anyone to quickly check certain Medicaid statistics and follow recent program trends. View previous reports at the Medicaid Vital Signs Archive. Enrollment Enrollment
- [Dr. Robert Besinger joins Medicaid as new Medical Director](https://medicaid.ms.gov/dr-robert-besinger-joins-medicaid-as-new-medical-director/) - Jackson, Miss. – The Mississippi Division of Medicaid (DOM) has named Dr. Robert Besinger, a pediatrician from Brandon, to serve as the agency’s new Medical Director, effective April 1, 2026. Before joining DOM, Besinger worked in outpatient pediatrics at St. Dominic Family Health in Flowood, as well as Rankin Children’s Group in Flowood. He has
- [BAC/MAC meetings to be held April 17, 2026](https://medicaid.ms.gov/bac-mac-meetings-to-be-held-january-16-2026-2/) - The Mississippi Beneficiary Advisory Council (BAC) will meet at 10 a.m. on April 17, 2026, in the Cobb Conference Center at 550 High Street, Jackson, MS. This meeting may be viewed virtually by clicking on the following link (the link will be live shortly before the meeting begins): BAC April 17, 2026 Meeting Learn more about
- [Members](https://medicaid.ms.gov/members/)
- [MS SPA 25-0002 Automatic Enrollment approved by CMS](https://medicaid.ms.gov/ms-spa-25-0002-automatic-enrollment-approved-by-cms/) - State Plan Amendment (SPA) 25-0002 was submitted to allow the Division of Medicaid (DOM) to include automatic enrollment to Medicaid Managed Care Organizations (MCOs), include language excluding beneficiaries receiving 1915(i) Community Support Program services from the Mississippi Coordinated Access Network (MSCAN), exclude tribal members from automatic enrollment, update the State Plan pages to the new
- [Public Notice for MS SPA 26-0001 Ventilator Dependent Care (VDC)](https://medicaid.ms.gov/public-notice-for-ms-spa-26-0001-ventilator-dependent-care-vdc/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 26-0001 Ventilator Dependent Care (VDC). The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective February 1, 2026, contingent
- [Other Requestors](https://medicaid.ms.gov/other-requestors/)
- [For Providers](https://medicaid.ms.gov/for-providers/)
- [BAC/MAC meetings to be held January 16, 2026](https://medicaid.ms.gov/bac-mac-meetings-to-be-held-january-16-2026/) - The Mississippi Beneficiary Advisory Council (BAC) will meet at 10 a.m. on January 16, 2026, in the Cobb Conference Center at 550 High Street, Jackson, MS. This meeting may be viewed virtually by clicking on the following link (the link will be live shortly before the meeting begins): BAC January 16, 2025 Meeting Learn more about
- [Public Notice for DOM’s 2026 Managed Care Quality Strategy](https://medicaid.ms.gov/public-notice-for-doms-2026-managed-care-quality-strategy/) - Pursuant to 42 C.F.R. Section 438.340(c), public notice is hereby given to the Division of Medicaid’s 2026 Managed Care Quality Strategy Report. A copy of the proposed 2026 Managed Care Quality Strategy will be available in each county Health Department office and in the Department of Human Services office in Issaquena County for review. A
- [MS SPA 25-0019 Medication Assisted Treatment (MAT) approved by CMS](https://medicaid.ms.gov/ms-spa-25-0019-medication-assisted-treatment-mat-approved-by-cms/) - State Plan Amendment (SPA) 25-0019 Medication Assisted Treatment (MAT) was submitted to update the pages to a new CMS template and to remove the end date of September 30, 2025 in accordance with Section 201 of the Consolidated Appropriations Act, 2024 that made the mandatory MAT benefit permanent by amending 1905(a)(29) of the Act, effective
- [MS SPA 25-0003 Autism Spectrum Disorder (ASD) Rates submitted to CMS](https://medicaid.ms.gov/ms-spa-25-0003-autism-spectrum-disorder-asd-rates-submitted-to-cms/) - State Plan Amendment (SPA) 25-0003 is being submitted to allow the Division of Medicaid (DOM) to update the reimbursement rates for Autism Spectrum Disorder (ASD) services, effective December 1, 2025. For more information, read the proposed SPA pages.
- [MS SPA 25-0015 Patient-Driven Payment Model (PDPM) and State-Owned Pediatric Skilled Nursing Facility (PSNF) submitted to CMS](https://medicaid.ms.gov/ms-spa-25-0015-patient-driven-payment-model-pdpm-and-state-owned-pediatric-skilled-nursing-facility-psnf-submitted-to-cms/) - State Plan Amendment (SPA) 25-0015 Patient-Driven Payment Model (PDPM) and State-Owned Pediatric Skilled Nursing Facility (PSNF) is being submitted to allow the Division of Medicaid (DOM) to transition the case mix model for nursing facility services to the Patient-Driven Payment Model (PDPM) and to add state-owned Pediatric Skilled Nursing Facilities (PSNFs) as a covered and
- [Value-Based Incentives Archive](https://medicaid.ms.gov/value-based-incentives-archive/) - Physician Quality Incentive Payment Program (PQIPP) The PQIPP program development process did not result in a new payment program request to CMS. Physician Quality Incentive Payment Program (PQIPP) PQIPP Survey Hospital Physician Directed Payment Arrangement The Mississippi Division of Medicaid is working on the development of a new directed payment for physician services. This
- [MS SPA 25-0002 Automatic Enrollment submitted to CMS](https://medicaid.ms.gov/ms-spa-25-0002-automatic-enrollment-submitted-to-cms/) - State Plan Amendment (SPA) 25-0002 is being submitted to allow the Division of Medicaid (DOM) to include automatic enrollment to Medicaid Managed Care Organizations (MCOs), include language excluding beneficiaries receiving 1915(i) Community Support Program services from the Mississippi Coordinated Access Network (MSCAN), exclude tribal members from automatic enrollment, update the State Plan pages to the
- [MS SPA 25-0019 Medication Assisted Treatment (MAT) submitted to CMS](https://medicaid.ms.gov/ms-spa-25-0019-medication-assisted-treatment-mat-submitted-to-cms/) - State Plan Amendment (SPA) 25-0019 Medication Assisted Treatment (MAT) is being submitted to update the pages to a new CMS template and to remove the end date of September 30, 2025 in accordance with Section 201 of the Consolidated Appropriations Act, 2024 that made the mandatory MAT benefit permanent by amending 1905(a)(29) of the Act,
- [Late Breaking News 2024-2023](https://medicaid.ms.gov/late-breaking-news-2024-2023/) - 12/30/2024 Letters Available in Provider Portal Effective immediately, providers will be able to view copies of letters received by mail directly in the Provider Portal. Access to these letters will be determined by the status of the application and the age of the letter. Please refer to the following instructions for guidance on how to
- [Medicaid Vital Signs – July-September 2025](https://medicaid.ms.gov/medicaid-vital-signs-july-september-2025/) - This update of the Medicaid Vital Signs dashboard contains enrollment and expenditure data from the third quarter of 2025. Launched in early 2019, Vital Signs displays key Mississippi Medicaid metrics allowing anyone to quickly check certain Medicaid statistics and follow recent program trends. View previous reports at the Medicaid Vital Signs Archive. Enrollment Enrollment
- [Medicaid Vital Signs – April-June 2025](https://medicaid.ms.gov/medicaid-vital-signs-april-june-2025/) - This update of the Medicaid Vital Signs dashboard contains enrollment and expenditure data from the second quarter of 2025. Launched in early 2019, Vital Signs displays key Mississippi Medicaid metrics allowing anyone to quickly check certain Medicaid statistics and follow recent program trends. View previous reports at the Medicaid Vital Signs Archive. Enrollment Enrollment
- [Public Notice for 25-0003 Autism Spectrum Disorder (ASD) Rates](https://medicaid.ms.gov/public-notice-for-25-0003-autism-spectrum-disorder-asd-rates/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 25-0003 Autism Spectrum Disorder (ASD) Rates. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective December 1, 2025,
- [MESA Provider Portal FAQs](https://medicaid.ms.gov/mesa-provider-faqs/) - Claims What is timely filing? As defined in the Mississippi Division of Medicaid (DOM) Administrative Code, a claim is considered timely if it is submitted: Within 365 days from the date of service, or Within 180 days from the Medicare paid date, whichever is applicable. Adjustments to Medicaid Fee-For-Service (FFS) claims are permitted within the
- [MS SPA 25-0006 High-Cost Drugs approved by CMS](https://medicaid.ms.gov/ms-spa-25-0006-high-cost-drugs-approved-by-cms/) - State Plan Amendment (SPA) 25-0006 High-Cost Drugs was submitted to allow the Division of Medicaid (DOM) to reimburse certain high-cost drugs outside of the All-Patient Refined Diagnosis Related Group (APR-DRG) reimbursement system, effective January 1, 2025. For more information, read the approved SPA pages.
- [BAC/MAC meetings to be held Oct. 17, 2025](https://medicaid.ms.gov/bac-mac-meetings-to-be-held-oct-17-2025/) - The Mississippi Beneficiary Advisory Council (BAC) will meet at 10 a.m. on October 17, 2025, in the Cobb Conference Center at 550 High Street, Jackson, MS. This meeting may be viewed virtually by clicking on the following link (the link will be live shortly before the meeting begins): BAC October 17, 2025 Meeting Learn more about
- [Survey open for public input on development of Rural Health Transformation Plan](https://medicaid.ms.gov/survey-open-for-public-input-on-development-of-rural-health-transformation-plan/) - On July 3, Congress passed via the FY 2025 budget reconciliation process H.R.1, the One Big Beautiful Bill Act (OBBBA), and on July 4, the President signed it into law. Section 71401 of the Bill modifies Section 2105 of the Social Security Act and establishes a $50 billion grant program ($10 billion per fiscal year
- [Public Notice for 25-0015 Patient-Driven Payment Model (PDPM) and state-owned Pediatric Skilled Nursing Facility (PSNF)](https://medicaid.ms.gov/public-notice-for-25-0015-patient-driven-payment-model-pdpm-and-state-owned-pediatric-skilled-nursing-facility-psnf/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 25-0015 Patient-Driven Payment Model (PDPM) and state-owned Pediatric Skilled Nursing Facility (PSNF). The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid
- [Medicaid Vital Signs – January-March 2025](https://medicaid.ms.gov/medicaid-vital-signs-january-march-2025/) - This update of the Medicaid Vital Signs dashboard contains enrollment and expenditure data from the first quarter of 2025. Launched in early 2019, Vital Signs displays key Mississippi Medicaid metrics allowing anyone to quickly check certain Medicaid statistics and follow recent program trends. View previous reports at the Medicaid Vital Signs Archive. Enrollment Enrollment
- [MS SPA 25-0012 Prescribed Pediatric Extended Care (PPEC) Rate Update approved by CMS](https://medicaid.ms.gov/18178-2/) - State Plan Amendment (SPA) 25-0012 Prescribed Pediatric Extended Care (PPEC) Rate Update was submitted to allow the Division of Medicaid (DOM) to update the calculation of the Prescribed Pediatric Extended Care (PPEC) rates to use the 2023 average small nursing facility rate, effective May 1, 2025 For more information, read the approved SPA pages.
- [DOM seeks consultant to support Rural Health Transformation Program](https://medicaid.ms.gov/dom-seeks-consultant-to-support-rural-health-transformation-program/) - The Mississippi Division of Medicaid (DOM), in coordination with the Office of the Governor and the Mississippi State Department of Health (MSDH), is soliciting quotes from consultants to prepare the State’s Application for the Rural Health Transformation Program provided for in The One Big Beautiful Bill Act. Offers must be submitted by 2 p.m. on
- [MS SPA 25-0007 Indirect Graduate Medical Education (IME) submitted to CMS](https://medicaid.ms.gov/ms-spa-25-0007-indirect-graduate-medical-education-ime-submitted-to-cms/) - State Plan Amendment (SPA) 25-0007 Indirect Graduate Medical Education (IME) is being submitted to allow the Division of Medicaid (DOM) to reimburse for indirect medical education costs, effective August 6, 2025. For more information, read the proposed SPA pages.
- [Public Notice for SPA 25-0007 Indirect Graduate Medical Education (IME)](https://medicaid.ms.gov/public-notice-for-spa-25-0007-indirect-graduate-medical-education-ime/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 25-0007 Indirect Graduate Medical Education (IME). The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective August 6, 2025,
- [For Providers](https://medicaid.ms.gov/providers/)
- [Medicaid Advisory Committee to meet on July 25, 2025](https://medicaid.ms.gov/medicaid-advisory-committee-to-meet-on-july-25-2025/) - The Mississippi Medicaid Advisory Committee will meet at 2 p.m. on July 25, 2025, in the Cobb Conference Center at 550 High Street, Jackson, MS. This meeting may be viewed virtually by clicking on the following link: MAC July 25, 2025 Meeting Please note: This link is for the public to view the meeting virtually;
- [Beneficiary Advisory Council to meet on July 25, 2025](https://medicaid.ms.gov/beneficiary-advisory-council-to-meet-on-july-25-2025/) - The Mississippi Beneficiary Advisory Council will meet at 10 a.m. on July 25, 2025, in the Cobb Conference Center at 550 High Street, Jackson, MS. BAC July 25, 2025 Meeting Please note: This link is for the public to view the meeting virtually; it is not for BAC members. This link will only be live
- [Medicaid Vital Signs – October-December 2024](https://medicaid.ms.gov/medicaid-vital-signs-october-december-2024/) - This update of the Medicaid Vital Signs dashboard contains enrollment and expenditure data from the fourth quarter of 2024. Launched in early 2019, Vital Signs displays key Mississippi Medicaid metrics allowing anyone to quickly check certain Medicaid statistics and follow recent program trends. View previous reports at the Medicaid Vital Signs Archive. Enrollment Enrollment
- [MS SPA 24-0010 Presumptive Eligibility for Pregnant Women approved by CMS](https://medicaid.ms.gov/ms-spa-24-0010-presumptive-eligibility-for-pregnant-women-approved-by-cms/) - State Plan Amendment (SPA) 24-0010 is being submitted to allow the Division of Medicaid (DOM) to provide coverage of ambulatory prenatal care to women deemed presumptively eligible by a qualified provider, effective July 1, 2024. For more information, read the approved SPA pages.
- [MS SPA 25-0009 Inpatient Hospital Physician Visits approved by CMS](https://medicaid.ms.gov/ms-spa-25-0009-inpatient-hospital-physician-visits-approved-by-cms/) - State Plan Amendment (SPA) 25-0009 Inpatient Hospital Physician Visits was submitted to allow the Division of Medicaid (DOM) to remove prior authorization language and clarify details for inpatient referrals of physician specialist and inpatient hospital physician visit limits effective May 1, 2025. For more information, read the approved SPA pages.
- [Update Your Plan](https://medicaid.ms.gov/update-your-plan/) - How to update your managed care plan.
- [MS SPA 25-0019-CHIP Benefit Limits submitted to CMS](https://medicaid.ms.gov/ms-spa-25-0019-chip-benefit-limits-submitted-to-cms/) - State Plan Amendment (SPA) MS-25-0019 CHIP Benefit Limits is being submitted to allow the Division of Medicaid (DOM) to remove annual and lifetime limits on benefits in CHIP as required by the Medicaid & CHIP Eligibility and Enrollment final rule, effective June 1, 2025. For more information, read the proposed SPA pages.
- [MS SPA 25-0011 Out-of-State Psychiatric Residential Treatment Facility (PRTF) submitted to CMS](https://medicaid.ms.gov/ms-spa-25-0011-out-of-state-psychiatric-residential-treatment-facility-prtf-submitted-to-cms/) - State Plan Amendment (SPA) 25-0011 Out-of-State Psychiatric Residential Treatment Facility (PRTF). This SPA will allow the Division of Medicaid to set the out-of-state rate for Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IIDs) and PRTFs the same as the Medicaid rate of the domicile state for the facility, effective May 1, 2025. For more
- [MS SPA 25-0018-CHIP Incarcerated Youth submitted to CMS](https://medicaid.ms.gov/ms-spa-25-0018-chip-incarcerated-youth-submitted-to-cms/) - State Plan Amendment (SPA) CHIP # 18 Incarcerated Youth is being submitted to allow the Division of Medicaid (DOM) to comply with amendments made by Section 5121 of the Consolidated Appropriations Act, 2023 (CAA, 2023) which requires states attest to coverage of screening and diagnostic services, that are currently available under the CHIP State Plan,
- [Training Required for E&D Providers of ADC, PCS, & IHR](https://medicaid.ms.gov/training-required-for-ed-providers-of-adc-pcs-ihr/) - Training Required for E&D Providers of ADC, PCS, & IHR Providers of Elderly and Disabled (E&D) Waiver services must satisfy all requirements set forth in Title 23 Miss. Admin. Code Part 208, newly revised effective June 1, 2025. To ensure all providers are educated on these requirements, the Office of Long Term Services and Supports has
- [Annual Public Forum  for Mississippi Section 1115(a) Family Planning Waiver Demonstration](https://medicaid.ms.gov/annual-public-forum-for-mississippi-section-1115a-family-planning-waiver-demonstration-2/) - Pursuant to 42 C.F.R. § 431.420(c), a public forum is required annually after the implementation of the Division of Medicaid’s Family Planning Waiver. This public forum provides stakeholders the opportunity to provide meaningful comments on the progress of the Family Planning Waiver. The Family Planning Waiver operates under the authority of an 1115(a) wavier approved
- [MS SPA 25-0012 Prescribed Pediatric Extended Care (PPEC) Rate Update submitted to CMS](https://medicaid.ms.gov/ms-spa-25-0012-prescribed-pediatric-extended-care-ppec-rate-update-submitted-to-cms/) - State Plan Amendment (SPA) 25-0012 Prescribed Pediatric Extended Care (PPEC) Rate Update is being submitted to allow the Division of Medicaid (DOM) to update the calculation of the Prescribed Pediatric Extended Care (PPEC) rates to use the 2023 average small nursing facility rate, effective May 1, 2025. There are no system or coding changes needed
- [MS SPA 25-0009 Inpatient Hospital Physician Visits submitted to CMS](https://medicaid.ms.gov/ms-spa-25-0009-inpatient-hospital-physician-visits-submitted-to-cms/) - State Plan Amendment (SPA) 25-0009 Inpatient Hospital Physician Visits is being submitted to allow the Division of Medicaid (DOM) to remove prior authorization language and clarify details for inpatient referrals of physician specialist and inpatient hospital physician visit limits effective May 1, 2025. For more information, read the proposed SPA pages.
- [How to Enroll/Contract with TrueCare Based on Enrollment with DOM](https://medicaid.ms.gov/how-to-enroll-contract-with-truecare-based-on-enrollment-with-dom/) - How to Enroll/Contract with TrueCare Based on Enrollment with DOM As previously communicated through Late Breaking News articles and Provider Bulletins, TrueCare will join Molina and Magnolia as a Coordinated Care Organization (CCO) serving Mississippi Medicaid members, effective July 1, 2025. At that time, UnitedHealthcare will no longer provide coverage for Mississippi members (members will
- [Medicaid Vital Signs – July-September 2024](https://medicaid.ms.gov/medicaid-vital-signs-july-september-2024/) - This update of the Medicaid Vital Signs dashboard contains enrollment and expenditure data from the third quarter of 2024. Launched in early 2019, Vital Signs displays key Mississippi Medicaid metrics allowing anyone to quickly check certain Medicaid statistics and follow recent program trends. View previous reports at the Medicaid Vital Signs Archive. Enrollment Enrollment
- [Public Notice for SPA 25-0012 Prescribed Pediatric Extended Care (PPEC) Rate Update](https://medicaid.ms.gov/public-notice-for-spa-25-0012-prescribed-pediatric-extended-care-ppec-rate-update/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 25-0012 Prescribed Pediatric Extended Care (PPEC) Rate Update. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective May
- [Public Notice for SPA 25-0011 Out-of-State Psychiatric Residential Treatment Facility (PRTF)](https://medicaid.ms.gov/public-notice-for-spa-25-0011-out-of-state-psychiatric-residential-treatment-facility-prtf/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 25-0011 Out-of-State Psychiatric Residential Treatment Facility (PRTF). The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective May 1,
- [Special enrollment period underway for managed care members](https://medicaid.ms.gov/special-enrollment-period-underway-for-managed-care-members/) - Special Enrollment Period for Managed Care Members What is Special Open Enrollment? Special Open Enrollment a time frame designated for Medicaid members to make a one-time change to their plan prior to the operational phase of a new contract and its Coordinated Care Organizations (CCOs). When is Special Open Enrollment? Special Open Enrollment is from
- [Beneficiary Advisory Council to meet on May 16, 2025](https://medicaid.ms.gov/beneficiary-advisory-council-to-meet-on-may-16-2025/) - The Mississippi Beneficiary Advisory Council will meet at 10 a.m. on May 16, 2025, in the Cobb Conference Center at 550 High Street, Jackson, MS. Beneficiary Advisory Council 2nd Quarter Meeting | May 16, 2025, 10:00 AM +1 769-230-0549 United States, Jackson (Toll) Conference ID: 905 111 500# The Mississippi Medicaid Beneficiary Advisory Council The
- [Family planning waiver renewal changes](https://medicaid.ms.gov/family-planning-waiver-renewal-changes/) - Family planning waiver renewal changes Effective Jan. 1, 2015, Division of Medicaid’s Family Planning Waiver (FPW) was renewed by Centers for Medicare and Medicaid Services (CMS). The FPW renewal stipulates that coverage now includes males and females aged 13-44 with family income at or below 194 percent of the Federal Poverty Level and must not have
- [MS SPA 25-0006 High-Cost Drugs Submitted to CMS](https://medicaid.ms.gov/ms-spa-25-0006-high-cost-drugs-submitted-to-cms/) - State Plan Amendment (SPA) 25-0006 High-Cost Drugs is being submitted to allow the Division of Medicaid (DOM) to reimburse certain high-cost drugs outside of the All-Patient Refined Diagnosis Related Group (APR-DRG) reimbursement system, effective January 1, 2025. For more information, read the proposed SPA pages.
- [MS SPA 25-0004 Hospice submitted to CMS](https://medicaid.ms.gov/ms-spa-25-0004-hospice-submitted-to-cms/) - State Plan Amendment (SPA) 25-0004 is being submitted to allow the Division of Medicaid (DOM) to reimburse the hospice provider for services rendered on the date of death, effective January 1, 2025. For more information, read the proposed SPA pages.
- [Public Notice for Post Award Public Forum on Healthier Mississippi Waiver](https://medicaid.ms.gov/public-notice-for-post-award-public-forum-on-healthier-mississippi-waiver/) - Pursuant to 42 C.F.R. Section 431.420(c), public notice is hereby given for the Post Award Public Forum on the Division of Medicaid’s Healthier Mississippi Waiver. The Post Award Public Forum provides stakeholders and the general public the opportunity to provide meaningful comments on the progress of the Healthier Mississippi Waiver. The Healthier Mississippi Waiver operates
- [MS SPA 24-0019 State Governor’s Review approved by CMS](https://medicaid.ms.gov/ms-spa-24-0019-state-governors-review-approved-by-cms/) - State Plan Amendment (SPA) 24-0019 was submitted to allow the Division of Medicaid (DOM) to update the appointed Executive Director authorized to submit the State Plan on behalf of the Division of Medicaid, Office of the Governor, the single state agency effective October 11, 2024. For more information, read the approved SPA pages.
- [Public Notice for DOM’s 2021 Managed Care Quality Strategy](https://medicaid.ms.gov/public-notice-for-doms-2021-comprehensive-quality-strategy/) - Pursuant to 42 C.F.R. Section 438.340(c), public notice is hereby given to the Division of Medicaid’s 2021 Managed Care Quality Strategy Report. A copy of the proposed 2021 Managed Care Quality Strategy will be available in each county Health Department office and in the Department of Human Services office in Issaquena County for review. A
- [Public Notice for SPA 25-0001 Incarcerated Youth](https://medicaid.ms.gov/public-notice-for-spa-25-0001-incarcerated-youth/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 25-0001 Incarcerated Youth. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective January 1, 2025, contingent upon approval
- [MS SPA 24-0019 State Governor's Review submitted to CMS](https://medicaid.ms.gov/ms-spa-24-0019-state-governors-review-submitted-to-cms/) - State Plan Amendment (SPA) 24-0019 is being submitted to allow the Division of Medicaid (DOM) to update the appointed Executive Director authorized to submit the State Plan on behalf of the Division of Medicaid, Office of the Governor, the single state agency effective October 11, 2024. For more information, read the proposed SPA pages.
- [Mississippi Division of Medicaid announces Beneficiary Advisory Council](https://medicaid.ms.gov/mississippi-division-of-medicaid-announces-beneficiary-advisory-council/) - Mississippi Division of Medicaid Announces Beneficiary Advisory Council The Mississippi Division of Medicaid is excited to announce the establishment of a new Beneficiary Advisory Council. The Beneficiary Advisory Council will be comprised of individuals who have firsthand experience with Medicaid programs and services. The Council will advise the State regarding their experience with program matters
- [Public Notice for SPA 25-0004 Hospice](https://medicaid.ms.gov/public-notice-for-spa-25-0004-hospice/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 25-0004 Hospice. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective January 1, 2025, contingent upon approval from
- [Public Notice for SPA 25-0006 High-Cost Drugs](https://medicaid.ms.gov/public-notice-for-spa-25-0006-high-cost-drugs/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 25-0006 High-Cost Drugs. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective January 1, 2025, contingent upon approval
- [MS SPA 24-0004 Core Set Reporting has been approved by CMS](https://medicaid.ms.gov/ms-spa-24-0004-core-set-reporting-has-been-approved-by-cms/) - State Plan Amendment (SPA) 24-0004 was submitted to attest to mandatory Adult and Child Core Set reporting requirements in compliance with 42 C.F.R. § 437.20, effective December 1, 2024. For more information, read the approved SPA pages.
- [MS SPA 24-0011 Affiliation Disclosures approved by CMS](https://medicaid.ms.gov/ms-spa-24-0011-affiliation-disclosures-approved-by-cms/) - State Plan Amendment (SPA) 24-0011 Affiliation Disclosures was submitted to comply with 42 C.F.R. § 455.107 requiring newly enrolling and revalidating providers to disclose affiliation information, effective October 1, 2024 For more information, read the approved SPA pages.
- [MS SPA 24-0004 Core Set Reporting submitted to CMS](https://medicaid.ms.gov/ms-spa-24-0004-core-set-reporting-submitted-to-cms/) - State Plan Amendment (SPA) 24-0004 is being submitted to attest to mandatory Adult and Child Core Set reporting requirements in compliance with 42 C.F.R. § 437.20, effective December 1, 2024. For more information, read the proposed SPA pages.
- [MS SPA 24-0014 Diabetic Supplies approved by CMS](https://medicaid.ms.gov/ms-spa-24-0014-diabetic-supplies-approved-by-cms/) - State Plan Amendment (SPA) 24-0014 was submitted to allow the Division of Medicaid (DOM) to reimburse certain diabetic equipment and supplies according to the reimbursement methodology for drugs when provided through the pharmacy venue, effective July 1, 2024. For more information, read the approved SPA pages.
- [MS SPA 24-0007 Rural Emergency Hospitals (REH) submitted to CMS](https://medicaid.ms.gov/ms-spa-24-0007-rural-emergency-hospitals-reh-submitted-to-cms/) - (SPA) 24-0007 is being submitted to allow the Division of Medicaid (DOM) to set the reimbursement for REH in the Medicaid state plan at the APC rate plus 5% or Medicare payment rate in the Medicare outpatient Addendum B, effective October 1, 2024. For more information, read the proposed SPA pages.
- [MS SPA 24-0003 Physician Upper Payment Limit (UPL) approved by CMS](https://medicaid.ms.gov/ms-spa-24-0003-physician-upper-payment-limit-upl-approved-by-cms/) - State Plan Amendment (SPA) 24-0003 Physician Upper Payment Limit (UPL) was submitted to allow the Division of Medicaid (DOM) to update the Medicare Equivalent of the average commercial rate (ACR) ratio and remove other professional practitioners, effective April 1, 2024. For more information, read the approved SPA pages.
- [MS SPA 24-0015 Prescription Drugs approved by CMS](https://medicaid.ms.gov/ms-spa-24-0015-prescription-drugs-approved-by-cms/) - State Plan Amendment (SPA) 24-0015 was submitted to allow adults to receive above the monthly prescription limit when prior authorized as medically necessary and to allow for coverage of prescription drugs that are not covered outpatient drugs when medically necessary during drug shortages identified by the Food and Drug Administration (FDA), effective October 1, 2024.
- [MS SPA 24-0012 Value-Based Drug Rebate approved by CMS](https://medicaid.ms.gov/ms-spa-24-0012-value-based-drug-rebate-approved-by-cms/) - State Plan Amendment (SPA) 24-0012 was submitted to allow the Division of Medicaid (DOM) to enter into value-based contracts with manufacturers on a voluntary basis, effective July 1, 2024. For more information, read the approved SPA pages.
- [MS SPA 24-0011 Affiliation Disclosures submitted to CMS](https://medicaid.ms.gov/ms-spa-24-0011-affiliation-disclosures-submitted-to-cms/) - State Plan Amendment (SPA) 24-0011 Affiliation Disclosures is being submitted to comply with 42 C.F.R. § 455.107 requiring newly enrolling and revalidating providers to disclose affiliation information, effective October 1, 2024. For more information, read the proposed SPA pages.
- [New coverage requirements for eligible incarcerated youth](https://medicaid.ms.gov/new-coverage-requirements-for-eligible-incarcerated-youth/) - Facilities asked to complete survey by Oct. 31 Beginning January 1, 2025, the Division of Medicaid is required to provide coverage for specific screening, diagnostic, and targeted case management services to eligible juveniles who are being held post adjudication as inmates of a public institution. These services are required to be covered in the 30
- [MS SPA 24-0015 Prescription Drugs submitted to CMS](https://medicaid.ms.gov/ms-spa-24-0015-prescription-drugs-submitted-to-cms/) - State Plan Amendment (SPA) 24-0015 is being submitted to allow adults to receive above the monthly prescription limit when prior authorized as medically necessary and to allow for coverage of prescription drugs that are not covered outpatient drugs when medically necessary during drug shortages identified by the Food and Drug Administration (FDA), effective October 1,
- [Public Notice for SPA 24-0007 Rural Emergency Hospitals (REH)](https://medicaid.ms.gov/public-notice-for-spa-24-0007-rural-emergency-hospitals-reh/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 24-0007 Rural Emergency Hospital. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective October 1, 2024, contingent upon
- [MS SPA 24-0014 Diabetic Supplies submitted to CMS](https://medicaid.ms.gov/ms-spa-24-0014-diabetic-supplies-submitted-to-cms/) - State Plan Amendment (SPA) 24-0014 is being submitted to allow the Division of Medicaid (DOM) to reimburse certain diabetic equipment and supplies according to the reimbursement methodology for drugs when provided through the pharmacy venue, effective July 1, 2024. For more information, read the proposed SPA pages.
- [Healthier Mississippi 1115 Demonstration Extension - Approved](https://medicaid.ms.gov/healthier-mississippi-1115-demonstration-extension-approved/) - On September 24, 2024, the Healthier Mississippi 1115 Demonstration was extended for five years through September 30, 2029, with no programmatic changes. For more information, read the approved pages.
- [MS SPA 24-0013 Recovery Audit Contractor (RAC) Exemption approved by CMS](https://medicaid.ms.gov/ms-spa-24-0013-recovery-audit-contractor-rac-exemption-approved-by-cms/) - State Plan Amendment (SPA) 24-0013 was submitted to allow the Division of Medicaid (DOM) to request an exemption under 42 CFR § 455.516 from the federal requirement to contract with a Recovery Audit Contractor (RAC), effective July 1, 2024. For more information, read the approved SPA pages.
- [MS SPA 24-0006 Home Health LPN approved by CMS](https://medicaid.ms.gov/ms-spa-24-0006-home-health-lpn-approved-by-cms/) - State Plan Amendment (SPA) 24-0006 was submitted to allow the Division of Medicaid (DOM) to include coverage of home health services provided by a licensed practical nurse (LPN) under the supervision of a registered nurse (RN), effective July 1, 2024. For more information, read the approved SPA pages.
- [MS SPA 24-0005 Anesthesia approved by CMS](https://medicaid.ms.gov/ms-spa-24-0005-anesthesia-approved-by-cms/) - State Plan Amendment (SPA) 24-0005 was submitted to allow the Division of Medicaid (DOM) to clarify reimbursement of anesthesia services, effective June 1, 2024. For more information, read the approved SPA pages.
- [Medicaid Vital Signs – June 2024](https://medicaid.ms.gov/medicaid-vital-signs-june-2024/) - This update of the Medicaid Vital Signs dashboard contains enrollment and expenditure data from June 2024. Launched in early 2019, Vital Signs displays key Mississippi Medicaid metrics allowing anyone to quickly check certain Medicaid statistics and follow recent program trends. View previous reports at the Medicaid Vital Signs Archive. Enrollment Enrollment figures do not
- [MS SPA 24-0012 Value-Based Drug Rebate submitted to CMS](https://medicaid.ms.gov/ms-spa-24-0012-value-based-drug-rebate-submitted-to-cms/) - State Plan Amendment (SPA) 24-0012 is being submitted to allow the Division of Medicaid (DOM) to enter into value-based contracts with manufacturers on a voluntary basis, effective July 1, 2024. For more information, read the proposed SPA pages.
- [Medicaid Vital Signs – May 2024](https://medicaid.ms.gov/medicaid-vital-signs-may-2024/) - This update of the Medicaid Vital Signs dashboard contains enrollment and expenditure data from May 2024. Launched in early 2019, Vital Signs displays key Mississippi Medicaid metrics allowing anyone to quickly check certain Medicaid statistics and follow recent program trends. View previous reports at the Medicaid Vital Signs Archive. Enrollment Enrollment figures do not
- [Mississippi Medicaid issues new beneficiary identification cards](https://medicaid.ms.gov/mississippi-medicaid-issues-new-beneficiary-identification-card/) - Beginning May 2014, Mississippi Medicaid beneficiaries will be issued a new Medicaid identification (ID) card. New cards are being issued by categories of eligibility over the next several weeks. New Medicaid ID cards do not reflect any change in eligibility or the benefits and services beneficiaries are currently receiving. About the new Medicaid ID Cards
- [Medicaid Vital Signs – April 2024](https://medicaid.ms.gov/medicaid-vital-signs-april-2024/) - This update of the Medicaid Vital Signs dashboard contains enrollment and expenditure data from April 2024. Launched in early 2019, Vital Signs displays key Mississippi Medicaid metrics allowing anyone to quickly check certain Medicaid statistics and follow recent program trends. View previous reports at the Medicaid Vital Signs Archive. Enrollment Enrollment figures do not
- [MS SPA 24-0013 Recovery Audit Contractor (RAC) Exemption submitted to CMS](https://medicaid.ms.gov/ms-spa-24-0013-recovery-audit-contractor-rac-exemption-submitted-to-cms/) - State Plan Amendment (SPA) 24-0013 was submitted to allow the Division of Medicaid (DOM) to request an exemption under 42 CFR § 455.516 from the federal requirement to contract with a Recovery Audit Contractor (RAC), effective July 1, 2024. For more information, read the proposed SPA pages.
- [MS SPA 24-0010 Presumptive Eligibility for Pregnant Women submitted to CMS](https://medicaid.ms.gov/ms-spa-24-0010-presumptive-eligibility-for-pregnant-women-submitted-to-cms/) - State Plan Amendment (SPA) 24-0010 is being submitted to allow the Division of Medicaid (DOM) to provide coverage of ambulatory prenatal care to women deemed presumptively eligible by a qualified provider, effective July 1, 2024. For more information, read the proposed SPA pages.
- [PHE Unwinding Reports](https://medicaid.ms.gov/phe-unwinding-reports/)
- [MS SPA 24-0006 Home Health LPN submitted to CMS](https://medicaid.ms.gov/ms-spa-24-0006-home-health-lpn-submitted-to-cms/) - State Plan Amendment (SPA) 24-0006 is being submitted to allow the Division of Medicaid (DOM) to include coverage of home health services provided by a licensed practical nurse (LPN) under the supervision of a registered nurse (RN), effective July 1, 2024. For more information, read the proposed SPA pages.
- [Medicaid to implement single Pharmacy Benefit Administrator July 1, 2024](https://medicaid.ms.gov/medicaid-to-implement-single-pharmacy-benefit-administrator-july-1/) - Medicaid to implement single Pharmacy Benefit Administrator for all pharmacy claims on July 1, 2024 On July 1, the Mississippi Division of Medicaid (DOM) will implement a single Pharmacy Benefit Administrator (PBA) to streamline and enhance the processing and management of pharmacy claims for all Medicaid members, including those enrolled in MississippiCAN and CHIP. Operated
- [Public Notice for SPA 24-0014 Diabetic Supplies](https://medicaid.ms.gov/public-notice-for-spa-24-0014-diabetic-supplies/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 24-0014 Diabetic Supplies. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2024, contingent upon approval
- [MS SPA 24-0005 Anesthesia submitted to CMS](https://medicaid.ms.gov/ms-spa-24-0005-anesthesia-submitted-to-cms/) - State Plan Amendment (SPA) 24-0005 is being submitted to allow the Division of Medicaid (DOM) to clarify reimbursement of anesthesia services, effective June 1, 2024. For more information, read the proposed SPA pages.
- [MS SPA 24-0001 End-Stage Renal Disease (ESRD) Services approved by CMS](https://medicaid.ms.gov/ms-spa-24-0001-end-stage-renal-disease-esrd-services-approved-by-cms/) - State Plan Amendment (SPA) 24-0001 ESRD Services was submitted to comply with 42 C.F.R. § 447.201 which requires the Division of Medicaid to describe the policy and methods used in setting payment rates for each type of service in the Mississippi Medicaid State Plan. For more information, read the approved SPA pages.
- [2024 Provider Workshops set for April, May](https://medicaid.ms.gov/2024-provider-workshops-set-for-april-may/) - Workshops to be held both in-person and as virtual webinars Mississippi Medicaid is holding a series of provider workshops throughout April and May designed to educate providers on issues such as contracting, prior authorizations and claims. For convenience, three of the workshops will be offered as virtual webinars, and two will be held in-person. To
- [Annual Public Forum for Mississippi Section 1115(a) Healthier Mississippi Waiver](https://medicaid.ms.gov/annual-public-forum-for-mississippi-section-1115a-healthier-mississippi-waiver/) - Pursuant to 42 C.F.R. Section 431.420(c), public notice is hereby given for the annual Public Forum on the Division of Medicaid’s Healthier Mississippi Waiver. The annual Public Forum provides stakeholders and the general public the opportunity to provide meaningful comments on the progress of the Healthier Mississippi Waiver. The Healthier Mississippi Waiver operates under the
- [Annual Public Forum for Mississippi Section 1115(a) Family Planning Waiver Demonstration](https://medicaid.ms.gov/annual-public-forum-for-mississippi-section-1115a-family-planning-waiver-demonstration/) - Pursuant to 42 C.F.R. Section 431.420(c), a Public Forum is required annually after the implementation of the Division of Medicaid’s Family Planning Waiver. This Public Forum provides stakeholders the opportunity to provide meaningful comments on the progress of the Family Planning Waiver. The Family Planning Waiver operates under the authority of an 1115(a) wavier approved
- [Medicaid Vital Signs – March 2024](https://medicaid.ms.gov/medicaid-vital-signs-february-2024-2/) - This update of the Medicaid Vital Signs dashboard contains enrollment and expenditure data from March 2024. Launched in early 2019, Vital Signs displays key Mississippi Medicaid metrics allowing anyone to quickly check certain Medicaid statistics and follow recent program trends. View previous reports at the Medicaid Vital Signs Archive. Enrollment Enrollment figures do not
- [Public Notice for SPA 24-0005 Anesthesia](https://medicaid.ms.gov/public-notice-for-spa-24-0005-anesthesia/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 24-0005 Anesthesia. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective June 1, 2024, contingent upon approval from
- [MS SPA 24-0003 Physician Upper Payment Limit (UPL) submitted to CMS](https://medicaid.ms.gov/ms-spa-24-0003-physician-upper-payment-limit-upl-submitted-to-cms/) - State Plan Amendment (SPA) 24-0003 Physician Upper Payment Limit (UPL) is being submitted to allow the Division of Medicaid (DOM) to update the Medicare Equivalent of the average commercial rate (ACR) ratio and remove other professional practitioners, effective April 1, 2024. For more information, read the proposed SPA pages.
- [Medicaid to implement single Pharmacy Benefit Administrator](https://medicaid.ms.gov/medicaid-to-implement-single-pharmacy-benefit-administrator-for-all-pharmacy-claims-on-july-1/) - Medicaid to implement single Pharmacy Benefit Administrator for all pharmacy claims on July 1 On July 1, the Mississippi Division of Medicaid (DOM) will implement a single Pharmacy Benefit Administrator (PBA) to streamline and enhance the processing and management of pharmacy claims for all Medicaid members, including those enrolled in MississippiCAN. Operated by Gainwell Technologies,
- [Modivcare to replace MTM as the new Non-Emergency Transportation (NET) Broker](https://medicaid.ms.gov/modivcare-to-replace-mtm-as-the-new-non-emergency-transportation-net-broker/) - Phone numbers for Member Reservations and Member Ride Assist will not change The Mississippi Division of Medicaid (DOM) will begin the transition to a new NET Broker starting on May 24, 2024. The new broker, Modivcare will begin scheduling and conducting rides on Saturday, June 8, 2024. All rides occurring prior to June 8th will
- [Coverage Champions: Help Mississippians Stay Covered](https://medicaid.ms.gov/coverage-champions-help-mississippians-stay-covered/) - Eligibility renewals to begin April 1 We need your partnership to ensure eligible members can keep their health coverage and those who no longer qualify know where they can go for affordable coverage resources. Sign up to be a Coverage Champion and help us share important information and resources, including the Stay Covered Flyer. Use
- [Medicaid responds to severe weather disaster](https://medicaid.ms.gov/medicaid-responds-to-severe-weather-disaster/) - Medicaid lifts prescription limits in response to State of Emergency The Mississippi Division of Medicaid has enacted its State of Emergency provision which allows fee-for-service beneficiaries affected by the tornadoes to receive early refills and additional prescriptions above the 2brand/6prescription monthly limit. Pharmacy providers should follow the billing guidelines found at this link: https://medicaid.ms.gov/disaster-billing-directions/. Medicaid’s
- [MS SPA 23-0029 Hospital Upper Payment Limit (UPL) approved by CMS](https://medicaid.ms.gov/ms-spa-23-0029-hospital-upper-payment-limit-upl-approved-by-cms/) - State Plan Amendment (SPA) 23-0029 Hospital Upper Payment Limit (UPL) was submitted to allow the Division of Medicaid (DOM) to establish a hospital upper payment limit (UPL) program effective October 1, 2023. For more information, read the approved SPA pages.
- [Medicaid Vital Signs – February 2024](https://medicaid.ms.gov/medicaid-vital-signs-february-2024/) - This update of the Medicaid Vital Signs dashboard contains enrollment and expenditure data from February 2024. Launched in early 2019, Vital Signs displays key Mississippi Medicaid metrics allowing anyone to quickly check certain Medicaid statistics and follow recent program trends. Enrollment Enrollment figures do not include retroactive eligibility additions and certain reinstatements.
- [Medicaid Vital Signs – January 2024](https://medicaid.ms.gov/medicaid-vital-signs-january-2024/) - This update of the Medicaid Vital Signs dashboard contains enrollment and expenditure data from January 2024. Launched in early 2019, Vital Signs displays key Mississippi Medicaid metrics allowing anyone to quickly check certain Medicaid statistics and follow recent program trends. Enrollment Enrollment figures do not include retroactive eligibility additions and certain reinstatements.
- [MS SPA 24-0001 End-Stage Renal Disease (ESRD) Services submitted to CMS](https://medicaid.ms.gov/ms-spa-24-0001-end-stage-renal-disease-esrd-services-submitted-to-cms/) - State Plan Amendment (SPA) 24-0001 ESRD Services is being submitted to comply with 42 C.F.R. § 447.201 which requires the Division of Medicaid to describe the policy and methods used in setting payment rates for each type of service in the Mississippi Medicaid State Plan. For more information, read the proposed SPA pages.
- [MESA Provider Webinars](https://medicaid.ms.gov/mesa-provider-workshop-webinars/) - 2024 Provider Workshops set for April, May Mississippi Medicaid is holding a series of provider workshops throughout April and May designed to educate providers on issues such as contracting, prior authorizations and claims. For convenience, three of the workshops will be offered as virtual webinars, and two will be held in-person. To learn more about
- [MS SPA 23-0025 MYPAC Coverage and Reimbursement approved by CMS](https://medicaid.ms.gov/ms-spa-23-0025-mypac-coverage-and-reimbursement-approved-by-cms/) - State Plan Amendment (SPA) 23-0025 was submitted to allow the Division of Medicaid (DOM) to revise rates to an hourly rate and a fifteen (15) minute add-on rate and remove rate freeze language. These rates are based on actuarial analysis of historical utilization, payment and cost data for Early and Periodic Screening, Diagnosis, and Treatment
- [MS SPA 23-0030 Orthodontic Services approved by CMS](https://medicaid.ms.gov/ms-spa-23-0030-orthodontic-services-approved-by-cms/) - State Plan Amendment (SPA) 23-0030 Orthodontic Services was submitted to allow the Division of Medicaid (DOM) to increase reimbursement rates for orthodontic services by ten percent (10%), effective October 1, 2023. For more information, read the approved SPA pages.
- [Medicaid Vital Signs – October-December 2023](https://medicaid.ms.gov/medicaid-vital-signs-october-december-2023/) - This update of the Medicaid Vital Signs dashboard contains enrollment and expenditure data from the fourth quarter of 2023. Launched in early 2019, Vital Signs displays key Mississippi Medicaid metrics allowing anyone to quickly check certain Medicaid statistics and follow recent program trends. Enrollment Enrollment figures do not include retroactive eligibility additions and certain
- [MS SPA 23-0024 Tobacco Cessation approved by CMS](https://medicaid.ms.gov/ms-spa-23-0024-tobacco-cessation-approved-by-cms/) - State Plan Amendment (SPA) 23-0024 was submitted to allow the Division of Medicaid (DOM) to add coverage for up to twelve (12) tobacco cessation counseling sessions per year, effective July 1, 2023. For more information, read the approved SPA pages.
- [Telligen Authorization Status Inquiries](https://medicaid.ms.gov/telligen-authorization-status-inquiries/) - Providers: Register with Telligen to submit fee-for-service authorizations Providers are reminded to register with Telligen for Qualitrac portal access to submit fee-for-service authorizations. Providers who submit requests to Telligen via Qualitrac can also check case status within the Qualitrac portal. Additionally, the automated call system has an option to check case status by following the
- [MS SPA 23-0017-CHIP Adult Vaccine Attestation approved by CMS](https://medicaid.ms.gov/ms-spa-23-0017-chip-adult-vaccine-attestation-approved-by-cms/) - State Plan Amendment (SPA) 23-0017-CHIP Adult Vaccine Attestation was submitted to comply with the Inflation Reduction Act (IRA) requirement for the Division of Medicaid to attest to the coverage of all Advisory Committee on Immunization Practices (ACIP) recommended vaccines and their administration in the CHIP program, effective October 1, 2023. For more information, read the
- [MS SPA 23-0031 Adult Vaccines Attestation approved by CMS](https://medicaid.ms.gov/ms-spa-23-0031-adult-vaccines-attestation-approved-by-cms/) - State Plan Amendment (SPA) 23-0031 was submitted to comply with the Inflation Reduction Act (IRA) requirement for the Division of Medicaid to attest to the coverage of all Advisory Committee on Immunization Practices (ACIP) recommended vaccines and their administration, effective October 1, 2023. For more information, read the approved SPA pages.
- [MS SPA 23-0026 Non-Emergency Transportation (NET) Emergency Contract approved by CMS](https://medicaid.ms.gov/ms-spa-23-0026-non-emergency-transportation-net-emergency-contract-approved-by-cms/) - State Plan Amendment (SPA) 23-0026 was submitted to allow the Division of Medicaid to revise NET broker reimbursement in accordance with an emergency contract effective October 1, 2023. For more information, read the approved SPA pages.
- [Medicaid aims to increase access to physician-administered drugs](https://medicaid.ms.gov/medicaid-aims-to-increase-access-to-physician-administered-drugs/) - During the 2018 legislative session, lawmakers passed Senate Bill 2836, which includes provisions aimed at enhancing the Mississippi Division of Medicaid’s (DOM) coverage of certain pharmacy services and allowing for greater access to care. As a result, on July 1, 2018, DOM will allow certain physician-administered drugs to be billed and reimbursed as either a
- [Medicaid to implement clinical edit for ADHD/ADD stimulants](https://medicaid.ms.gov/medicaid-to-implement-clinical-edit-for-adhd-add-stimulants/) - The Mississippi Drug Utilization Review Board (DUR) has recommended that the Mississippi Division of Medicaid (DOM) implement prescribing guidelines for stimulant drugs most commonly used to treat attention deficit hyperactivity disorder (ADHD)/attention deficit disorder (ADD). In accordance with the DUR Board’s March 1, 2018, recommendations DOM will implement diagnosis edits concerning the use of stimulant
- [Important MississippiCAN, CHIP billing changes for pharmacy providers](https://medicaid.ms.gov/important-mississippican-chip-billing-changes-for-pharmacy-providers/) - BIN/PCN changes for MississippiCAN and CHIP plans effective October 1, 2018 The Mississippi Division of Medicaid (DOM) has required the MississippiCAN Coordinated Care Organizations (CCOs) to obtain unique Bank Identification (BIN), now known as Issuer Identification Number (IIN), and Processor Control Number (PCN) combinations. The purpose of this requirement is to enable pharmacy providers to
- [Clarification regarding ADHD diagnosis requirement](https://medicaid.ms.gov/clarification-regarding-adhd-diagnosis-requirement/) - On October 1, 2018, the Mississippi Division of Medicaid (DOM) began requiring an FDA-approved indication or compendia-supported indication for each stimulant prescription. It has come to DOM’s attention that the MississippiCAN pharmacy claims systems do not interface with the medical claims systems and may not be able to perform a search for diagnoses in the
- [Medicaid updates Voluntary 90-Day Drug Maintenance List for providers](https://medicaid.ms.gov/medicaid-updates-voluntary-90-day-drug-maintenance-list-for-providers/) - Effective April 1, 2019, the Mississippi Division of Medicaid (DOM) has updated its Voluntary 90-Day Drug Maintenance List for prescribing/pharmacy providers. The Voluntary 90-Day Drug Maintenance List is a resource giving providers the option of prescribing and dispensing certain widely-used drugs for common disease states in 90-day supplies in order to schedule the refilling of
- [Medicaid to implement new opioid initiative effective Aug. 1](https://medicaid.ms.gov/medicaid-to-implement-new-opioid-initiative-effective-aug-1/) - Pharmacy changes and claims system edits in response to opioid crisis Effective Aug. 1, 2019, the Mississippi Division of Medicaid (DOM) will implement a new opioid initiative, which will affect pharmacy point-of-sale claims and will apply to beneficiaries enrolled in fee-for-service (FFS) Medicaid and all three MississippiCAN coordinated care plans. The initiative involves four changes
- [Age prior authorization requirement for tricyclic antidepressants to take effect August 17](https://medicaid.ms.gov/10667-2/) - Age prior authorization requirement for tricyclic antidepressants to take effect August 17 Beginning Aug. 17, 2020, the Mississippi Division of Medicaid (DOM) will require prior authorization of (PA) tricyclic antidepressants (TCA) prescribed for patients under 25 years of age for all Medicaid beneficiaries. Following recommendations by the Drug Utilization Review Board (DUR), the PA requirement
- [NCPDP Field Required on CII prescriptions, effective September 21, 2020.](https://medicaid.ms.gov/ncpdp-field-required-on-cii-prescriptions-effective-september-21-2020/) - NCPDP Field Required on CII prescriptions, effective September 21, 2020. On January 24, 2020, the CMS-0055-F final rule regarding a modification to the use of the Telecommunication D.0 Standard was published in the Federal Register. This final rule is not a modification of the standard itself. The modification to the NCPDP D.0 Standard involves treating
- [Updated: Pharmacy providers billing directions for COVID-19 vaccines](https://medicaid.ms.gov/pharmacy-providers-billing-directions-for-covid-19-vaccines/) - Pharmacy providers billing directions for COVID-19 vaccines via NCPDP D.0 pharmacy claims Updated Jan. 8, 2021 The purpose of this notice is to update the COVID-19 vaccine administration fees for pharmacy providers to 100% of Medicare rates. Two-dose series vaccine administration fees are $16.94/first dose and $28.39/second dose. The administration fee for single-dose vaccines will
- [New Pharmacy Rate Setting and Specialty Drug List vendor - effective June 1, 2021](https://medicaid.ms.gov/new-pharmacy-rate-setting-and-specialty-drug-list-vendor-effective-june-1-2021/) - Effective June 1, 2021, Myers and Stauffer, LC will become the new pharmacy rate setting and specialty drug list vendor for the Mississippi Division of Medicaid. The new rate setting Help Desk phone number will be 800-591-1183. Questions may be emailed to MSpharmacy@mslc.com. The website for Myers & Stauffer will be located at https://www.mslc.com/mississippi/pharmacy.aspx. Until
- [Synagis® 2022 off-season prior authorization form](https://medicaid.ms.gov/synagis-2021-2022-prior-authorization-form-updated/) - Effective July 29, 2022, prior authorization requests for Synagis will be considered for approval of 2 doses at least 30 days apart. If necessary, an additional 2 doses may be approved at a later date should elevated community RSV prevalence continue. DOM will continue to monitor RSV status in consultation with pediatricians throughout the state.
- [Synagis update - March 2023](https://medicaid.ms.gov/synagis-update-march-2023/) - Update regarding the 2022-2023 Mississippi Medicaid RSV season: Mississippi Medicaid coverage of palivizumab (Synagis®) for the 2022-2023 RSV season will end on March 31, 2023.
- [ATTENTION: All Providers](https://medicaid.ms.gov/attention-all-providers/) - Flovent HFA Discontinuation on the MS Medicaid Universal Preferred Drug List (PDL) Flovent HFA (fluticasone propionate inhalation aerosol) was recently discontinued by its manufacturer, GlaxoSmithKline. This is a business decision made by GlaxoSmithKline and not related to any new safety or efficacy information. Background Fluticasone propionate HFA (generic for Flovent HFA; 44, 110, & 220
- [Pharmacy price freeze update: reprocessing](https://medicaid.ms.gov/pharmacy-price-freeze-update-reprocessing/) - Effective July 1, 2022, the Mississippi Division of Medicaid (DOM) reestablished payment methods for the ingredient costs of prescription drugs that existed prior to the July 1, 2021 rate freeze. This change removed the freeze for dates of service on or after July 1, 2022. On 8/22/2022, Conduent will begin adjusting claims with dates of
- [Synagis Season 2022-2023](https://medicaid.ms.gov/synagis-season-2022-2023/) - The 2022-2023 MS Medicaid RSV season will begin soon. Prior authorization units are authorized to begin accepting Synagis® PA requests for consideration beginning October 11, 2022, for dates of service starting November 1, 2022. Synagis® will NOT be authorized for typical seasonal administration prior to the season start date. However, due to the atypical nature
- [Telligen MS UM/QIO Qualitrac Provider Portal Training](https://medicaid.ms.gov/telligen-ms-um-qio-qualitrac-provider-portal-training/) - Register Now for Telligen MS UM/QIO Qualitrac Provider Portal Training As previously announced, the Mississippi Division of Medicaid (DOM) will transition to Telligen, a new Utilization Management/Quality Improvement Organization (UM/QIO), on January 16, 2024. Beginning Tuesday, January 16, 2024, Telligen will begin performing all new prior authorization reviews for fee-for-service (FFS) Medicaid requests. All authorization
- [MS SPA 23-0022 Federally Qualified Health Clinics (FQHC)](https://medicaid.ms.gov/ms-spa-23-0022-federally-qualified-health-clinics-fqhc-2/) - State Plan Amendment (SPA) 23-0022 was submitted to add language detailing the requirement for FQHCs to submit their Medicare cost reports to the Division of Medicaid, effective October 1, 2023. For more information, read the withdrawn SPA pages.
- [MS SPA 23-0023 Rural Health Clinics (RHC)](https://medicaid.ms.gov/ms-spa-23-0023-rural-health-clinics-rhc-2/) - State Plan Amendment (SPA) 23-0023 was submitted to add language detailing the requirement for RHCs to submit their Medicare cost reports to the Division of Medicaid, effective October 1, 2023. For more information, read the withdrawn SPA pages.
- [Medicaid Vital Signs – July-September 2023](https://medicaid.ms.gov/medicaid-vital-signs-july-september-2023/) - This update of the Medicaid Vital Signs dashboard contains enrollment and expenditure data from the third quarter of 2023. Launched in early 2019, Vital Signs displays key Mississippi Medicaid metrics allowing anyone to quickly check certain Medicaid statistics and follow recent program trends. Enrollment Enrollment figures do not include retroactive eligibility additions and certain
- [Medicaid Vital Signs - April-June 2023](https://medicaid.ms.gov/medicaid-vital-signs-april-june-2023/) - This update of the Medicaid Vital Signs dashboard contains enrollment and expenditure data from the second quarter of 2023. Launched in early 2019, Vital Signs displays key Mississippi Medicaid metrics allowing anyone to quickly check certain Medicaid statistics and follow recent program trends. Enrollment Enrollment figures do not include retroactive eligibility additions and certain
- [Public Notice for SPA 24-0003 Physician Upper Payment Limit (UPL)](https://medicaid.ms.gov/public-notice-for-spa-24-0003-physician-upper-payment-limit-upl/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 24-0003 Physician Upper Payment Limit (UPL). The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective January 1, 2024,
- [Public Notice for SPA 24-0001 End-Stage Renal Disease (ESRD) Services](https://medicaid.ms.gov/public-notice-for-spa-24-0001-end-stage-renal-disease-esrd-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 24-0001 End-Stage Renal Disease (ESRD) Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective January 1, 2024,
- [Training Videos Now Available for MESA Provider Portal](https://medicaid.ms.gov/training-videos-now-available-for-mesa-provider-portal/) - In preparation for the Oct. 3 transition to a new Fiscal Agent system, including a new provider portal known as MESA, Provider Portal Training Videos are now available online to help providers become familiar with navigating the new system. Find the videos linked below by subject matter. PRM 102: Provider Enrollment Process - Added 12/20/23
- [MS SPA 23-0025 MYPAC Coverage and Reimbursement submitted to CMS](https://medicaid.ms.gov/ms-spa-23-0025-mypac-coverage-and-reimbursement-submitted-to-cms/) - State Plan Amendment (SPA) 23-0025 is being submitted to allow the Division of Medicaid (DOM) to revise rates to an hourly rate and a fifteen (15) minute add-on rate and remove rate freeze language. These rates are based on actuarial analysis of historical utilization, payment and cost data for Early and Periodic Screening, Diagnosis, and
- [MS SPA 23-0017-CHIP Adult Vaccine Attestation submitted to CMS](https://medicaid.ms.gov/ms-spa-23-0017-chip-adult-vaccine-attestation-submitted-to-cms/) - State Plan Amendment (SPA) 23-0017-CHIP Adult Vaccine Attestation is being submitted to comply with the Inflation Reduction Act (IRA) requirement for the Division of Medicaid to attest to the coverage of all Advisory Committee on Immunization Practices (ACIP) recommended vaccines and their administration in the CHIP program, effective October 1, 2023. For more information, read
- [MS SPA 23-0030 Orthodontic Services submitted to CMS](https://medicaid.ms.gov/ms-spa-23-0030-orthodontic-services-submitted-to-cms/) - State Plan Amendment (SPA) 23-0030 Orthodontic Services is being submitted to allow the Division of Medicaid (DOM) to increase reimbursement rates for orthodontic services by ten percent (10%), effective October 1, 2023. For more information, read the proposed SPA pages.
- [Recredentialing and Revalidation](https://medicaid.ms.gov/recredentialing-and-revalidation/) - Recredentialing and Revalidation As 2023 draws to a close, there are two recent developments within the Mississippi Division of Medicaid (DOM) that are critically important for Medicaid providers to be aware of going forward. Recredentialing: Beginning Oct. 1, 2022, providers no longer need to credential with each coordinated care organization to participate as a Medicaid-enrolled
- [MS SPA 23-CHIP-0016 CHIP Postpartum approved by CMS](https://medicaid.ms.gov/ms-spa-23-chip-0016-chip-postpartum-approved-by-cms/) - State Plan Amendment (SPA) MS-23-CHIP-0016 was submitted to provide continuous 12-month postpartum coverage for pregnant women in CHIP, effective April 1, 2023. For more information, read the approved SPA pages.
- [MS SPA 23-0015 Postpartum Coverage approved by CMS](https://medicaid.ms.gov/ms-spa-23-0015-postpartum-coverage-approved-by-cms/) - State Plan Amendment (SPA) 23-0015 was submitted to extend postpartum coverage for pregnant women from sixty (60) days to twelve (12) months, effective April 1, 2023. For more information, read the approved SPA pages.
- [Updates to MESA Portal for Providers](https://medicaid.ms.gov/updates-to-mesa-portal-for-providers/) - Updates to MESA Portal for Providers Mississippi Medicaid’s web portal for providers had been modified with the following improvements to make information easier to locate. Eligibility Verification Request: • The ‘Eligibility Verification Request’ section was modified to allow the users to run a search for a span of 3 years. The system now allows running
- [MS SPA 23-0032 Ambulatory Surgical Centers (ASC) Dental Services approved by CMS](https://medicaid.ms.gov/ms-spa-23-0032-ambulatory-surgical-centers-asc-dental-services-approved-by-cms/) - State Plan Amendment (SPA) 23-0032 was submitted to allow the Division of Medicaid (DOM) to update reimbursement of dental services provided in an ambulatory surgical center (ASC). For ASC dental services that do not have a fee on the Medicare ASC Fee Schedule, effective December 1, 2023, the SPA will allow ASC’s to be reimbursed
- [Public Notice for SPA 23-0025 MYPAC Coverage and Reimbursement](https://medicaid.ms.gov/public-notice-for-spa-23-0025-mypac-coverage-and-reimbursement/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 23-0025 MYPAC Coverage and Reimbursement. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective November 1, 2023, contingent
- [MS SPA 23-0028 Hemophilia Coverage approved by CMS](https://medicaid.ms.gov/ms-spa-23-0028-hemophilia-coverage-approved-by-cms/) - State Plan Amendment (SPA) 23-0028 was submitted to allow the Division of Medicaid (DOM) to include beneficiaries diagnosed with hemophilia in the MississippiCAN program, effective July 1, 2023. For more information, read the approved SPA pages.
- [MS SPA 23-0023 Rural Health Clinics (RHC) submitted to CMS](https://medicaid.ms.gov/ms-spa-23-0023-rural-health-clinics-rhc/) - State Plan Amendment (SPA) 23-0023 is being submitted to add language detailing the requirement for RHCs to submit their Medicare cost reports to the Division of Medicaid, effective October 1, 2023. For more information, read the proposed SPA pages.
- [MS SPA 23-0022 Federally Qualified Health Clinics (FQHC)](https://medicaid.ms.gov/ms-spa-23-0022-federally-qualified-health-clinics-fqhc/) - State Plan Amendment (SPA) 23-0022 is being submitted to add language detailing the requirement for FQHCs to submit their Medicare cost reports to the Division of Medicaid, effective October 1, 2023. For more information, read the proposed SPA pages.
- [MS SPA 23-0026 Non-Emergency Transportation (NET) Emergency Contract](https://medicaid.ms.gov/ms-spa-23-0026-non-emergency-transportation-net-emergency-contract/) - State Plan Amendment (SPA) 23-0026 is being submitted to allow the Division of Medicaid to revise NET broker reimbursement in accordance with an emergency contract effective October 1, 2023. For more information, read the proposed SPA pages.
- [MS SPA 23-0031 Adult Vaccines Attestation](https://medicaid.ms.gov/ms-spa-23-0031-adult-vaccines-attestation/) - State Plan Amendment (SPA) 23-0032 is being submitted to allow the Division of Medicaid (DOM) to update reimbursement of dental services provided in an ambulatory surgical center (ASC). For ASC dental services that do not have a fee on the Medicare ASC Fee Schedule, effective December 1, 2023, the SPA will allow ASC’s to be
- [MS SPA 23-0032 Ambulatory Surgical Centers (ASC) Dental Services submitted to CMS](https://medicaid.ms.gov/ms-spa-23-0032-ambulatory-surgical-centers-asc-dental-services-submitted-to-cms/) - State Plan Amendment (SPA) 23-0032 is being submitted to allow the Division of Medicaid (DOM) to update reimbursement of dental services provided in an ambulatory surgical center (ASC). For ASC dental services that do not have a fee on the Medicare ASC Fee Schedule, effective December 1, 2023, the SPA will allow ASC’s to be
- [MS SPA 23-0007 Outpatient Prospective Payment System (OPPS) approved by CMS](https://medicaid.ms.gov/ms-spa-23-0007-outpatient-prospective-payment-system-opps-approved-by-cms/) - State Plan Amendment (SPA) 23-0007 Outpatient Prospective Payment System (OPPS) was submitted to allow the Division of Medicaid (DOM) to remove the rate freeze and increase the SFY18 Mississippi conversion factor by 5%, effective July 1, 2023. For more information, read the approved SPA pages.
- [DOM to submit first completed month of eligibility renewal data to CMS](https://medicaid.ms.gov/dom-to-submit-first-completed-month-of-eligibility-renewal-data-to-cms/) - Today, the Mississippi Division of Medicaid (DOM) will submit figures to the Centers for Medicare and Medicaid Services (CMS) reflecting the first month of eligibility renewals that have been initiated as part of a yearlong, federally mandated effort for state Medicaid programs to restore regular eligibility operations following the end of the continuous coverage provision
- [Preparing for the COVID-19 Public Health Emergency Unwinding            ](https://medicaid.ms.gov/preparing-for-the-covid-19-public-health-emergency-unwinding/) - Attention Medicaid beneficiaries, providers, advocacy groups and other partners The Mississippi Division of Medicaid (DOM) is preparing for the end of the national COVID-19 public health emergency (PHE). The PHE is set to expire January 11, 2023, unless extended by the Secretary of Health and Human Services. As we prepare for the end of the
- [MS SPA 23-0016 All Patient Refined Diagnosis Related Groups (APR-DRG) Reimbursement Approved by CMS](https://medicaid.ms.gov/ms-spa-23-0016-all-patient-refined-diagnosis-related-groups-apr-drg-reimbursement-approved-by-cms/) - MS SPA 23-0016 All Patient Refined Diagnosis Related Groups (APR-DRG) Reimbursement was submitted to update the hospital inpatient methodology with an effective date of July 1, 2023. For more information, read the approved SPA pages.
- [Stay Covered Toolkit](https://medicaid.ms.gov/stay-covered-toolkit/) - ​​​Help Medicaid Members Get Ready​ The Mississippi Division of Medicaid will begin the eligibility renewal process for all Medicaid members this spring, and many households will soon begin receiving renewal forms. You can help Medicaid members get ready for redeterminations by encouraging them to do the following: Update their contact information. Check their mail
- [MS SPA 23-0021 Community Mental Health Services Rate Update approved by CMS](https://medicaid.ms.gov/ms-spa-23-0021-community-mental-health-services-rate-update-approved-by-cms/) - MS SPA 23-0021 Community Mental Health Services Rate Update - Approved by CMS State Plan Amendment (SPA) 23-0021 was submitted to allow the Division of Medicaid (DOM) to increase the reimbursement rates for certain mental health services by 15.8% with half of the increase implemented in State Fiscal Year (SFY) 2024 and the second half
- [Public Notice for SPA 23-0032 Ambulatory Surgical Centers (ASC) Dental Services](https://medicaid.ms.gov/public-notice-for-spa-23-0032-ambulatory-surgical-centers-asc-dental-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 23-0032 Ambulatory Surgical Centers (ASC) Dental Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective December 1,
- [How to Complete Your Renewal Online](https://medicaid.ms.gov/how-to-return-your-renewal/) - The Mississippi Division of Medicaid offers an option to complete your renewal online at Access.ms.gov. Follow these steps to complete your renewal online. 1. Wait to receive a renewal form in the mail before submitting a renewal application form online. 2. Click this link: Access.ms.gov. The page looks like this: 3. Click the
- [MS SPA 23-0017 Graduate Medical Education (GME) approved by CMS](https://medicaid.ms.gov/ms-spa-23-0017-graduate-medical-education-gme-approved-by-cms/) - State Plan Amendment (SPA) 23-0017 Graduate Medical Education was submitted to allow the Division of Medicaid (DOM) to change the payment per resident to a flat rate for all eligible resident programs, effective July 1, 2023. For more information, read the approved SPA pages.
- [MS SPA 23-0027 Recovery Audit Contractors (RACs) approved by CMS](https://medicaid.ms.gov/ms-spa-23-0027-recovery-audit-contractors-racs-approved-by-cms/) - State Plan Amendment (SPA) 23-0027 Recovery Audit Contractors (RACs) was submitted to allow the Division of Medicaid (DOM) to request an extension for a period of one (1) year to attempt to procure a new, competitively bid RAC contract that complies with the current state and federal laws and regulations, effective July 1, 2023. For
- [MS SPA 23-0029 Hospital Upper Payment Limit (UPL) submitted to CMS](https://medicaid.ms.gov/ms-spa-23-0029-hospital-upper-payment-limit-upl-submitted-to-cms/) - State Plan Amendment (SPA) 23-0029 Hospital Upper Payment Limit (UPL) is being submitted to allow the Division of Medicaid (DOM) to establish a hospital upper payment limit (UPL) program effective October 1, 2023. For more information, read the proposed SPA pages.
- [Public Notice for MS SPA 23-0030 Orthodontic Services](https://medicaid.ms.gov/public-notice-for-ms-spa-23-0030-orthodontic-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 23-0030 Orthodontic Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective October 1, 2023, contingent upon approval
- [Public Notice for MS SPA 23-0026 Non-Emergency Transportation (NET) Emergency Contract](https://medicaid.ms.gov/public-notice-for-ms-spa-23-0026-non-emergency-transportation-net-emergency-contract/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 23-0026 Non-Emergency Transportation (NET) Emergency Contract. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective October 1, 2023,
- [Public Notice for MS SPA 23-0029 Hospital Upper Payment Limit (UPL)](https://medicaid.ms.gov/public-notice-for-ms-spa-23-0029-hospital-upper-payment-limit-upl/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 23-0029 Hospital Upper Payment Limit (UPL). The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective October 1, 2023,
- [MS SPA 23-0028 Hemophilia Coverage submitted to CMS](https://medicaid.ms.gov/ms-spa-23-0028-hemophilia-coverage-submitted-to-cms/) - State Plan Amendment (SPA) 23-0028 is being submitted to allow the Division of Medicaid (DOM) to include beneficiaries diagnosed with hemophilia in the MississippiCAN program, effective July 1, 2023. For more information, read the proposed SPA pages.
- [Governor Reeves proposes nearly $700 million in additional hospital funding through Medicaid](https://medicaid.ms.gov/governor-reeves-proposes-nearly-700-million-in-additional-hospital-funding-through-medicaid/) - This week Governor Tate Reeves announced two hospital payment initiatives that could generate almost $700 million annually in additional Medicaid funds for Mississippi hospitals. The first initiative, an amendment to the existing Mississippi Hospital Access Program (MHAP), will provide direct payments to hospitals serving patients in the Mississippi Medicaid managed care delivery system. With these
- [MS SPA 23-0021 Community Mental Health Services Rate Update](https://medicaid.ms.gov/ms-spa-23-0021-community-mental-health-services-rate-update/) - State Plan Amendment (SPA) 23-0021 is being submitted to allow the Division of Medicaid (DOM) to increase the reimbursement rates for certain mental health services by 15.8% with half of the increase implemented in State Fiscal Year (SFY) 2024 and the second half of the increase implemented in SFY 2025. Rates are effective for services
- [MS SPA 23-0024 Tobacco Cessation submitted to CMS](https://medicaid.ms.gov/ms-spa-23-0024-tobacco-cessation-submitted-to-cms/) - State Plan Amendment (SPA) 23-0024 is being submitted to allow the Division of Medicaid (DOM) to add coverage for up to twelve (12) tobacco cessation counseling sessions per year, effective July 1, 2023. For more information, read the proposed SPA pages.
- [MS SPA 23-0018 1915i Community Support Program (CSP) approved by CMS](https://medicaid.ms.gov/ms-spa-23-0018-1915i-community-support-program-csp-approved-by-cms/) - MS SPA 23-0018 1915i Community Support Program (CSP) State Plan Amendment (SPA) 23-0018 was submitted to allow the Division of Medicaid to revise the requirements for Targeted Case Manager providers; comply with the Home and Community Based Services (HCBS) final rule through ongoing monitoring and person-centered training; revise service definitions for Day Services, Prevocational Services,
- [MS SPA 23-0013 Drugs to Treat Obesity approved by CMS](https://medicaid.ms.gov/ms-spa-23-0013-drugs-to-treat-obesity-approved-by-cms/) - State Plan Amendment (SPA) 23-0013 Drugs to Treat Obesity was submitted to add coverage for selected drugs that treat obesity, effective July 1, 2023. For more information, read the approved SPA pages.
- [MS SPA 23-0027 Recovery Audit Contractors (RACs) submitted to CMS](https://medicaid.ms.gov/ms-spa-23-0027-recovery-audit-contractors-racs-submitted-to-cms/) - State Plan Amendment (SPA) 23-0027 Recovery Audit Contractors (RACs) is being submitted to allow the Division of Medicaid (DOM) to request an extension for a period of one (1) year to attempt to procure a new, competitively bid RAC contract that complies with the current state and federal laws and regulations, effective July 1, 2023.
- [MS SPA 23-0007 Outpatient Prospective Payment System (OPPS) submitted to CMS](https://medicaid.ms.gov/ms-spa-23-0007-outpatient-prospective-payment-system-opps-submitted-to-cms/) - State Plan Amendment (SPA) 23-0007 Outpatient Prospective Payment System (OPPS) is being submitted to allow the Division of Medicaid (DOM) to remove the rate freeze and increase the SFY18 Mississippi conversion factor by 5%, effective July 1, 2023. For more information, read the proposed SPA pages.
- [MS SPA 23-0011 Copay approved by CMS](https://medicaid.ms.gov/ms-spa-23-0011-copay-approved-by-cms/) - State Plan Amendment (SPA) 23-0011 was submitted to allow the Division of Medicaid (DOM) to remove copays from Medicaid services effective May 1, 2023. For more information, read the approved SPA pages.
- [CMS approves renewal of Medicaid’s five Home and Community Based Services waivers](https://medicaid.ms.gov/cms-approves-renewal-of-medicaids-five-home-and-community-based-services-waivers/) - Alignment to enhance services, efficiency The Centers for Medicare and Medicaid Services (CMS) earlier this summer approved the renewal of all five Mississippi Medicaid Home and Community Based Services (HCBS) waivers, authorizing an alignment of the programs that will enhance services and increase administrative efficiency. The five HCBS waivers currently include the Assisted Living Waiver,
- [MS SPA 23-0016 All Patient Refined Diagnosis Related Groups (APR-DRG) Reimbursement Submitted to CMS](https://medicaid.ms.gov/ms-spa-23-0016-all-patient-refined-diagnosis-related-groups-apr-drg-reimbursement-submitted-to-cms/) - MS SPA 23-0016 All Patient Refined Diagnosis Related Groups (APR-DRG) Reimbursement is being submitted to update the hospital inpatient methodology with an effective date of July 1, 2023. For more information, read the proposed SPA pages.
- [MS SPA 23-0010 Private Duty Nursing (PDN) Rate Updates approved by CMS](https://medicaid.ms.gov/ms-spa-23-0010-private-duty-nursing-pdn-rate-updates-approved-by-cms/) - State Plan Amendment (SPA) 23-0010 is being submitted to allow the Division of Medicaid to continue the same PDN rates in effect January 1, 2023, for dates of service beginning May 12, 2023. For more information, read the approved SPA pages.
- [MS SPA 23-0019 Prescribed Pediatric Extended Care (PPEC) approved by CMS](https://medicaid.ms.gov/ms-spa-23-0019-prescribed-pediatric-extended-care-ppec-approved-by-cms/) - State Plan Amendment (SPA) 23-0019 was submitted to allow the Division of Medicaid (DOM) to continue the fifteen percent (15%) increase for Prescribed Pediatric Extended Care (PPEC) facilities that were made effective October 1, 2022, beyond the end of the federal Public Health Emergency. For more information, read the approved SPA pages.
- [Public Notice for SPA 23-0024 Tobacco Cessation](https://medicaid.ms.gov/public-notice-for-spa-23-0024-tobacco-cessation/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 23-0024 Tobacco Cessation. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2023, contingent upon approval
- [MS SPA 23-0009 Early Intervention Case Manager approved by CMS](https://medicaid.ms.gov/ms-spa-23-0009-early-intervention-case-manager-approved-by-cms/) - State Plan Amendment (SPA) 23-0009 was submitted to allow the Division of Medicaid (DOM) to revise the education and experience requirements for Early Intervention case managers, effective April 1, 2023. For more information, read the approved SPA pages.
- [MS SPA 23-0017 Graduate Medical Education (GME) submitted to CMS](https://medicaid.ms.gov/ms-spa-23-0017-graduate-medical-education-gme-submitted-to-cms/) - State Plan Amendment (SPA) 23-0017 Graduate Medical Education is being submitted to allow the Division of Medicaid (DOM) to change the payment per resident to a flat rate for all eligible resident programs, effective July 1, 2023. For more information, read the proposed SPA pages.
- [MS SPA 23-0013 Drugs to Treat Obesity submitted to CMS](https://medicaid.ms.gov/ms-spa-23-0013-drugs-to-treat-obesity-submitted-to-cms/) - State Plan Amendment (SPA) 23-0013 Drugs to Treat Obesity is being submitted to add coverage for selected drugs that treat obesity, effective July 1, 2023. For more information, read the proposed SPA pages.
- [MS SPA 23-CHIP-0016 CHIP Postpartum submitted to CMS](https://medicaid.ms.gov/ms-spa-23-chip-0016-chip-postpartum-submitted-to-cms/) - State Plan Amendment (SPA) MS-23-CHIP-0016 is being submitted to provide continuous 12-month postpartum coverage for pregnant women in CHIP, effective April 1, 2023. For more information, read the proposed SPA pages.
- [Public Notice for SPA 23-0021 Community Mental Health Services Rate Update](https://medicaid.ms.gov/public-notice-for-spa-23-0021-community-mental-health-services-rate-update/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 23-0021 Community Mental Health Services Rate Update. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1,
- [Public Notice for SPA 23-0017 Graduate Medical Education (GME) Payment](https://medicaid.ms.gov/public-notice-for-spa-23-0017-graduate-medical-education-gme-payment/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 23-0017 Graduate Medical Education (GME) Payment. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2023,
- [Public Notice for SPA 23-0007 Outpatient Prospective Payment System (OPPS)](https://medicaid.ms.gov/public-notice-for-spa-23-0007-outpatient-prospective-payment-system-opps/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 23-0007 Outpatient Prospective Payment System (OPPS). The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2023,
- [Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) Waiver Renewal Approved by CMS](https://medicaid.ms.gov/traumatic-brain-injury-spinal-cord-injury-tbi-sci-waiver-renewal-approved-by-cms/) - The Centers for Medicare and Medicaid Services (CMS) has approved the following Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) Waiver renewal. For more information, read the approved waiver pages. Posted June 27, 2023
- [Elderly and Disabled (E&D) Waiver Renewal Approved by CMS](https://medicaid.ms.gov/elderly-and-disabled-ed-waiver-renewal-approved-by-cms-2/) - The Centers for Medicare and Medicaid Services (CMS) has approved the following Elderly and Disabled (E&D) Waiver renewal. For more information, read the approved waiver pages. Posted June 27, 2023
- [Intellectual Disabilities/Developmental Disabilities (ID/DD) Waiver Renewal Approved by CMS](https://medicaid.ms.gov/intellectual-disabilities-developmental-disabilities-id-dd-waiver-renewal-approved-by-cms/) - The Centers for Medicare and Medicaid Services (CMS) has approved the following Intellectual Disabilities/Developmental Disabilities (ID/DD) Waiver renewal. For more information, read the approved waiver pages. Posted June 27, 2023
- [Independent Living (IL) Waiver Renewal Approved by CMS](https://medicaid.ms.gov/independent-living-il-waiver-renewal-approved-by-cms/) - The Centers for Medicare and Medicaid Services (CMS) has approved the following Independent Living (IL) Waiver renewal. For more information, read the approved waiver pages. Posted June 27, 2023
- [Assisted Living (AL) Waiver Renewal Approved by CMS](https://medicaid.ms.gov/assisted-living-al-waiver-renewal-approved-by-cms-2/) - The Centers for Medicare and Medicaid Services (CMS) has approved the following Assisted Living (AL) Waiver renewal. For more information, read the approved waiver pages. Posted June 27, 2023
- [Medicaid Vital Signs - January-March 2023](https://medicaid.ms.gov/medicaid-vital-signs-january-march-2023/) - This update of the Medicaid Vital Signs dashboard contains enrollment and expenditure data from the first quarter of 2023. Launched in early 2019, Vital Signs displays key Mississippi Medicaid metrics allowing anyone to quickly check certain Medicaid statistics and follow recent program trends. Enrollment Enrollment figures do not include retroactive eligibility additions and certain
- [MS SPA 23-0015 Postpartum Coverage submitted to CMS](https://medicaid.ms.gov/ms-spa-23-0015-postpartum-coverage-submitted-to-cms/) - State Plan Amendment (SPA) 23-0015 is being submitted to extend postpartum coverage for pregnant women from sixty (60) days to twelve (12) months, effective April 1, 2023. For more information, read the proposed SPA pages.
- [MS SPA 23-0012 Emergency Transportation approved by CMS](https://medicaid.ms.gov/ms-spa-23-0012-emergency-transportation-approved-by-cms/) - MS State Plan Amendment (SPA) 23-0012 Emergency Transportation was submitted to allow the Division of Medicaid (DOM) to clarify the categories of emergency ground ambulance services, effective January 1, 2023. For more information, read the approved SPA pages.
- [Public Notice for SPA 23-0016 All Patient Refined Diagnosis Related Groups (APR-DRG) Reimbursement](https://medicaid.ms.gov/public-notice-for-spa-23-0016-all-patient-refined-diagnosis-related-groups-apr-drg-reimbursement/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA). The Division of Medicaid, in the Office of the Governor, is submitting SPA 23-0016 All Patient Refined Diagnosis Related Groups (APR-DRG) Reimbursement to update the hospital inpatient payment methodology with an effective date of
- [MS SPA 23-0006 One-Time Hospital Payment approved by CMS](https://medicaid.ms.gov/ms-spa-23-0006-one-time-hospital-payment-approved-by-cms/) - State Plan Amendment (SPA) 23-0006 One-Time Hospital Payment was submitted to allow the Division of Medicaid to make a one-time, lump-sum payment to all Mississippi hospitals eligible for supplemental payments under federal and state laws and regulations upon CMS approval and not later than the end of the federal Public Health Emergency, effective March 1,
- [MS SPA 23-0004 Ambulance Mileage approved by CMS](https://medicaid.ms.gov/ms-spa-23-0004-ambulance-mileage-approved-by-cms/) - State Plan Amendment (SPA) 23-0004 was submitted to add reimbursement for emergency ambulances for the initial twenty-five (25) miles at a rate of $.01 per mile, effective February 1, 2023. For more information read the approved SPA pages.
- [MS SPA 23-0009 Early Intervention Case Manager submitted to CMS](https://medicaid.ms.gov/ms-spa-23-0009-early-intervention-case-manager-submitted-to-cms/) - State Plan Amendment (SPA) 23-0009 is being submitted to allow the Division of Medicaid (DOM) to revise the education and experience requirements for Early Intervention case managers, effective April 1, 2023. For more information, read the proposed SPA pages.
- [MS SPA 23-0018 1915i Community Support Program (CSP) submitted to CMS](https://medicaid.ms.gov/ms-spa-23-0018-1915i-community-support-program-csp-state-plan-amendment-spa-23-0018/) - MS SPA 23-0018 1915i Community Support Program (CSP) State Plan Amendment (SPA) 23-0018 is being submitted to allow the Division of Medicaid to revise the requirements for Targeted Case Manager providers; comply with the Home and Community Based Services (HCBS) final rule through ongoing monitoring and person-centered training; revise service definitions for Day Services, Prevocational
- [Public Notice for SPA 23-0019 Prescribed Pediatric Extended Care](https://medicaid.ms.gov/public-notice-for-spa-23-0019-prescribed-pediatric-extended-care/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 23-0019 Prescribed Pediatric Extended Care (PPEC). The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective May 1, 2023,
- [Public Notice for SPA 23-0010 Private Duty Nursing (PDN) Rate Updates](https://medicaid.ms.gov/public-notice-for-spa-23-0010-private-duty-nursing-pdn-rate-updates/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 23-0010 Private Duty Nursing (PDN) Rate Updates. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective May 1,
- [Mississippi Medicaid to remove all Medicaid copayments effective May 1, 2023](https://medicaid.ms.gov/mississippi-medicaid-to-remove-all-medicaid-copayments-effective-may-1-2023/) - Attention Providers: Effective May 1, 2023, the Mississippi Division of Medicaid (DOM) is eliminating all Medicaid copayments for pharmacy and health care services. DOM plans to submit MS State Plan Amendment (SPA) 23-0011 to allow the agency to remove copays from Medicaid services. While DOM will continue to pay providers for their services, providers will
- [Medicaid Vital Signs - October-December 2022](https://medicaid.ms.gov/medicaid-vital-signs-october-december-2022/) - This update of the Medicaid Vital Signs dashboard contains enrollment and expenditure data from the fourth quarter of 2022. Launched in early 2019, Vital Signs displays key Mississippi Medicaid metrics allowing anyone to quickly check certain Medicaid statistics and follow recent program trends. Enrollment Enrollment figures do not include retroactive eligibility additions and certain
- [Medicaid Vital Signs - July-September 2022](https://medicaid.ms.gov/medicaid-vital-signs-july-september-2022/) - This update of the Medicaid Vital Signs dashboard contains enrollment and expenditure data from the third quarter of 2022. Launched in early 2019, Vital Signs displays key Mississippi Medicaid metrics allowing anyone to quickly check certain Medicaid statistics and follow recent program trends. Enrollment Enrollment figures do not include retroactive eligibility additions and certain
- [Medicaid Vital Signs - April-June 2022](https://medicaid.ms.gov/medicaid-vital-signs-april-june-2022/) - This update of the Medicaid Vital Signs dashboard contains enrollment and expenditure data from the second quarter of 2022. Launched in early 2019, Vital Signs displays key Mississippi Medicaid metrics allowing anyone to quickly check certain Medicaid statistics and follow recent program trends. Enrollment Enrollment figures do not include retroactive eligibility additions and certain
- [MS SPA 22-0023 Ambulance Supplemental Payment Program Approved by CMS](https://medicaid.ms.gov/ms-spa-22-0023-ambulance-supplemental-payment-program-approved-by-cms/) - State Plan Amendment (SPA) 22-0023 was submitted to allow the Division of Medicaid (DOM) to establish a Medicaid Supplemental Payment Program for emergency ambulance transportation providers, effective July 1, 2022. For more information read the approved SPA pages.
- [MS SPA 22-0004 COVID Vaccines and Administration approved by CMS](https://medicaid.ms.gov/ms-spa-22-0004-covid-vaccines-and-administration-approved-by-cms/) - State Plan Amendment (SPA) 22-0004 was submitted to comply with the American Rescue Plan (ARP) requirements for coverage of COVID vaccines, their administration and vaccine counseling services for children. This SPA was submitted with an 1135 waiver request to allow the effective date to comply with the ARP, effective March 11, 2021. For more information
- [MS SPA 23-0002 Autism Spectrum Disorder (ASD) Service Rate Update approved by CMS](https://medicaid.ms.gov/ms-spa-23-0002-autism-spectrum-disorder-asd-service-rate-update-approved-by-cms/) - CMS approved State Plan Amendment (SPA) 23-0002 on April 13, 2023. This 23-0002 Autism Spectrum Disorder (ASD) Services Rate Update was submitted to allow the Division of Medicaid (DOM) to update reimbursement for autism spectrum disorder services to the lesser of the usual and customary charge or a rate calculated by an actuarial firm, effective
- [MS SPA 23-CHIP-0015 for Coverage Required by the American Rescue Plan Act](https://medicaid.ms.gov/ms-spa-23-chip-0015-for-coverage-required-by-the-american-rescue-plan-act/) - The purpose of this SPA is to demonstrate compliance with the American Rescue Plan Act which includes coverage of treatment, testing, and vaccinations for COVID-19 without cost sharing in CHIP, effective March 11, 2021. For more information, read the proposed pages.
- [MS SPA 23-0003 Home Health Services approved by CMS](https://medicaid.ms.gov/ms-spa-23-0003-home-health-services-approved-by-cms/) - CMS approved State Plan Amendment (SPA) 23-0003 on April 11, 2023. This SPA 23-0003 Home Health Services was submitted to remove rate freeze language and allow reimbursement to be updated annually based on cost reports, effective February 1, 2023. For more information read the approved SPA pages.
- [Public Notice for 1915(c) Intellectual Disabilities/Developmental Disabilities (ID/DD) Waiver Renewal](https://medicaid.ms.gov/public-notice-for-1915c-intellectual-disabilities-developmental-disabilities-id-dd-waiver-renewal/) - Public Notice for 1915(c) Intellectual Disabilities/Developmental Disabilities (ID/DD) Waiver Renewal Pursuant to 42 C.F.R. Section 441.304, public notice is hereby given to the submission of a Medicaid 1915(c) Intellectual Disabilities/Developmental Disabilities (ID/DD) Waiver renewal. The Division of Medicaid, in the Office of the Governor, will submit this proposed waiver to the Centers for Medicare and
- [CMP Reinvestment Application Resources](https://medicaid.ms.gov/cmp-reinvestment-application-resources/) - CMP Reinvestment Application Resources CMP Reinvestment Application Resource Guide_October 2022 CMP Reinvestment Application Tips for Goals and Objectives_October 2022 Example CMP Reinvestment Application Budget Template_October 2022 Example CMP Reinvestment Application Template_October 2022 Examples of CMP Funded Projects_ Updated Aug 2021 FAQ CMP Reinvestment Applications_October 2022 FAQ CMP Reinvestment General Information_October 2022 Updates to CMP
- [Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) Waiver Renewal Submitted to CMS](https://medicaid.ms.gov/traumatic-brain-injury-spinal-cord-injury-tbi-sci-waiver-renewal-submitted-to-cms/) - The Division of Medicaid has submitted to the Centers for Medicare and Medicaid Services (CMS) the following Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) Waiver renewal. For more information, read the proposed waiver pages. Posted March 31, 2023
- [Public Notice for SPA 23-0018 1915(i) Community Support Program Renewal Public Notice](https://medicaid.ms.gov/public-notice-for-spa-23-0018-1915i-community-support-program-renewal-public-notice/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 1915(i) Community Support Program (CSP) Renewal. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective November 1, 2023,
- [MS SPA 23-0005 Former Foster Care Eligibility submitted to CMS](https://medicaid.ms.gov/ms-spa-23-0005-former-foster-care-eligibility-submitted-to-cms/) - State Plan Amendment (SPA) 23-0005 is being submitted to add coverage for individuals that were enrolled in Medicaid as former foster care children in any state, as required by Section 1002(a) of the SUPPORT Act, effective January 1, 2023. For more information, read the proposed SPA pages.
- [Independent Living Waiver Renewal Submitted to CMS](https://medicaid.ms.gov/independent-living-waiver-renewal-submitted-to-cms/) - The Division of Medicaid has submitted to the Centers for Medicare and Medicaid Services (CMS) the following Independent Living Waiver (IL) Waiver renewal. For more information, read the proposed waiver pages. Posted March 31, 2023
- [Intellectual Disabilities/Developmental Disabilities (ID/DD) Waiver renewal Submitted to CMS](https://medicaid.ms.gov/intellectual-disabilities-developmental-disabilities-id-dd-waiver-renewal-submitted-to-cms/) - The Division of Medicaid has submitted to the Centers for Medicare and Medicaid Services (CMS) the following Intellectual Disabilities/Developmental Disabilities (ID/DD) Waiver renewal. For more information, read the proposed waiver pages. Posted March 31, 2023
- [Elderly and Disabled (E&D) Waiver Renewal Submitted to CMS](https://medicaid.ms.gov/elderly-and-disabled-ed-waiver-renewal-submitted-to-cms-2/) - The Division of Medicaid has submitted to the Centers for Medicare and Medicaid Services (CMS) the following Elderly and Disabled (E&D) Waiver Waiver renewal. For more information, read the proposed waiver pages. Posted March 31, 2023
- [Assisted Living Waiver Renewal Submitted to CMS](https://medicaid.ms.gov/assisted-living-waiver-renewal-submitted-to-cms-2/) - The Division of Medicaid has submitted to the Centers for Medicare and Medicaid Services (CMS) the following Assisted Living Waiver (AL) Waiver renewal. For more information, read the proposed waiver pages. Posted March 31, 2023
- [MS SPA 23-0012 Emergency Transportation submitted to CMS](https://medicaid.ms.gov/ms-spa-23-0012-emergency-transportation-submitted-to-cms/) - State Plan Amendment (SPA) 23-2012 Emergency Transportation is being submitted to allow the Division of Medicaid (DOM) to clarify the categories of emergency ground ambulance services, effective January 1, 2023. For more information, read the proposed SPA pages.
- [MS SPA 23-0003 Home Health Services submitted to CMS](https://medicaid.ms.gov/ms-spa-23-0003-home-health-services-submitted-to-cms/) - State Plan Amendment (SPA) 23-0003 Home Health Services is being submitted to remove rate freeze language and allow reimbursement to be updated annually based on cost reports, effective February 1, 2023. For more information, read the proposed SPA pages.
- [MS SPA 23-0002 Autism Spectrum Disorder (ASD) Services Rate Update submitted to CMS](https://medicaid.ms.gov/ms-spa-23-0002-autism-spectrum-disorder-asd-services-rate-update-submitted-to-cms/) - State Plan Amendment (SPA) 23-0002 Autism Spectrum Disorder (ASD) Services Rate Update is being submitted to allow the Division of Medicaid (DOM) to update reimbursement for autism spectrum disorder services to the lesser of the usual and customary charge or a rate calculated by an actuarial firm, effective January 1, 2023. For more information, read
- [MS SPA 23-0006 One-Time Hospital Payment submitted to CMS](https://medicaid.ms.gov/ms-spa-23-0006-one-time-hospital-payment-submitted-to-cms/) - State Plan Amendment (SPA) 23-0006 One -Time Hospital Payment is being submitted to allow the Division of Medicaid to make a one-time, lump-sum payment to all Mississippi hospitals eligible for supplemental payments under federal and state laws and regulations upon CMS approval and not later than the end of the federal Public Health Emergency, effective
- [Public Notice for 1915(c) Elderly and Disabled (E&D) Waiver](https://medicaid.ms.gov/public-notice-for-1915c-elderly-and-disabled-ed-waiver/) - Pursuant to 42 C.F.R. Section 441.304, public notice is hereby given to the submission of a Medicaid 1915(c) Elderly and Disabled (E&D) Waiver renewal. The Division of Medicaid, in the Office of the Governor, will submit this proposed waiver to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2023, contingent upon approval
- [MS SPA 23-0004 Ambulance Mileage submitted to CMS](https://medicaid.ms.gov/ms-spa-23-0004-ambulance-mileage-submitted-to-cms/) - State Plan Amendment (SPA) 23-0004 is being submitted to add reimbursement for emergency ambulances for the initial twenty-five (25) miles at a rate of $.01 per mile, effective February 1, 2023. For more information, read the proposed SPA pages.
- [Medicaid urges members to update their contact information before renewals begin April 1](https://medicaid.ms.gov/medicaid-urges-members-to-update-their-contact-information-before-renewals-begin-april-1/) - Continuous coverage requirement to end March 31 With the federal government ending the continuous Medicaid coverage requirement on March 31, the Mississippi Division of Medicaid (DOM) is notifying Medicaid members that eligibility renewals will begin on April 1. DOM urges all Medicaid members to make sure their contact information is correct by visiting www.medicaid.ms.gov/staycovered. During
- [Stay Covered! FAQs](https://medicaid.ms.gov/stay-covered-faqs/) - Stay Covered! FAQs This page will be updated with additional FAQs as they become available. Why are redeterminations resuming? Beginning April 1, 2023, the Mississippi Division of Medicaid (DOM) will resume eligibility determinations in compliance with the requirements of the Consolidated Appropriations Act (CAA) passed by Congress in December. Because of the COVID-19 public
- [MS SPA 22-0025 Disproportionate Share Hospital (DSH) approved by CMS](https://medicaid.ms.gov/ms-spa-22-0025-disproportionate-share-hospital-dsh-approved-by-cms/) - CMS approved State Plan Amendment (SPA) 22-0025 on February 24, 2023. State Plan Amendment (SPA) 22-0025 was submitted to allow the Division of Medicaid (DOM) to change redistribution methodology for disproportionate share hospital (DSH) audits to allow all providers who were underpaid to receive some benefit, effective October 1, 2022. For more information read the
- [Coverage Champions](https://medicaid.ms.gov/coverage-champions/) - ​​​Help Medicaid Members Get Ready​ The Mississippi Division of Medicaid will begin the requalification (or redetermination) process for all Medicaid members this spring, and many households will soon begin receiving renewal forms. As Coverage Champions, you can help Medicaid members get ready for redeterminations by encouraging them to do the following: Update their contact information.
- [Public Notice for 1915(c) Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) Waiver](https://medicaid.ms.gov/public-notice-for-1915c-traumatic-brain-injury-spinal-cord-injury-tbi-sci-waiver/) - Public Notice for 1915(c) Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) Waiver Pursuant to 42 C.F.R. Section 441.304, public notice is hereby given to the submission of a Medicaid 1915(c) Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) Waiver renewal. The Division of Medicaid, in the Office of the Governor, will submit this proposed waiver to the Centers
- [Public Notice for 1915(c) Independent Living (IL) Waiver](https://medicaid.ms.gov/public-notice-for-1915c-independent-living-il-waiver/) - Pursuant to 42 C.F.R. Section 441.304, public notice is hereby given to the submission of a Medicaid 1915(c) Independent Living (IL) Waiver renewal. The Division of Medicaid, in the Office of the Governor, will submit this proposed waiver to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2023, contingent upon approval from
- [Public Notice for 1915(c) Assisted Living (AL) Waiver Renewal](https://medicaid.ms.gov/public-notice-for-1915c-assisted-living-al-waiver-renewal/) - Pursuant to 42 C.F.R. Section 441.304, public notice is hereby given to the submission of a Medicaid 1915(c) Assisted Living (AL) Waiver renewal. The Division of Medicaid, in the Office of the Governor, will submit this proposed waiver to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2023, contingent upon approval from
- [Public Notice for SPA 23-0006 One-Time Hospital Payment](https://medicaid.ms.gov/public-notice-for-spa-23-0006-one-time-hospital-payment/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 23-0006 One-Time Hospital Payment. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective March 1, 2023, contingent upon
- [MS SPA 22-0028 Private Duty Nursing (PDN) and Prescribed Pediatric Extended Care (PPEC) Services approved by CMS](https://medicaid.ms.gov/ms-spa-22-0028-private-duty-nursing-pdn-and-prescribed-pediatric-extended-care-ppec-services-approved-by-cms/) - CMS approved State Plan Amendment (SPA) 22-0028 on February 24, 2023. State Plan Amendment (SPA) 22-0028 was submitted to allow the Division of Medicaid (DOM) to increase the rates for PDN and PPEC services by fifteen percent (15%) for the duration of the Public Health Emergency, effective October 1, 2022. For more information read the
- [Frequently Denied Edits](https://medicaid.ms.gov/frequently-denied-edits/) - Frequently Denied Edits That Are Posting on Remittance Advices and Helpful Hints to Correct 1. Error 4502 - MEDICARE XOVER EOMB UNDER REVIEW Crossover Claims submitted on the 837-claim transaction or through portal – Reminders Inpatient Crossovers, the Medicare information must be submitted at the header. Professional and Outpatient Crossovers, the Medicare information must
- [Important Health Coverage Tax Documents](https://medicaid.ms.gov/important-health-coverage-tax-documents/) - Change to the Mississippi Medicaid 1095-B Form Process According to the Internal Revenue Service, because the individual shared responsibility payment is zero beginning in 2020, an individual does not need the information on Form 1095-B to file income taxes with the IRS. Therefore, the IRS is allowing reporting entities to furnish 1095-B forms upon request.
- [MS SPA 22-0027 Durable Medical Equipment (DME) and Medical Supplies approved by CMS](https://medicaid.ms.gov/ms-spa-22-0027-durable-medical-equipment-dme-and-medical-supplies-approved-by-cms/) - CMS approved State Plan Amendment (SPA) 22-0027 Durable Medical Equipment (DME) and Medical Supplies on January 5, 2023. This SPA was submitted to allow the Division of Medicaid (DOM) to update the rates for durable medical equipment (DME) and Medical Supplies October 1, 2022, and July 1 of each year thereafter based on the Medicare
- [Medicaid members urged to update contact information before return to routine eligibility operations](https://medicaid.ms.gov/medicaid-members-urged-to-update-contact-information-before-return-to-routine-eligibility-operations/) - Stay Covered website to keep members, partners informed of latest updates, resources Following the passage of the Consolidated Appropriations Act (CAA), states will soon return to routine eligibility operations, and the Mississippi Division of Medicaid (DOM) will begin re-qualifying all Medicaid members this spring. It is very important for Medicaid members to update their contact
- [Public Notice for SPA 23-0004 Ambulance Mileage](https://medicaid.ms.gov/public-notice-for-spa-23-0004-ambulance-mileage/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 23-0004 Ambulance Mileage. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective February 1, 2023, contingent upon approval
- [Public Notice for SPA 23-0003 Home Health Services](https://medicaid.ms.gov/public-notice-for-spa-23-0003-home-health-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 23-0003 Home Health Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective February 1, 2023, contingent upon
- [ID/DD Waiver Community Support Program](https://medicaid.ms.gov/id-dd-waiver-community-support-program/) - The Mississippi Division of Medicaid (DOM) Office of Mental Health in conjunction with the Mississippi Department of Mental Health (DMH) Bureau of Intellectual and Developmental Disabilities requests your feedback in the renewal of the 1915(c) Home and Community Based Intellectual Disabilities/Developmental Disabilities (ID/DD) Waiver and 1915(i) Community Support Program (CSP). DOM and DMH are seeking
- [MS SPA 22-0005 COVID Treatment and Complications Coverage approved by CMS](https://medicaid.ms.gov/ms-spa-22-0005-covid-treatment-and-complications-coverage-approved-by-cms/) - MS SPA 22-0005 COVID Treatment and Complications Coverage approved by CMS CMS approved State Plan Amendment (SPA) 22-0005 on January 20, 2023. This SPA was submitted to comply with the ARP requirements for coverage of OVID-19 treatment or for a condition that may seriously complicate the treatment of COVID-19 for individuals diagnosed with or presumed
- [Update Contact Info](https://medicaid.ms.gov/update-contact-info/) - Attention Medicaid Members! Click here to provide us with your new address and telephone number to ensure that you are receiving the latest updates, resources and other important information.
- [MS SPA 22-0010 Orthotics and Prosthetics (EPSDT only) approved by CMS](https://medicaid.ms.gov/ms-spa-22-0010-orthotics-and-prosthetics-epsdt-only-approved-by-cms/) - CMS approved State Plan Amendment (SPA) 22-0010 on November 4, 2022. This SPA was submitted to allow reimbursement rates for orthotics and prosthetics to be updated based on eighty (80%) of the Medicare Rate. For more information read the approved SPA pages.
- [MS SPA 22-0007 Tribal Consultation approved by CMS](https://medicaid.ms.gov/ms-spa-22-0007-tribal-consultation-approved-by-cms/) - CMS approved State Plan Amendment (SPA) 22-0007 on December 30, 2022, with an effective date of October 1, 2022. This state plan amendment was submitted to allow the Division of Medicaid (DOM) to update and identify the Mississippi Band of Choctaw Indians (MBCI) designees. For more information read the approved SPA pages.
- [Public Notice for SPA 23-0002 Autism Spectrum Disorder (ASD) Services Rate Update](https://medicaid.ms.gov/public-notice-for-spa-23-0002-autism-spectrum-disorder-asd-services-rate-update/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 23-0002 Autism Spectrum Disorder (ASD) Services Rate Update. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective January
- [MS SPA 22-0026 Ambulatory Surgical Centers (ASCs) approved by CMS](https://medicaid.ms.gov/ms-spa-22-0026-ambulatory-surgical-centers-ascs-approved-by-cms/) - CMS approved State Plan Amendment (SPA) 22-0026 on December 19, 2022.This state plan amendment was submitted to allow the Division of Medicaid (DOM) to update the rates for ambulatory surgical centers (ASCs) October 1 of each year, based on the Medicare rate in effect July 1 of that year, effective October 1, 2022. For more
- [MS SPA 22-0025 Disproportionate Share Hospital (DSH) submitted to CMS](https://medicaid.ms.gov/ms-spa-22-0025-disproportionate-share-hospital-dsh-submitted-to-cms/) - State Plan Amendment (SPA) 22-0025 is being submitted to allow the Division of Medicaid (DOM) to change redistribution methodology for disproportionate share hospital (DSH)audits to allow all providers who were underpaid to receive some benefit, effective October 1, 2022. For more information, read the proposed SPA pages.
- [MS SPA 22-0024 Recovery Audit Contractors (RAC) approved by CMS](https://medicaid.ms.gov/ms-spa-22-0024-recovery-audit-contractors-rac-approved-by-cms/) - CMS approved State Plan Amendment (SPA) 22-0024 on December 12, 2022, with an effective date of July 1, 2022 through June 30, 2023. This state plan amendment was submitted to request an exception to the RAC requirements for a period of one (1) year from the approval date of SPA 22-0024 in order to attempt
- [Public Notice for SPA 23-0001 Value-Based Purchasing](https://medicaid.ms.gov/public-notice-for-spa-23-0001-value-based-purchasing/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 23-0001 Value-Based Purchasing. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective January 1, 2023, contingent upon approval
- [TBI/SCI Waiver - Request for Public Input](https://medicaid.ms.gov/tbi-sci-waiver-request-for-public-input/) - The Mississippi Division of Medicaid (DOM) Office of Long Term Care in conjunction with the Mississippi Department of Rehabilitation Services (MDRS) Office of Special Disability Programs requests your feedback in the renewal of the 1915(c) Home and Community Based Traumatic Brain Injury/Spinal Cord Injury Waiver. DOM and MDRS are seeking input regarding recommended changes from
- [Independent Living Waiver - Request for Public Input](https://medicaid.ms.gov/independent-living-waiver-request-for-public-input/) - The Mississippi Division of Medicaid (DOM) Office of Long Term Care in conjunction with the Mississippi Department of Rehabilitation Services (MDRS) Office of Special Disability Programs requests your feedback in the renewal of the 1915(c) Home and Community Based Independent Living Waiver. DOM and MDRS are seeking input regarding recommended changes from participants, caregivers, providers,
- [Assisted Living Waiver - Request for Public Input](https://medicaid.ms.gov/assisted-living-waiver-request-for-public-input/) - The Mississippi Division of Medicaid (DOM) Office of Long Term Care requests your feedback in the renewal of the 1915(c) Home and Community Based Assisted Living Waiver. DOM is seeking input regarding recommended changes from participants, caregivers, providers, and other community stakeholders prior to the submission of the renewal application to the Centers for Medicare
- [Elderly and Disabled Waiver - Request for Public Input](https://medicaid.ms.gov/elderly-and-disabled-waiver-request-for-public-input/) - The Mississippi Division of Medicaid (DOM) Office of Long Term Care requests your feedback in the renewal of the 1915(c) Home and Community Based Elderly and Disabled Waiver. DOM is seeking input regarding recommended changes from participants, caregivers, providers, and other community stakeholders prior to the submission of the renewal application to the Centers for
- [Medicaid Vital Signs - January-March 2022](https://medicaid.ms.gov/medicaid-vital-signs-january-march-2022/) - This update of the Medicaid Vital Signs dashboard contains enrollment and expenditure data from the first quarter of 2022. Launched in early 2019, Vital Signs displays key Mississippi Medicaid metrics allowing anyone to quickly check certain Medicaid statistics and follow recent program trends. Enrollment Enrollment figures do not include retroactive eligibility additions and certain
- [MS SPA 22-0028 Private Duty Nursing (PDN) and Prescribed Pediatric Extended Care (PPEC) Services submitted to CMS](https://medicaid.ms.gov/ms-spa-22-0028-private-duty-nursing-pdn-and-prescribed-pediatric-extended-care-ppec-services-submitted-to-cms/) - State Plan Amendment (SPA) 22-0028 is being submitted to allow the Division of Medicaid (DOM) to increase the rates for PDN and PPEC services by fifteen percent (15%) for the duration of the Public Health Emergency, effective October 1, 2022. For more information, read the proposed SPA pages.
- [MS SPA 22-0007 Tribal Consultation submitted to CMS](https://medicaid.ms.gov/ms-spa-22-0007-tribal-consultation-submitted-to-cms/) - State Plan Amendment (SPA) 22-0007 Tribal Consultation is being submitted to allow the Division of Medicaid (DOM) to update and identify the Mississippi Band of Choctaw Indians (MBCI) designees effective October 1, 2022. For more information, read the proposed SPA pages.
- [MS SPA 22-0033 Nursing Facility Level of Care submitted to CMS](https://medicaid.ms.gov/ms-spa-22-0033-nursing-facility-level-of-care-submitted-to-cms/) - State Plan Amendment (SPA) 22-0033 is being submitted to reflect needed updates and changes to the tool used to determine nursing facility level of care for beneficiaries prior to receiving long-term care services, effective October 1, 2022. The process to determine nursing facility level of care along with level of care requirements remain unchanged. For
- [MS SPA 22-0019 Preventative Services approved by CMS](https://medicaid.ms.gov/ms-spa-22-0019-preventative-services-approved-by-cms/) - CMS approved State Plan Amendment (SPA) 22-0019 on December 1, 2022. This state plan amendment was submitted to allow the Division of Medicaid (DOM) to update rates for preventative services according to the appropriate payment methodology for the service. For more information read the approved SPA pages.
- [MS SPA 22-0026 Ambulatory Surgical Centers (ASCs) submitted to CMS](https://medicaid.ms.gov/ms-spa-22-0026-ambulatory-surgical-centers-ascs-submitted-to-cms/) - State Plan Amendment (SPA) 22-0026 is being submitted to allow the Division of Medicaid (DOM) to update the rates for ambulatory surgical centers (ASCs) October 1 of each year, based on the Medicare rate in effect July 1 of that year, effective October 1, 2022. For more information, read the proposed SPA pages.
- [MS SPA 22-0027 Durable Medical Equipment (DME) and Medical Supplies submitted to CMS](https://medicaid.ms.gov/ms-spa-22-0027-durable-medical-equipment-dme-and-medical-supplies/) - State Plan Amendment (SPA) 22-0027 is being submitted to allow the Division of Medicaid (DOM) to update the rates for durable medical equipment (DME) and Medical Supplies October 1, 2022 and July 1 of each year thereafter based on the Medicare Rural Rate in effect January 1 of that year, effective October 1, 2022. For
- [MS SPA 22-0001 COVID Testing approved by CMS](https://medicaid.ms.gov/ms-spa-22-0001-covid-testing-approved-by-cms/) - CMS approved State Plan Amendment (SPA) 22-0001 on November 14, 2022. State Plan Amendment (SPA) 22-0001 was submitted to allow the Division of Medicaid (DOM) to comply with the American Rescue Plan (ARP) requirements regarding coverage of U.S. Food & Drug Administration (FDA)-authorized COVID diagnostic and screening tests consistent with the Centers for Disease Control
- [MS SPA 22-0017 Therapy Services approved by CMS](https://medicaid.ms.gov/cms-approved-ms-spa-22-0017-therapy-services/) - CMS approved State Plan Amendment (SPA) 22-0017 on November 4, 2022. State Plan Amendment (SPA) 22-0017 was submitted to allow the Division of Medicaid (DOM) to reimburse for therapy services at ninety percent (90%) of the Medicare rate in effect on January 1, 2022, and as may be adjusted each July thereafter. For more information
- [MS SPA 22-0014 Clinic Services approved by CMS](https://medicaid.ms.gov/ms-spa-22-0014-clinic-services-approved-by-cms/) - CMS approved MS SPA 22-0014 on November 4, 2022. State Plan Amendment (SPA) 22-0014 is being submitted to allow the encounter rate for clinic services provided by the Mississippi Department of Health clinics to be updated July of each year. For more information read the approved SPA pages.
- [MS SPA 22-0009 Other Licensed Practitioners approved by CMS](https://medicaid.ms.gov/ms-spa-22-0009-other-licensed-practitioners-approved-by-cms/) - CMS approved State Plan Amendment (SPA) 22-0009 on November 4, 2022. State Plan Amendment (SPA) 22-0009 was submitted to allow reimbursement rates for other licensed practitioners to be updated, when applicable, according to the appropriate State Plan payment methodology. For more information read the approved SPA pages.
- [MS SPA 22-0008 Independent Lab and X-ray Services approved by CMS](https://medicaid.ms.gov/ms-spa-22-0008-independent-lab-and-x-ray-services-approved-by-cms/) - CMS approved State Plan Amendment (SPA) 22-0008 on November 4, 2022. State Plan Amendment (SPA) 22-0008 was submitted to allow the Division of Medicaid (DOM) to reimburse independent laboratory and X-Ray services from a statewide uniform fee schedule based on ninety percent (90%) of the Medicare fee schedule in effect January 1 of each year
- [MS SPA 22-0011 Physician Services approved by CMS](https://medicaid.ms.gov/ms-spa-22-0011-physician-services-approved-by-cms/) - CMS approved MS SPA 22-0011 Physician Services on November 4, 2022. State Plan Amendment (SPA) 22-0011 was submitted to allow the Division of Medicaid (DOM) reimburse for physician services at ninety percent (90%) of the Medicare Physician Fee schedule established on January 1, 2022 and as may be adjusted each July thereafter. For more information
- [MS SPA 22-0020 Medication Assisted Treatment (MAT) Services approved by CMS](https://medicaid.ms.gov/ms-spa-22-0020-medication-assisted-treatment-mat-services-approved-by-cms/) - CMS approved State Plan Amendment (SPA) 22-0020 on November 4, 2022. State Plan Amendment (SPA) 22-0020 was submitted to allow the Division of Medicaid (DOM) to update rates for Medication Assisted Treatment (MAT) services according to the applicable fee schedule and reimburse for Opioid Treatment Programs (OTPs) based on ninety percent (90%) of the Medicare
- [MS SPA 22-0022 EPSDT Extended Services approved by CMS](https://medicaid.ms.gov/ms-spa-22-0022-epsdt-extended-services-approved-by-cms/) - CMS approved MS SPA 22-0022 on November 4, 2022. State Plan Amendment (SPA) 22-0022 was submitted to allow the Division of Medicaid (DOM) to update the rates for certain EPSDT services, including physician services and autism spectrum disorder services, effective July 1, 2022 For more information read the approved SPA pages.
- [MS SPA 22-0012 Rehabilitative Services approved by CMS](https://medicaid.ms.gov/ms-spa-22-0012-rehabilitative-services-approved-by-cms/) - CMS approved State Plan Amendment (SPA) 22-0012 on November 4, 2022. State Plan Amendment (SPA) 22-0012 Rehabilitative Services was submitted to allow rates for psychiatric therapeutic procedures that are billed using Current Procedural Terminology (CPT) codes to be updated based on ninety percent (90%) of the Medicare fee schedule in effect on January 1, 2022
- [MS SPA 22-0015 Family Planning Services approved by CMS](https://medicaid.ms.gov/ms-spa-22-0015-family-planning-services-approved-by-cms/) - CMS approved MS SPA 22-0015 on November 4, 2022. State Plan Amendment (SPA) 22-0015 was submitted to allow family planning services to be reimbursed ninety percent (90%) of the Medicare fee schedule in effect January 1, 2022 and as may be adjusted each July thereafter. For more information read the approved SPA pages.
- [MS SPA 22-0013 Chiropractor Services approved by CMS](https://medicaid.ms.gov/ms-spa-22-0013-chiropractor-services-approved-by-cms/) - CMS approved MS SPA 22-0013 on November 4, 2022. State Plan Amendment (SPA) 22-0013 was submitted to allow the Division of Medicaid (DOM) to reimburse for chiropractic services at seventy percent (70%) of the Medicare rate in effect as of January 1, 2022 and as may be adjusted each July thereafter. For more information read
- [MS SPA 22-0018 Midwife Services approved by CMS](https://medicaid.ms.gov/ms-spa-22-0018-midwife-services-approved-by-cms/) - CMS approved State Plan Amendment (SPA) 22-0018 on November 4, 2022. State Plan State Plan Amendment (SPA) 22-0018 was submitted to allow the Division of Medicaid (DOM) to update the reimbursement rates for midwife services when applicable. For more information read the approved SPA pages.
- [MS SPA 22-0016 Dental and Orthodontic Services approved by CMS](https://medicaid.ms.gov/ms-spa-22-0016-dental-and-orthodontic-services-approved-by-cms/) - CMS approved MS SPA 22-0016 Dental and Orthodontic Services on November 4, 2022. State Plan Amendment (SPA) 22-0016 was submitted to allow the Division of Medicaid (DOM) to update reimbursement rates, when applicable, and increase reimbursement rates for restorative dental services five percent (5%) above the previous year for state fiscal years (SFY) 2023, 2024,
- [Medicaid seeks to boost payments to emergency ambulance providers](https://medicaid.ms.gov/medicaid-seeks-to-boost-payments-to-emergency-ambulance-providers/) - Program aims to ensure access, improve quality The Mississippi Division of Medicaid (DOM) is aiming to support Mississippi’s emergency ambulance providers through a new program generating a significant boost in direct payments to those enrolled as Mississippi Medicaid providers. The Transforming Reimbursement for Emergency Ambulance Transportation program – or TREAT – will increase Medicaid payments
- [MS SPA 22-0005 COVID Treatment and Complications Coverage submitted to CMS](https://medicaid.ms.gov/ms-spa-22-0005-covid-treatment-and-complications-coverage-submitted-to-cms/) - State Plan Amendment (SPA) SPA 22-0005 is being submitted to comply with the ARP requirements for coverage of COVID-19 treatment or for a condition that may seriously complicate the treatment of COVID-19 for individuals diagnosed with or presumed to have COVID-19 during the period the individual has COVID-19. This SPA is being submitted with an
- [Healthier MS Waiver Renewal Application submitted to CMS](https://medicaid.ms.gov/healthier-ms-waiver-renewal-application-submitted-to-cms/) - The Division of Medicaid submitted to the Centers for Medicare and Medicaid Services (CMS) the Healthier Mississippi Waiver Renewal Application on October 13, 2022. For more information, read the proposed waiver pages.
- [Member Advisory Board](https://medicaid.ms.gov/member-advisory-board/) - Seeking board volunteers! The Mississippi Division of Medicaid (DOM) is looking for active Medicaid members and caregivers who are interested in sharing their experiences while enrolled in the Medicaid program by volunteering to serve on a Member Advisory Board. The Division is looking for individuals who are open, honest, and respectful of others to meet
- [Late Breaking News](https://medicaid.ms.gov/late-breaking-news/) - The latest updates and information Mississippi Medicaid providers need to know is posted in Late Breaking News 12/22/2022 Targeted Case Management (TCM) and HCBS Services Please be advised that individuals receiving Home and Community Based Services (HCBS) case management/support coordination (CM/SC) cannot also receive Community Mental Health Services Targeted Case Management (T2017). This
- [MESA Tips](https://medicaid.ms.gov/mesa-tips/) - MESA Tip: A Newborn Enrollment in Provider Portal MESA Tip: AVRS Quick Reference for Providers MESA Tip: Delegate Accounts MESA Tip: FAQ for Provider Portal for Eligibility Verification MESA Tip: Eligibility Verification MESA Tip: Letters for Provider Portal Pharmacy Reports MESA Tip: Universal PA Form Rules, Part 1 MESA Tip: Trading Partner Enrollment MESA Tip:
- [Billing tip for LTSS Providers](https://medicaid.ms.gov/billing-tip-for-ltss-providers/) - LTSS Providers, please see the following FAQ addressing a a common billing error which seems to be disproportionately affecting institutional claims for LTC providers. In the new MESA system, it is vital that complete information be submitted at both the header and detail level. Q: Why are my claims denying for error/edit 528 DTL
- [New Medicaid Provider Portal to go-live Oct. 3, 2022](https://medicaid.ms.gov/new-medicaid-provider-portal-to-go-live-oct-3-2022/) - Providers can register in MESA Provider Portal, submit all claims types beginning on Monday The Mississippi Division of Medicaid’s (DOM) new Fiscal Agent (Gainwell Technologies) system, including a new provider portal known as MESA, will begin full operations on Oct. 3, 2022. Medicaid providers can find a link to the portal and resources to help them
- [Public Notice for SPA 22-0028 Emergency Private Duty Nursing (PDN) and Prescribed Pediatric Extended Care (PPEC) Services](https://medicaid.ms.gov/public-notice-for-spa-22-0028-emergency-private-duty-nursing-pdn-and-prescribed-pediatric-extended-care-ppec-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 22-0028 Emergency Private Duty Nursing (PDN) and Prescribed Pediatric Extended Care (PPEC) Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and
- [Public Notice for SPA 22-0027 Durable Medical Equipment (DME) and Medical Supplies](https://medicaid.ms.gov/public-notice-for-spa-22-0027-durable-medical-equipment-dme-and-medical-supplies/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 22-0027 Durable Medical Equipment (DME) and Medical Supplies. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective October
- [Public Notice for SPA 22-0025 Disproportionate Share Hospital (DSH)](https://medicaid.ms.gov/public-notice-for-spa-22-0025-disproportionate-share-hospital-dsh/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 22-0025 Disproportionate Share Hospital (DSH). The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective October 1, 2022, contingent
- [Public Notice for SPA 22-0026 Ambulatory Surgical Center (ASC)](https://medicaid.ms.gov/public-notice-for-spa-22-0026-ambulatory-surgical-center-asc/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 22-0026 Ambulatory Surgical Center (ASC). The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective October 1, 2022, contingent
- [MESA workshop webinars available throughout October for Medicaid providers](https://medicaid.ms.gov/mesa-workshop-webinars-available-throughout-october-for-medicaid-providers/) - Registration details included in workshop schedule In preparation for the transition to a new Fiscal Agent system, including a new provider portal known as MESA, Provider Portal workshop webinars are available throughout October to help providers become familiar with navigating the new system. Providers can find dates, times and registration information for each webinar at
- [MS SPA 22-0024 Recovery Audit Contractors (RAC) Exception submitted....](https://medicaid.ms.gov/ms-spa-22-0024-recovery-audit-contractors-rac-exception-submitted/) - State Plan Amendment (SPA) 22-0024 is being submitted to allow the Division of Medicaid (DOM) to request an exception to the Recovery Audit Contractors (RAC) requirements for a period of one (1) year from the approval date of State Plan Amendment (SPA) 22-0024 in order to attempt to procure a new, competitively bid RAC contract
- [MS SPA 22-0023 Ambulance Supplemental Payment Program submitted to CMS](https://medicaid.ms.gov/ms-spa-22-0023-ambulance-supplemental-payment-program-submitted-to-cms/) - State Plan Amendment (SPA) 22-0023 is being submitted to allow the Division of Medicaid (DOM) to establish a Medicaid Supplemental Payment Program for emergency ambulance transportation providers, effective July 1, 2022. For more information read the submitted SPA pages.
- [Medicaid providers can now register for MESA workshop webinars set for August and September](https://medicaid.ms.gov/medicaid-providers-can-now-register-for-mesa-workshop-webinars-set-for-august-and-september/) - Follow the instructions below to register online As part of the Mississippi Division of Medicaid’s (DOM) transition to a new Medicaid Management Information System (MMIS), we are excited to announce a series of workshop webinars will be available in August and September to train providers in how to use the new system, MESA: Medicaid Enterprise
- [UPDATE: Conduent pharmacy point-of-sale claims system to shut down on Thursday, Sept. 29, 2022, as part of Fiscal Agent transition](https://medicaid.ms.gov/conduent-pharmacy-point-of-sale-claims-system-to-shut-down-on-thursday-sept-29-2022-as-part-of-fiscal-agent-transition/) - Updated Sept. 28, 2022 Conduent pharmacy point-of-sale claims system to shut down on Thursday, Sept. 29, 2022 The Mississippi Division of Medicaid (DOM) is in the process of implementing a new Fiscal Agent system, which will take effect at the beginning of October. This will result in a transition from Conduent to the new Fiscal
- [EDI medical claims can be submitted to new Fiscal Agent effective Sept. 23, 2022](https://medicaid.ms.gov/edi-medical-claims-can-be-submitted-to-new-fiscal-agent-effective-sept-23-2022/) - As part of the Mississippi Division of Medicaid’s (DOM) transition to a new Fiscal Agent system, Electronic Data Interchange (EDI) medical claims can now be submitted to Gainwell Technologies, effective Sept. 23, 2022. Claims submitted between Sept. 23, 2022, and Oct. 3, 2022, will begin to be processed the week of Oct. 3, 2022. Trading
- [Conduent to cease acceptance of all EDI medical claims submissions on Thursday, Sept. 22, 2022, as part of Fiscal Agent transition](https://medicaid.ms.gov/conduent-to-cease-acceptance-of-all-medical-claims-on-thursday-sept-22-2022-as-part-of-fiscal-agent-transition/) - In preparation for the Oct. 3 transition to a new Fiscal Agent, including a new provider portal known as MESA, the Mississippi Division of Medicaid (DOM) will cease the acceptance of all EDI medical claims submissions by the current Fiscal Agent, Conduent, at 5:00 p.m. CST on Thursday, Sept. 22, 2022. Previously, the acceptance of
- [Time to get September prescription refills!](https://medicaid.ms.gov/time-to-get-september-prescription-refills/) - Attention Beneficiaries: If you have traditional, or “fee for service”, Medicaid (if you are not in a MississippiCAN or CHIP plan) and need your prescription(s) refilled during the last week of September, please be sure to refill them before 9.p.m. on Thursday, September 29, 2022. Due to the implementation of a new Medicaid system, pharmacies
- [MS SPA 22-0006 Long Term Care was approved by CMS](https://medicaid.ms.gov/ms-spa-22-0006-long-term-care-was-approved-by-cms/) - CMS approved MS SPA 22-0006 on September 13, 2022. SPA 22-0006 Long-Term Care was submitted to allow the Division of Medicaid (DOM) to remove the rate freeze from long-term care facilities and reimburse providers according to the previous payment methodology, effective May 1, 2022. For more information read the approved SPA pages.
- [IMMEDIATE ACTION REQUIRED: See updated instructions for EDI enrollment and testing](https://medicaid.ms.gov/immediate-action-required-see-updated-instructions-for-edi-enrollment-and-testing/) - EDI enrollment and testing required to prepare for new Provider Portal The Mississippi Division of Medicaid (DOM) is in the process of implementing a new Medicaid Management Information System (MMIS) – which will include a new Provider Portal – known as MESA: Medicaid Enterprise System Assistance. The new system, going live at the beginning of
- [MS SPA 22-0018 Midwife Services submitted to CMS](https://medicaid.ms.gov/ms-spa-22-0018-midwife-services-submitted-to-cms/) - State Plan Amendment (SPA) 22-0018 is being submitted to allow the Division of Medicaid (DOM) to update the reimbursement rates for midwife services when applicable. For more information read the submitted SPA pages.
- [MS SPA 22-0022 EPSDT Extended Services submitted to CMS](https://medicaid.ms.gov/ms-spa-22-0022-epsdt-extended-services-submitted-to-cms/) - State Plan Amendment (SPA) 22-0022 is being submitted to allow the Division of Medicaid (DOM) to update the rates for certain EPSDT services, including physician services and autism spectrum disorder services, effective July 1, 2022. For more information read the submitted SPA pages.
- [MS SPA 22-0020 Medication Assisted Treatment submitted to CMS](https://medicaid.ms.gov/ms-spa-22-0020-medication-assisted-treatment-submitted-to-cms/) - State Plan Amendment (SPA) 22-020 is being submitted to allow the Division of Medicaid (DOM) to update rates for Medication Assisted Treatment (MAT) services according to the applicable fee schedule and reimburse for Opioid Treatment Programs (OTPs) based on ninety percent (90%) of the Medicare fee schedule updated each July, effective for services provided on
- [MS SPA 22-0019 Preventive Services Vaccines](https://medicaid.ms.gov/ms-spa-22-0019-preventive-services-vaccines/) - State Plan Amendment (SPA) 22-0019 is being submitted to allow the Division of Medicaid (DOM) to update rates for preventative services according to the appropriate payment methodology for the service. For more information read the submitted SPA pages.
- [MS SPA 22-0017 Therapy submitted to CMS](https://medicaid.ms.gov/ms-spa-22-0017-therapy-submitted-to-cms/) - State Plan Amendment (SPA) 22-0017 is being submitted to allow the Division of Medicaid (DOM) to reimburse for therapy services at ninety percent (90%) of the Medicare rate in effect on January 1, 2022, and as may be adjusted each July thereafter. For more information read the submitted SPA pages.
- [MS SPA 22-0016 Dental and Orthodontic Services submitted to CMS](https://medicaid.ms.gov/ms-spa-22-0016-dental-and-orthodontic-services-submitted-to-cms/) - State Plan Amendment (SPA) 22-0016 is being submitted to allow the Division of Medicaid (DOM) to update reimbursement rates, when applicable, and increase reimbursement rates for restorative dental services five percent (5%) above the previous year for state fiscal years (SFY) 2023, 2024, and 2025. For more information read the submitted SPA pages.
- [MS SPA 22-0015 Family Planning Services submitted to CMS](https://medicaid.ms.gov/ms-spa-22-0015-family-planning-services-submitted-to-cms/) - State Plan Amendment (SPA) 22-0015 is being submitted to allow family planning services to be reimbursed ninety percent (90%) of the Medicare fee schedule in effect January 1, 2022 and as may be adjusted each July thereafter. For more information read the submitted SPA pages.
- [MS SPA 22-0014 Clinic Services submitted to CMS](https://medicaid.ms.gov/ms-spa-22-0014-clinic-services-submitted-to-cms/) - State Plan Amendment (SPA) 22-0014 is being submitted to allow the encounter rate for clinic services provided by the Mississippi Department of Health clinics to be updated July of each year. For more information read the submitted SPA pages.
- [MS SPA 22-0013 Chiropractor Services submitted to CMS](https://medicaid.ms.gov/ms-spa-22-0013-chiropractor-services-submitted-to-cms/) - State Plan Amendment (SPA) 22-0013 is being submitted to allow the Division of Medicaid (DOM) to reimburse for chiropractic services at seventy percent (70%) of the Medicare rate in effect as of January 1, 2022 and as may be adjusted each July thereafter. For more information read the submitted SPA pages.
- [MS SPA 22-0012 Rehabilitative Services submitted to CMS](https://medicaid.ms.gov/ms-spa-22-0012-rehabilitative-services-submitted-to-cms/) - State Plan Amendment (SPA) 22-0012 Rehabilitative Services is being submitted to allow the Division of Medicaid (DOM) to reimburse for psychiatric therapeutic procedures that are billed using Current Procedural Terminology (CPT) codes at ninety percent (90%) of the Medicare fee schedule in effect on January 1, 2022 and as may be adjusted each July thereafter.
- [MS SPA 22-0009 Other Licensed Practitioners submitted to CMS](https://medicaid.ms.gov/ms-spa-22-0009-other-licensed-practitioners-submitted-to-cms/) - State Plan Amendment (SPA) 22-0009 is being submitted to allow reimbursement rates for other licensed practitioners to be updated, when applicable, according to the appropriate State Plan payment methodology. For more information read the submitted SPA pages.
- [MS SPA 22-0011 Physician Services submitted to CMS](https://medicaid.ms.gov/ms-spa-22-0011-physician-services-submitted-to-cms/) - State Plan Amendment (SPA) 22-0011 is being submitted to allow the Division of Medicaid (DOM) reimburse for physician services at ninety percent (90%) of the Medicare Physician Fee schedule established on January 1, 2022 and as may be adjusted each July thereafter. For more information read the submitted SPA pages.
- [MS SPA 22-0010 Orthotics and Prosthetics (EPSDT only) submitted to CMS](https://medicaid.ms.gov/ms-spa-22-0010-orthotics-and-prosthetics-epsdt-only-submitted-to-cms/) - State Plan Amendment (SPA) 22-0010 is being submitted to allow reimbursement rates for orthotics and prosthetics to be updated based on eighty percent (80%) of the Medicare rate. For more information read the submitted SPA pages.
- [MS SPA 22-0008 Independent Lab and X-Ray submitted to CMS](https://medicaid.ms.gov/ms-spa-22-0008-independent-lab-and-x-ray-submitted-to-cms/) - State Plan Amendment (SPA) 22-0008 is being submitted to allow the Division of Medicaid (DOM) to reimburse independent laboratory and X-Ray services from a statewide uniform fee schedule based on ninety percent (90%) of the Medicare fee schedule in effect January 1 of each year and updated each July, effective for services provided on or
- [Suspension of paper claims to take effect Sept. 12, 2022](https://medicaid.ms.gov/suspension-of-paper-claims-to-take-effect-sept-12-2022/) - In preparation for the Oct. 3 transition to a new Fiscal Agent, including a new provider portal known as MESA, the Mississippi Division of Medicaid (DOM) will suspend the acceptance of paper claims by the current Fiscal Agent, Conduent, on Sept. 12, 2022. Please note that claims submitted via Pharmacy Point of Sale, the current
- [MS SPA 21-0018 Covered Outpatient Drugs disapproved by CMS](https://medicaid.ms.gov/ms-spa-21-0018-covered-outpatient-drugs-disapproved-by-cms/) - State Plan Amendment (SPA) 21-0018 was submitted to allow the Division of Medicaid (DOM) to 1) set the fees for covered outpatient drugs the same as those in effect on July 1, 2020, and 2) remove the five percent (5%) reimbursement reduction for physician administered drugs effective July 1, 2021. Additionally, this SPA allowed for
- [MS SPA 21-0018A Covered Outpatient Drugs approved by CMS](https://medicaid.ms.gov/ms-spa-21-0018a-covered-outpatient-drugs-approved-by-cms/) - During CMS review of MS SPA 21-0018, MS SPA 21-0018A was created to ensure the removal of the five percent (5%) reduction for physician administered drugs would take effect July 1, 2021. This SPA removes the five percent (5%) reimbursement reduction for physician administered drugs and includes some minor edits to language for clarification, effective
- [Public Notice for Healthier MS Waiver](https://medicaid.ms.gov/public-notice-for-healthier-ms-waiver/) - Pursuant to 42 C.F.R. Section 431.408, public notice is hereby given to the submission of a Medicaid proposed demonstration renewal request of the Healthier Mississippi Waiver (HMW), effective October 1, 2023, through September 30, 2028. The Division of Medicaid is requesting no changes with this renewal request. HMW has operated since 2006. For more information,
- [Medicaid announces free housing locator service](https://medicaid.ms.gov/medicaid-announces-free-housing-locator-service/) - JACKSON, Miss. - The Mississippi Division of Medicaid (DOM) along with other state agencies and partners introduced a free housing listing and locator service at a public launch ceremony Tuesday, Aug. 26, at Cade Courtyard Senior Apartments in Jackson. The service includes a website, MSHousingSearch.org, and a full-service call center designed to offer individuals or
- [MS SPA 22-0004 COVID Vaccines and Administration submitted to CMS](https://medicaid.ms.gov/ms-spa-22-0004-covid-vaccines-and-administration-submitted-to-cms/) - State Plan Amendment (SPA) 22-0004 is being submitted to comply with the American Rescue Plan (ARP) requirements for coverage of COVID vaccines, their administration and vaccine counseling services for children. This SPA is being submitted with an 1135 waiver request to allow the effective date to comply with the ARP, effective March 11, 2021. For
- [MS SPA 22-0001 COVID Testing submitted to CMS](https://medicaid.ms.gov/ms-spa-22-0001-covid-testing-submitted-to-cms/) - State Plan Amendment (SPA) 22-0001 is being submitted to allow the Division of Medicaid (DOM) to comply with the American Rescue Plan (ARP) requirements regarding coverage of U.S. Food & Drug Administration (FDA)-authorized COVID diagnostic and screening tests consistent with the Centers for Disease Control and Prevention (CDC) definitions and recommendations when ordered by a
- [Update on Mississippi Coordinated Care Procurement](https://medicaid.ms.gov/update-on-mississippi-coordinated-care-procurement/) - Intended contract awardees are TrueCare, Magnolia Health Plan, and Molina Healthcare JACKSON, Miss. – In December 2021, the Mississippi Division of Medicaid (DOM) released a competitive solicitation, known as a request for qualifications, seeking at least two but no more than three contractors to administer the statewide Mississippi Coordinated Access Network (MississippiCAN) and the Mississippi
- [IMMEDIATE ACTION REQUIRED: Medicaid Providers must follow instructions for EDI registration and testing to prepare for new Provider Portal](https://medicaid.ms.gov/immediate-action-required-medicaid-providers-must-follow-instructions-for-edi-registration-and-testing-to-prepare-for-new-provider-portal/) - EDI registration and testing required to prepare for new Provider Portal The Mississippi Division of Medicaid (DOM) is in the process of implementing a new Medicaid Management Information System (MMIS) – which will include a new Provider Portal – known as MESA: Medicaid Enterprise System Assistance. The new system, going live at the beginning of
- [Suspension of Provider Enrollments](https://medicaid.ms.gov/suspension-of-provider-enrollments/) - The Mississippi Division of Medicaid (DOM) requests that all providers currently planning to enroll as a Mississippi Medicaid Provider submit their application and all supporting documentation no later than Aug. 15, 2022. DOM must temporarily suspend application processing on Aug. 15 in preparation for the Oct. 3 launch of the agency’s new MMIS, known as
- [Mississippi Statewide Transition Plan Final Approval](https://medicaid.ms.gov/mississippi-statewide-transition-plan-final-approval/) - The Centers for Medicare and Medicaid Services (CMS) is granting Mississippi final approval of its Statewide Transition Plan (STP) to bring settings into compliance with the federal home and community-based services (HCBS) regulations found at 42 CFR Section 441.301(c)(4)(5) and Section 441.710(a)(1)(2). Upon receiving initial approval for completion of its systemic assessment and outline of
- [Public Notice for 1915(c) Elderly and Disabled (E&D) Waiver renewal](https://medicaid.ms.gov/public-notice-for-1915c-elderly-and-disabled-ed-waiver-renewal/) - Pursuant to 42 C.F.R. Section 441.304, public notice is hereby given to the submission of a Medicaid 1915(c) Elderly and Disabled (E&D) Waiver renewal. The Division of Medicaid, in the Office of the Governor, will submit this proposed waiver to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2022, contingent upon approval
- [Elderly and Disabled (E&D) Waiver Renewal Approved by CMS](https://medicaid.ms.gov/elderly-and-disabled-ed-waiver-renewal-approved-by-cms/) - The Centers for Medicare and Medicaid Services (CMS) has approved the following Elderly and Disabled (E&D) Waiver renewal. For more information, read the proposed waiver pages.
- [Independent Living Waiver Renewal Approved by CMS](https://medicaid.ms.gov/independent-living-waiver-renewal-approved-by-cms/) - The Centers for Medicare and Medicaid Services (CMS) has approved the following Independent Living Waiver renewal. For more information, read the proposed waiver pages.
- [Public Notice for SPA 22-0022 EPSDT Extended Services](https://medicaid.ms.gov/public-notice-for-spa-22-0022-epsdt-extended-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 22-0022 Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Extended Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services
- [Public Notice for SPA 22-0010 Orthotics and Prosthetics](https://medicaid.ms.gov/public-notice-for-spa-22-0010-orthotics-and-prosthetics/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) State Plan Amendment (SPA) 22-0010 Orthotics and Prosthetics. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July
- [Public Notice for SPA 22-0013 Chiropractor Services](https://medicaid.ms.gov/public-notice-for-spa-22-0013-chiropractor-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 22-0013 Chiropractor Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2022, contingent upon approval
- [Public Notice for SPA 22-0012 Rehabilitative Services](https://medicaid.ms.gov/public-notice-for-spa-22-0012-rehabilitative-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 22-0012 Rehabilitative Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2022, contingent upon approval
- [Public Notice for SPA 22-0015 Family Planning Services](https://medicaid.ms.gov/public-notice-for-spa-22-0015-family-planning-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 22-0015 Family Planning Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2022, contingent upon
- [Public Notice for SPA 22-0023 Ambulance Supplemental Payment Program](https://medicaid.ms.gov/public-notice-for-spa-22-0023-ambulance-supplemental-payment-program/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 22-0023 Ambulance Supplemental Payment Program. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2022, contingent
- [Public Notice for SPA 22-0020 Medication Assisted Treatment (MAT)](https://medicaid.ms.gov/public-notice-for-spa-22-0020-medication-assisted-treatment-mat/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 22-0020 Medication Assisted Treatment (MAT) Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2022,
- [Public Notice for SPA 22-0019 Preventive Services Vaccines](https://medicaid.ms.gov/public-notice-for-spa-22-0019-preventive-services-vaccines/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 22-0019 Preventive Services Vaccines. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2022, contingent upon
- [Public Notice for SPA 22-0018 Midwife Services](https://medicaid.ms.gov/public-notice-for-spa-22-0018-midwife-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 22-0018 Midwife Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2022, contingent upon approval
- [Public Notice for SPA 22-0017 Therapy Services](https://medicaid.ms.gov/public-notice-for-spa-22-0017-therapy-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 22-0017 Therapy Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2022, contingent upon approval
- [Public Notice for SPA 22-0016 Dental and Orthodontic Services](https://medicaid.ms.gov/public-notice-for-spa-22-0016-dental-and-orthodontic-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 22-0016 Dental and Orthodontic Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2022, contingent
- [Public Notice for SPA 22-0014 Clinic Services](https://medicaid.ms.gov/public-notice-for-spa-22-0014-clinic-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 22-0014 Clinic Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2022, contingent upon approval
- [Public Notice for SPA 22-0011 Physician Services](https://medicaid.ms.gov/public-notice-for-spa-22-0011-physician-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 22-0011. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2022, contingent upon approval from CMS,
- [Public Notice for SPA 22-0009 Other Licensed Practitioners](https://medicaid.ms.gov/public-notice-for-spa-22-0009-other-licensed-practitioners/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 22-0009 Other Licensed Practitioners. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2022, contingent upon
- [Public Notice for SPA 22-0008 Independent Lab and X-ray Services](https://medicaid.ms.gov/public-notice-for-spa-22-0008-independent-lab-and-x-ray-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 22-0008 Independent Lab and X-ray Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2022,
- [Pharmacy reimbursement freeze to end effective July 1, 2022](https://medicaid.ms.gov/pharmacy-reimbursement-freeze-to-end-effective-july-1-2022/) - Effective July 1, 2022, the Mississippi Division of Medicaid (DOM) will reestablish payment methods for the ingredient costs of prescription drugs that existed prior to the July 1, 2021 rate freeze. This change will remove the freeze for dates of service on or after July 1, 2022. DOM has been in frequent communication with the
- [MS SPA 22-0006 Long-Term Care submitted to CMS](https://medicaid.ms.gov/ms-spa-22-0006-long-term-care-submitted-to-cms/) - State Plan Amendment (SPA) 22-0006 Long-Term Care is being submitted to allow the Division of Medicaid (DOM) to remove the rate freeze from long-term care facilities and reimburse providers according to the previous payment methodology, effective May 1, 2022. For more information read the submitted SPA pages.
- [Public Notice for SPA 22-0005 COVID Treatment and Complications](https://medicaid.ms.gov/public-notice-for-spa-22-0005-covid-treatment-and-complications/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 22-0005 COVID Treatment and Complications Coverage. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective March 11, 2021,
- [Public Notice for SPA 22-0004 COVID Vaccines and Administration](https://medicaid.ms.gov/public-notice-for-spa-22-0004-covid-vaccines-and-administration/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 22-0004 COVID Vaccines and Administration. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective March 11, 2021, contingent
- [Public Notice for SPA 22-0001 COVID Testing](https://medicaid.ms.gov/public-notice-for-spa-22-0001-covid-testing/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 22-0001 COVID Testing. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective March 11, 2021, contingent upon approval
- [Providers to be informed of changes to Medicaid Provider IDs](https://medicaid.ms.gov/providers-to-be-informed-of-changes-to-medicaid-provider-ids/) - As part of the Mississippi Division of Medicaid’s (DOM) transition to a new Medicaid Management Information System (MMIS), important changes are on the way involving Medicaid Provider IDs. Beginning June 1, 2022, all actively enrolled Medicaid providers will receive letters in the mail detailing changes that will be made to their Provider IDs. As outlined
- [Public Notice of Annual Post-Award Forum for 1115(a) Healthier Mississippi Waiver](https://medicaid.ms.gov/public-notice-of-annual-post-award-forum-for-1115a-healthier-mississippi-waiver-3/) - Pursuant to 42 C.F.R. Section 431.420(c), public notice is hereby given to the annual Post-Award Forum on the Division of Medicaid’s Healthier Mississippi Waiver. The annual Post-Award Forum provides stakeholders and the general public the opportunity to provide meaningful comment on the progress of the Healthier Mississippi Waiver. The Healthier Mississippi Waiver operates under the
- [Public Notice of Annual Public Forum for 1115(a) Family Planning Waiver](https://medicaid.ms.gov/public-notice-of-annual-public-forum-for-1115a-family-planning-waiver-4/) - Pursuant to 42 C.F.R. Section 431.420(c), a Public Forum is required annually after the implementation of the Division of Medicaid’s Family Planning Waiver. This Public Forum provides stakeholders the opportunity to provide meaningful comments on the progress of the Family Planning Waiver. The Family Planning Waiver operates under the authority of an 1115(a) waiver approved
- [MS SPA 22-0002 End-Stage Renal Disease (ESRD) Immunizations submitted to CMS](https://medicaid.ms.gov/ms-spa-22-0002-end-stage-renal-disease-esrd-immunizations-submitted-to-cms/) - State Plan Amendment (SPA) 22-0002 is being submitted to allow the Division of Medicaid (DOM) to add language detailing how immunizations are currently reimbursed in dialysis facilities effective May 1, 2022. For more information read the submitted SPA pages.
- [MS SPA 21-0052 Clinical Trial Coverage approved by CMS](https://medicaid.ms.gov/ms-spa-21-0052-clinical-trial-coverage-approved-by-cms/) - CMS approved State Plan Amendment (SPA) 21-0052 Clinical Trial Coverage on May 4, 2022. State Plan Amendment (SPA) 21-0052 was submitted to comply with Section 210 of the Consolidated Appropriations Act, 2021, which added a mandatory benefit for routine patient costs for items and services furnished in connection with participation by Medicaid beneficiaries in qualifying
- [Public Notice for 1915 (c) Independent Living (IL) Waiver Renewal](https://medicaid.ms.gov/public-notice-for-1915-c-independent-living-il-waiver-renewal/) - Pursuant to 42 C.F.R. Section 441.304(f), public notice is hereby given to the submission of the Independent Living (IL) Waiver Renewal. The Division of Medicaid, in the Office of the Governor, will submit this proposed waiver amendment to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2022, contingent upon approval from CMS.
- [MS SPA 21-0051 Disproportionate Share Hospital (DSH) Payment Update approved by CMS](https://medicaid.ms.gov/ms-spa-21-0051-disproportionate-share-hospital-dsh-payment-update-approved-by-cms/) - CMS approved State Plan Amendment (SPA) 21-0051 Disproportionate Share Hospital (DSH) Payment Update on April 26, 2022. On December 27, 2020, the Consolidated Appropriations Act for 2021 was signed into law after it was passed by Congress, which changes the calculation of a hospital’s DSH limit, OBRA, to remove costs and payments of individuals with
- [Public Notice for SPA 22-0006 Long-Term Care](https://medicaid.ms.gov/public-notice-for-spa-22-0006-long-term-care/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 22-0006 Long-Term Care. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective May 1, 2022, contingent upon approval
- [Public Notice for SPA 22-0002 End-Stage Renal Disease (ESRD) Immunizations](https://medicaid.ms.gov/public-notice-for-spa-22-0002-end-stage-renal-disease-esrd-immunizations/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 22-0002 End-Stage Renal Disease (ESRD) Immunizations. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective May 1, 2022,
- [Medicaid Vital Signs - January-December 2021](https://medicaid.ms.gov/medicaid-vital-signs-january-december-2021/) - This update of the Medicaid Vital Signs dashboard contains enrollment and expenditure data from January through December of 2021. Launched in early 2019, Vital Signs displays key Mississippi Medicaid metrics allowing anyone to quickly check certain Medicaid statistics and follow recent program trends. After a hiatus due to the COVID-19 pandemic, updates to the information
- [Medicaid to implement centralized credentialing process for Medicaid managed care providers in July](https://medicaid.ms.gov/medicaid-to-implement-centralized-credentialing-process-for-medicaid-managed-care-providers-in-july/) - Fee-for-service provider screening process to satisfy provider credentialing obligations during first-year implementation phase Jackson, Miss. – As part of an on-going effort to cut down on red tape and reduce administrative burdens for health care providers, the Mississippi Division of Medicaid (DOM) will be implementing a centralized credentialing process for providers enrolling with any MississippiCAN
- [MS SPA 21-0052 Clinical Trial Coverage submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0052-clinical-trial-coverage-submitted-to-cms/) - State Plan Amendment (SPA) 21-0052 was submitted to comply with Section 210 of the Consolidated Appropriations Act, 2021, which added a mandatory benefit for routine patient costs for items and services furnished in connection with participation by Medicaid beneficiaries in qualifying clinical trials, effective January 1, 2022. For more information read the submitted SPA pages.
- [MS SPA 21-0051 Disproportionate Share Hospital (DSH) Payment Update Submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0051-disproportionate-share-hospital-dsh-payment-update-submitted-to-cms/) - On December 27, 2020, the Consolidated Appropriations Act for 2021 was signed into law after it was passed by Congress, which changes the calculation of a hospital’s DSH limit, OBRA, to remove costs and payments of individuals with Medicare or third-party coverage, with the exception of hospitals that meet the 97th percentile for the most
- [MS Statewide Transition Plan submitted to CMS](https://medicaid.ms.gov/ms-statewide-transition-plan-submitted-to-cms/) - The Mississippi Statewide Transition Plan was submitted to CMS on February 25, 2022, for final approval from the Centers for Medicare and Medicaid Services (CMS). This submission included the public comments and responses from the comment period December 20, 2021, through January 19, 2022. Mississippi Statewide Transition Plan submitted for final approval clean: Feb. 25,
- [DOM seeks provider, stakeholder feedback on new quality incentive payment program](https://medicaid.ms.gov/dom-seeks-provider-stakeholder-feedback-on-new-quality-incentive-payment-program/) - The Mississippi Division of Medicaid (DOM) is conducting a survey to gather provider feedback regarding a new physician-directed payment program called the Physician Quality Incentive Payment Program (PQIPP). DOM is seeking stakeholder feedback about PQIPP through the survey linked below, including from hospitals and medical associations, providers (clinics, physicians, nurse practitioners, etc.), and any other
- [Governor declared disaster - Rx billing directions](https://medicaid.ms.gov/disaster-billing-directions/) - Billing Procedures During Officially Declared States of Emergency During states of officially declared emergencies, pharmacy providers should bill POS claims as follows: Enter a value of ’13-Payor Recognized Emergency’ in NCPDP Field ‘420-DK’ when it is necessary to override the following service limit edits: Two (2) Brand / Six (6) Prescription Limit Early Refill Please
- [CMS releases state-specific Payment Error Rate Measurement results](https://medicaid.ms.gov/cms-releases-state-specific-payment-error-rate-measurement-results/) - CMS data show Mississippi Medicaid payment, eligibility error rates among lowest in the nation Mississippi Medicaid’s overall payment error rate is the fourth lowest among the 34 states with publicly available results, according to new state-specific data released by the Centers for Medicare and Medicaid Services (CMS). Publicly released for the first time, the data
- [Public Notice for Mississippi Statewide Transition Plan](https://medicaid.ms.gov/public-notice-for-mississippi-statewide-transition-plan/) - Public notice is hereby given to the submission of the revised Mississippi Statewide Transition Plan (STP) for final approval from the Centers for Medicare and Medicaid Services (CMS). DOM is posting this final draft of the STP for public comment prior to submission to CMS. The document will be available for public comments for thirty
- [Public Notice for SPA 21-0052 Clinical Trial Costs](https://medicaid.ms.gov/public-notice-for-spa-21-0052-clinical-trial-costs/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0052 Clinical Trial Costs. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective January 1, 2022, contingent upon
- [Amended Public Notice for SPA 21-0051 Disproportionate Share Hospital (DSH) Payment Update](https://medicaid.ms.gov/amended-public-notice-for-spa-21-0051-disproportionate-share-hospital-dsh-payment-update/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0051 Disproportionate Share Hospital (DSH) Payment Update. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective January 1,
- [MS SPA 21-0017 Rural Health Center (RHC) Services approved by CMS](https://medicaid.ms.gov/ms-spa-21-0017-rural-health-center-rhc-services-approved-by-cms/) - CMS approved MS SPA 21-0017 Rural Health Center (RHC) Services on December 6, 2021. State Plan Amendment (SPA) 21-0017 was submitted to: 1) Clarify the different types of encounters and when more than one encounter is performed on the same day, 2) Add the requirements for RHC mobile units, and 3) add language to refer
- [MS SPA 21-0016 Federally Qualified Health Center (FQHC) Services approved by CMS](https://medicaid.ms.gov/ms-spa-21-0016-federally-qualified-health-center-fqhc-services-approved-by-cms/) - CMS approved MS SPA 21-0016 Federally Qualified Health Center (FQHC) Services on December 6, 2021. State Plan Amendment (SPA) 21-0016 was submitted to: 1) Clarify the different types of encounters and when reimbursement is made for more than one encounter performed on the same day, 2) Add the requirements for FQHC mobile units, and 3)
- [Public Notice for SPA 21-0051 Disproportionate Share Hospital (DSH) Payment Update](https://medicaid.ms.gov/public-notice-for-spa-21-0051-disproportionate-share-hospital-dsh-payment-update/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0051 Disproportionate Share Hospital (DSH) Payment Update. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective January 1,
- [New MississippiCAN procurement focuses on improved outcomes and quality](https://medicaid.ms.gov/new-mississippican-procurement-focuses-on-improved-outcomes-and-quality/) - DOM releases Request for Qualifications JACKSON, Miss. – Ten years after the launch of MississippiCAN, the Mississippi Division of Medicaid (DOM) is poised to usher in a new era of the coordinated care program focused on improving outcomes and quality of life for Medicaid members as it begins the procurement process for new vendor contracts.
- [PPRB approves petition for a Request for Qualifications (RFQ) procurement process](https://medicaid.ms.gov/pprb-approves-petition-for-a-request-for-qualifications-rfq-procurement-process/) - On Wednesday, June 2, the Public Procurement Review Board (PPRB) approved the Mississippi Division of Medicaid’s (DOM) Petition for Relief from Bidding as a Procurement Method, enabling the agency to pursue a Coordinated Care procurement process through a Request for Qualifications (RFQ). An RFQ allows DOM the ability to assess a bidding vendor’s experience and
- [CMS approved MS SPA 21-0048 Medication Assisted Treatment (MAT) Services](https://medicaid.ms.gov/cms-approved-ms-spa-21-0048-medication-assisted-treatment-mat-services/) - CMS approved State Plan Amendment (SPA) 21-0048 on November 29, 2021. State Plan Amendment (SPA) 21-0048 was submitted to allow the Division of Medicaid (DOM) to 1) set the fees for medication assisted treatment services the same as those in effect April 1, 2021, and 2) remove the five percent (5%) reimbursement reduction effective July
- [COVID-19 Vaccine Billing Guidance for Medical Claims](https://medicaid.ms.gov/covid-19-vaccine-billing-guidance-for-medical-claims/) - Medicaid Coverage of COVID-19 Vaccine Administration The Mississippi Division of Medicaid (DOM) will cover the administration of COVID-19 vaccines as shown in the chart below. The Centers for Medicare and Medicaid Services (CMS) indicates that the initial supply of COVID-19 vaccines will be federally purchased. CMS states that providers should not bill the vaccine product
- [MS SPA 21-0046 MSCAN Procurement Method approved by CMS](https://medicaid.ms.gov/ms-spa-21-0046-mscan-procurement-method-approved-by-cms/) - CMS approved MS SPA 21-0046 on November 4, 2021. The Mississippi Division of Medicaid MS SPA 21-0046 was submitted to ensure the state and the agency are able to use the method of procurement most likely to produce quality vendors for Managed Care services in the state. MSDOM intends to implement this SPA during its
- [Follow-up information regarding use of CPT Category II Codes](https://medicaid.ms.gov/follow-up-information-regarding-use-of-cpt-category-ii-codes/) - As a reminder, the Division of Medicaid (DOM) will require providers to include accurate CPT® Category II codes on physician, physician assistant, and nurse practitioner claims, effective October 1, 2021. The chart below reflects potential CPT Category I codes that could be used in combination with CPT Category II codes which are billed in the
- [MS SPA 21-0014 Targeted Case Management (TCM) for High Risk Pregnant Women approved by CMS](https://medicaid.ms.gov/ms-spa-21-0014-targeted-case-management-tcm-for-high-risk-pregnant-women-approved-by-cms/) - CMS approved MS SPA 21-0014 on September 17, 2021. State Plan Amendment (SPA) 21-0014 was submitted to allow the Division of Medicaid (DOM) to 1) update coverage and reimbursement of targeted case management to comply with federal regulations 42 C.F.R. §§ 440.169, 441.18, 2) set the fees for targeted case management for high-risk pregnant women
- [MS SPA 21-0021 Extended Services for Pregnant Women approved by CMS](https://medicaid.ms.gov/ms-spa-21-0021-extended-services-for-pregnant-women-approved-by-cms/) - CMS approved MS SPA 21-0021 on September 23, 2021. State Plan Amendment (SPA) 21-0021 was submitted to allow the Division of Medicaid (DOM) to 1) revise coverage and payment methodology for extended services for pregnant and post-partum women who are at risk of morbidity or mortality, 2) set the fees for extended services for pregnant
- [MS SPA 21-0039 Targeted Case Management (TCM) for Psychiatric Residential Treatment Facility (PRTF) Level of Care (LOC) approved by CMS](https://medicaid.ms.gov/ms-spa-21-0039-targeted-case-management-tcm-for-psychiatric-residential-treatment-facility-prtf-level-of-care-loc-approved-by-cms/) - CMS approved MS SPA 21-0039 on September 20, 2021. State Plan Amendment (SPA) 21-0039 was submitted to allow the Division of Medicaid (DOM) to cover and reimburse for wraparound services under the targeted case management benefit, effective July 1, 2021. The Division of Medicaid submitted MS SPA 20-0022 Mental Health Service Coverage and Reimbursement to
- [MS SPA 21-0035 Telehealth approved by CMS](https://medicaid.ms.gov/ms-spa-21-0035-telehealth-approved-by-cms/) - CMS approved MS SPA 21-0035 Telehealth on September 17, 2021. State Plan Amendment (SPA) 21-0035 was submitted to allow the Division of Medicaid (DOM) to 1) set the fees for telehealth services the same as those in effect on July 1, 2020, 2) add Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs) as
- [MS SPA 21-0040 Targeted Case Management (TCM) for Chronically Mentally Ill approved by CMS](https://medicaid.ms.gov/ms-spa-21-0040-targeted-case-management-tcm-for-chronically-mentally-ill-approved-by-cms/) - CMS approved MS SPA 21-0040 Targeted Case Management (TCM) for Chronically Mentally Ill on September 20, 2021. State Plan Amendment (SPA) 21-0040 was submitted to allow the Division of Medicaid (DOM) to add coverage language and requirements to targeted case management for the chronically mentally ill to comply with 42 C.F.R. § 440.169 and §
- [MS SPA 21-0023 Long-Term Care approved by CMS](https://medicaid.ms.gov/ms-spa-21-0023-long-term-care-approved-by-cms/) - CMS approved MS SPA 21-0023 Long-Term Care on September 23, 2021. State Plan Amendment (SPA) 21-0023 was submitted to allow the Division of Medicaid (DOM) to freeze all long-term care facility rates in effect July 1, 2021. For more information read the approved SPA pages.
- [MS SPA 21-0007 APR-DRG approved by CMS](https://medicaid.ms.gov/ms-spa-21-0007-apr-drg-approved-by-cms/) - CMS approved MS SPA 21-0007 APR-DRG on September 23, 2021. State Plan Amendment (SPA) 21-0007 All Patient Refined-Diagnosis Related Groups (APR-DRG) Reimbursement was submitted to update the following hospital inpatient services effective July 1, 2021: 1) Update APR-DRG parameters, 2) use cost-to-charge (CCRs) ratios in effect July 1, 2021 to calculate outlier payments for claims
- [MS SPA 21-0042 Targeted Case Management (TCM) for Infants Under the Age of One approved by CMS](https://medicaid.ms.gov/ms-spa-21-0042-targeted-case-management-tcm-for-infants-under-the-age-of-one-approved-by-cms/) - CMS approved MS SPA 21-0042 on September 13, 2021. State Plan Amendment (SPA) 21-0042 was submitted to allow the Division of Medicaid (DOM) to 1) update coverage and reimbursement of targeted case management (TCM) for infants under the age of one (1) to comply with federal regulations 42 C.F.R. §§ 440.169, 441.18, 2) set the
- [MS SPA 21-0022 Transportation Services approved by CMS](https://medicaid.ms.gov/ms-spa-21-0022-transportation-services-approved-by-cms/) - CMS approved MS SPA 21-0022 on September 13, 2021. State Plan Amendment (SPA) 21-0022 was submitted to allow the Division of Medicaid (DOM) to 1) set the fees for transportation services the same as those in effect on July 1, 2020, and 2) remove the five percent (5%) reimbursement reduction effective July 1, 2021. For
- [MS SPA 21-0001 COVID Vaccine Administration Reimbursement Emergency approved by CMS](https://medicaid.ms.gov/ms-spa-21-0001-covid-vaccine-administration-reimbursement-emergency-approved-by-cms/) - CMS approved MS SPA 21-0001 on September 20, 2021. State Plan Amendment (SPA) 21-0001 was submitted to allow the Division of Medicaid (DOM) to reimburse all Mississippi Medicaid pharmacies, physicians, and non-physician practitioners 100% of the Medicare rate for the administration of an FDA-approved COVID-19 vaccine. For more information read the approved SPA pages.
- [MS SPA 21-0028 Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Extended Services approved by CMS](https://medicaid.ms.gov/ms-spa-21-0028-early-and-periodic-screening-diagnosis-and-treatment-epsdt-extended-services-approved-by-cms/) - State Plan Amendment (SPA) 21-0028 has been approved by the Centers for Medicare and Medicaid services to allow the Division of Medicaid (DOM) to 1) set the fees for EPSDT extended services the same as those in effect on July 1, 2020, 2) remove the five percent (5%) reimbursement reduction effective July 1, 2021, and
- [MS SPA 21-0041 Preventive Services approved by CMS](https://medicaid.ms.gov/ms-spa-21-0041-preventive-services-approved-by-cms/) - CMS approved State Plan Amendment (SPA) 21-0041 on August 31, 2021. State Plan Amendment (SPA) 21-0041 was submitted to allow the Division of Medicaid (DOM) to 1) set the fees for vaccines and vaccine administration the same as those effective for State Fiscal Year (SFY) 2021, 2) to include language regarding the reimbursement for administration
- [MS SPA 21-0024 Rehabilitative Services approved by CMS](https://medicaid.ms.gov/ms-spa-21-0024-rehabilitative-services-approved-by-cms/) - CMS approved State Plan Amendment (SPA) 21-0024 on August 24, 2021. State Plan Amendment (SPA) 21-0024 Rehabilitative Services was submitted to 1) set the fees for rehabilitative services the same as those in effect on April 1, 2020, and 2) remove the five percent (5%) reimbursement reduction effective July 1, 2021. For more information read
- [MS SPA 21-0010 Other Licensed Practitioners approved by CMS](https://medicaid.ms.gov/ms-spa-21-0010-other-licensed-practitioners-approved-by-cms/) - CMS approved State Plan Amendment (SPA) 21-0010 on August 24, 2021. State Plan Amendment (SPA) 21-0010 was submitted to allow the Division of Medicaid (DOM) to 1) set the fees for nurse practitioner and physician assistant services the same as those in effect State Fiscal Year (SFY) 2021, and 2) remove the five percent (5%)
- [MS SPA 20-0022 Mental Health Service Coverage and Reimbursement approved by CMS](https://medicaid.ms.gov/ms-spa-20-0022-mental-health-service-coverage-and-reimbursement-approved-by-cms/) - CMS approved MS SPA 20-0022 on August 2, 2021. SPA 20-0022 was submitted to include: a) Replacing Intensive Outpatient Psychiatric (IOP) services with Intensive Community Outreach Teams (ICORT), b) Reimbursing ICORT services at the current IOP rate, c) Including reimbursement language for Early and Periodic Screening, Diagnosis and Treatment (EPSDT) mental health services which the
- [MS SPA 20-0015-CHIP Behavioral Health approved by CMS](https://medicaid.ms.gov/ms-spa-20-0015-chip-behavioral-health-approved-by-cms/) - CMS approved MS SPA 20-0015-CHIP Behavioral Health on September 1, 2021. Children’s Health Insurance Program State Plan Amendment (SPA) 20-0015-CHIP Behavioral Health was submitted to allow the Division of Medicaid to include mental health coverage as a mandatory benefit for all CHIP beneficiaries. Mandatory coverage will include services necessary to prevent, diagnose and treat a
- [MS SPA 21-0048 Medication Assisted Treatment (MAT) submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0048-medication-assisted-treatment-mat-submitted-to-cms/) - State Plan Amendment (SPA) 21-0048 is being submitted to allow the Division of Medicaid (DOM) to 1) set the fees for medication assisted treatment services the same as those in effect April 1, 2021, and 2) remove the five percent (5%) reimbursement reduction effective July 1, 2021. For more information read the approved SPA pages.
- [MS SPA 21-0037 Christian Science Services approved by CMS](https://medicaid.ms.gov/ms-spa-21-0037-christian-science-services-approved-by-cms/) - CMS approved MS SPA 21-0037 Christian Science Services on August 26, 2021. State Plan Amendment (SPA) 21-0037 was submitted to allow the Division of Medicaid (DOM) to 1) set the fees for Christian science services the same as those in effect for State Fiscal Year (SFY) 2021, and 2) remove the five percent (5%) reimbursement
- [MS SPA 21-0045 Dentures approved by CMS](https://medicaid.ms.gov/ms-spa-21-0045-dentures-approved-by-cms/) - CMS approved MS SPA 21-0045 Dentures on August 26, 2021. State Plan Amendment (SPA) 21-0045 was submitted to allow the Division of Medicaid (DOM) to 1) set the fees for dentures for EPSDT recipients the same as those effective for State Fiscal Year (SFY) 2021, and 2) remove the five percent (5%) reimbursement reduction effective
- [MS SPA 21-0044 Eyeglasses approved by CMS](https://medicaid.ms.gov/ms-spa-21-0044-eyeglasses-approved-by-cms/) - CMS approved MS SPA 21-0044 Eyeglasses on August 26, 2021. State Plan Amendment (SPA) 21-0044 was submitted to allow the Division of Medicaid (DOM) to 1) set the fees for eyeglasses the same as those effective for State Fiscal Year (SFY) 2021, and 2) remove the five percent (5%) reimbursement reduction effective July 1, 2021,
- [MS SPA 21-0031 Home Health, DME, and Medical Supply approved by CMS](https://medicaid.ms.gov/ms-spa-21-0031-home-health-dme-and-medical-supply-approved-by-cms/) - CMS approved MS SPA 21-0031 Home Health, DME, and Medical Supply on August 24, 2021. State Plan Amendment (SPA) 21-0031 was submitted to allow the Division of Medicaid (DOM) to 1) set the fees for home health services in effect as of October 1, 2020, 2) set the fees for durable medical equipment and medical
- [MS SPA 21-0032 Dental and Orthodontic Services approved by CMS](https://medicaid.ms.gov/ms-spa-21-0032-dental-and-orthodontic-services-approved-by-cms/) - CMS approved MS SPA 21-0032 Dental and Orthodontic Services on August 24, 2021. State Plan Amendment (SPA) 21-0032 was submitted to allow the Division of Medicaid (DOM) to 1) set the fees for dental and orthodontic services the same as those effective for State Fiscal Year (SFY) 2021, except for a five percent (5%) rate
- [MS SPA 21-0030 Hearing Aids approved by CMS](https://medicaid.ms.gov/ms-spa-21-0030-hearing-aids-approved-by-cms/) - CMS approved MS SPA 21-0030 Hearing Aids on August 24, 2021. State Plan Amendment (SPA) 21-0030 was submitted to allow the Division of Medicaid (DOM) to 1) set the fees for hearing aids the same as those effective for State Fiscal Year (SFY) 2021, and 2) remove the five percent (5%) reimbursement reduction for hearing
- [MS SPA 21-0029 Family Planning Services approved by CMS](https://medicaid.ms.gov/ms-spa-21-0029-family-planning-services-approved-by-cms/) - CMS approved MS SPA 21-0029 on August 24, 2021. State Plan Amendment (SPA) 21-0029 is being submitted to allow the Division of Medicaid (DOM) to set the fees for family planning services the same as those in effect on July 1, 2020." For more information read the approved SPA pages.
- [MS SPA 21-0027 Dialysis Services approved by CMS](https://medicaid.ms.gov/ms-spa-21-0027-dialysis-services-approved-by-cms/) - CMS approved MS SPA 21-0027 on August 24, 2021. State Plan Amendment (SPA) 21-0027 is being submitted to allow the Division of Medicaid (DOM) to set the fees for dialysis services the same as those in effect January 1, 2021. For more information read the approved SPA pages.
- [MS SPA 21-0025 Chiropractor Services approved by CMS](https://medicaid.ms.gov/ms-spa-21-0025-chiropractor-services-approved-by-cms/) - CMS approved MS SPA 21-0025 on August 24, 2021. State Plan Amendment (SPA) 21-0025 is being submitted to allow the Division of Medicaid (DOM) to 1) set the fees for chiropractic services the same as those in effect for State Fiscal Year (SFY) 2021, and 2) remove the five percent (5%) reimbursement reduction effective July
- [MS SPA 21-0026 Clinic Services approved by CMS](https://medicaid.ms.gov/ms-spa-21-0026-clinic-services-approved-by-cms/) - CMS approved MS SPA 21-0026 on August 24, 2021. State Plan Amendment (SPA) 21-0026 is being submitted to allow the Division of Medicaid (DOM) to 1) set the fees for clinic services the same as those in effect for State Fiscal Year (SFY) 2021, and 2) add language addressing cost reports that are not timely
- [MS SPA 21-0020 Targeted Case Management (TCM) Early Intervention approved by CMS](https://medicaid.ms.gov/ms-spa-21-0020-targeted-case-management-tcm-early-intervention-approved-by-cms/) - CMS approved MS SPA 21-0020 on August 24, 2021. State Plan Amendment (SPA) 21-0020 is being submitted to allow the Division of Medicaid (DOM) to set the fees for targeted case management early intervention services the same as those in effect on July 1, 2021. For more information read the approved SPA pages.
- [MS SPA 21-0015 Hospital Outpatient Services approved by CMS](https://medicaid.ms.gov/ms-spa-21-0015-hospital-outpatient-services-approved-by-cms/) - CMS approved MS SPA 21-0015 Hospital Outpatient Services on August 24, 2021. State Plan Amendment (SPA) 21-0015 is being submitted to allow the Division of Medicaid (DOM) to 1) set the fees for hospital outpatient services the same as those in effect on July 1, 2021, and 2) allow Rural Hospitals that have fifty (50)
- [MS SPA 21-0013 Ambulatory Surgical Center Services approved by CMS](https://medicaid.ms.gov/ms-spa-21-0013-ambulatory-surgical-center-services-approved-by-cms/) - CMS approved MS SPA 21-0013 Ambulatory Surgical Center Services on August 24, 2021. State Plan Amendment (SPA) 21-0013 is being submitted to allow the Division of Medicaid (DOM) to 1) set the fees for ambulatory surgical center services the same as those effective October 1, 2020, and 2) remove the five percent (5%) reimbursement reduction
- [MS SPA 21-0012 Physician Services approved by CMS](https://medicaid.ms.gov/ms-spa-21-0012-physician-services-approved-by-cms/) - CMS approved MS SPA 21-0012 Physician Services on August 24, 2021. State Plan Amendment (SPA) 21-0012 was submitted to allow the Division of Medicaid (DOM) 1) to set the fees for physician services the same as those effective State Fiscal Year (SFY) 2021, effective July 1, 2021, to be in compliance with Miss. Code §
- [Public Notice for SPA 21-0048 Medication Assisted Treatment (MAT) Services](https://medicaid.ms.gov/public-notice-for-spa-21-0048-medication-assisted-treatment-mat-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0048 Medication Assisted Treatment (MAT) Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2021,
- [MS SPA 21-0011 Orthotics and Prosthetics approved by CMS](https://medicaid.ms.gov/ms-spa-21-0011-orthotics-and-prosthetics-approved-by-cms/) - CMS approved State Plan Amendment (SPA) 21-0011 on August 24, 2021. State Plan Amendment (SPA) 21-0011 was submitted to allow the Division of Medicaid (DOM) to 1) set the fees for orthotics and prosthetics the same as those effective State Fiscal Year (SFY) 2021, and 2) remove the five percent (5%) reimbursement reduction effective July
- [MS SPA 21-0009 Podiatry Services approved by CMS](https://medicaid.ms.gov/ms-spa-21-0009-podiatry-services-approved-by-cms/) - CMS approved State Plan Amendment (SPA) 21-0009 on August 24, 2021. State Plan Amendment (SPA) 21-0009 was submitted to allow the Division of Medicaid (DOM) to allow the Division of Medicaid (DOM) to remove the five percent (5%) reimbursement reduction effective July 1, 2021. For more information read the approved SPA pages.
- [MS SPA 21-0008 Independent Lab and X-ray Services approved by CMS](https://medicaid.ms.gov/ms-spa-21-0008-independent-lab-and-x-ray-services-approved-by-cms/) - CMS approved State Plan Amendment (SPA) 21-0008 on August 24, 2021. State Plan Amendment (SPA) 21-0008 is being submitted to allow the Division of Medicaid (DOM) to 1) set the fees for independent laboratory and x-ray services the same as those effective State Fiscal Year (SFY) 2021, and 2) remove the five percent (5%) reimbursement
- [MS SPA 21-0033 Therapy Services approved by CMS](https://medicaid.ms.gov/ms-spa-21-0033-therapy-services-approved-by-cms/) - CMS approved State Plan Amendment (SPA) 21-0033 on August 24, 2021. State Plan Amendment (SPA) 21-0033 was submitted to allow the Division of Medicaid (DOM) to 1) set the fees for therapy services the same as those in effect for State Fiscal Year (SFY) 2021, and 2) remove the five percent (5%) reimbursement reduction effective
- [MS SPA 21-0034 Midwife Services approved by CMS](https://medicaid.ms.gov/ms-spa-21-0034-midwife-services-approved-by-cms/) - CMS approved State Plan Amendment (SPA) 21-0034 on August 24, 2021. State Plan Amendment (SPA) 21-0034 was submitted to allow the Division of Medicaid (DOM) to 1) set the fees for midwife services the same as those effective for State Fiscal Year (SFY) 2021, and 2) remove the five percent (5%) reimbursement reduction for midwife
- [MS SPA 21-0038 Targeted Case Management (TCM) for Individuals with Intellectual Disabilities (IDD) approved by CMS](https://medicaid.ms.gov/ms-spa-21-0038-targeted-case-management-tcm-for-individuals-with-intellectual-disabilities-idd-approved-by-cms/) - CMS approved State Plan Amendment (SPA) 21-0038 on August 24, 2021. State Plan Amendment (SPA) 21-0038 was submitted to allow the Division of Medicaid (DOM) to remove the five percent (5%) reimbursement reduction effective July 1, 2021. For more information read the approved SPA pages.
- [MS SPA 21-0036 Respiratory Services EPSDT Only approved by CMS](https://medicaid.ms.gov/ms-spa-21-0036-respiratory-services-epsdt-only-approved-by-cms/) - CMS approved State Plan Amendment (SPA) 21-0036 on August 24, 2021. State Plan Amendment (SPA) 21-0036 was submitted to allow the Division of Medicaid (DOM) to 1) set the fees the same as those effective for State Fiscal Year (SFY) 2021, and 2) remove the five percent (5%) reimbursement reduction for respiratory care for Early
- [MS SPA 21-0046 MSCAN Procurement Method submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0046-mscan-procurement-method-submitted-to-cms/) - The Mississippi Division of Medicaid (DOM) is submitting this SPA to ensure the state and the agency are able to use the method of procurement most likely to produce quality vendors for Managed Care services in the state. DOM intends to implement this SPA during its next Managed Care procurement cycle, beginning in the summer
- [MS SPA 21-0007 All Patient Refined-Diagnosis Related Groups (APR-DRG) Reimbursement submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0007-all-patient-refined-diagnosis-related-groups-apr-drg-reimbursement-submitted-to-cms/) - State Plan Amendment (SPA) 21-0007 All Patient Refined-Diagnosis Related Groups (APR-DRG) Reimbursement is being submitted to update the following hospital inpatient services effective July 1, 2021: 1) Update APR-DRG parameters, 2) use cost-to-charge (CCRs) ratios in effect July 1, 2021 to calculate outlier payments for claims with last dates of service on or after July
- [Public Notice for MS SPA 21-0028 Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Extended Services](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0028-early-and-periodic-screening-diagnosis-and-treatment-epsdt-extended-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0028 Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Extended Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services
- [Public Notice for MS SPA 21-0035 Telehealth Services](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0035-telehealth-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0035 Telehealth Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2021, contingent upon approval
- [Public Notice for MS SPA 21-0014 Targeted Case Management for High-Risk Pregnant Women](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0014-targeted-case-management-for-high-risk-pregnant-women/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0014 Targeted Case Management for High-Risk Pregnant Women. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July
- [MS SPA 20-0023 Medication Assisted Treatment approved by CMS](https://medicaid.ms.gov/ms-spa-20-0023-medication-assisted-treatment-approved-by-cms/) - CMS approved State Plan Amendment (SPA) 20-0023 on July 13, 2021. SPA 20-0023 was submitted to add coverage of Medication Assisted Treatment for beneficiaries diagnosed with opioid addiction provided by Opioid Treatment Programs certified by the Department of Mental Health in compliance with the SUPPORT Act, effective October 1, 2020. For more information read the approved
- [MS SPA 21-0014 Targeted Case Management for High-Risk Pregnant Women submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0014-targeted-case-management-for-high-risk-pregnant-women-submitted-to-cms/) - State Plan Amendment (SPA) 21-0014 is being submitted to allow the Division of Medicaid (DOM) to 1) update coverage and reimbursement of targeted case management to comply with federal regulations 42 C.F.R. §§ 440.169, 441.18, 2) set the fees for targeted case management for high-risk pregnant women the same as those in effect on July
- [MS SPA 21-0041 Preventive Services Vaccines submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0041-preventive-services-vaccines-submitted-to-cms/) - State Plan Amendment (SPA) 21-0041 is being submitted to allow the Division of Medicaid (DOM) to 1) set the fees for vaccines and vaccine administration the same as those effective for State Fiscal Year (SFY) 2021, 2) to include language regarding the reimbursement for administration of Vaccine For Children (VFC) vaccines, and 3) remove the
- [MS SPA 21-0045 Dentures submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0045-dentures-submitted-to-cms/) - State Plan Amendment (SPA) 21-0045 is being submitted to allow the Division of Medicaid (DOM) to 1) set the fees for dentures for EPSDT recipients the same as those effective for State Fiscal Year (SFY) 2021, and 2) remove the five percent (5%) reimbursement reduction effective July 1, 2021, to be in compliance with Miss.
- [MS SPA 20-0042 Targeted Case Management (TCM) for Infants Under the Age of One submitted to CMS](https://medicaid.ms.gov/ms-spa-20-0042-targeted-case-management-tcm-for-infants-under-the-age-of-one-submitted-to-cms/) - State Plan Amendment (SPA) 21-0042 is being submitted to allow the Division of Medicaid (DOM) to 1) update coverage and reimbursement of targeted case management (TCM) for infants under the age of one (1) to comply with federal regulations 42 C.F.R. §§ 440.169, 441.18, 2) set the fees for TCM for infants under the age
- [MS SPA 21-0044 Eyeglasses submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0044-eyeglasses-submitted-to-cms/) - State Plan Amendment (SPA) 21-0044 is being submitted to allow the Division of Medicaid (DOM) to 1) set the fees for eyeglasses the same as those effective for State Fiscal Year (SFY) 2021, and 2) remove the five percent (5%) reimbursement reduction effective July 1, 2021, to be in compliance with Miss. Code § 43-13-117,
- [MS SPA 21-0040 Targeted Case Management (TCM) for the Chronically Mentally Ill (CMI) submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0040-targeted-case-management-tcm-for-the-chronically-mentally-ill-cmi-submitted-to-cms/) - State Plan Amendment (SPA) 21-0040 is being submitted to allow the Division of Medicaid (DOM) to add coverage language and requirements to targeted case management for the chronically mentally ill to comply with 42 C.F.R. § 440.169 and § 441.18, effective July 1, 2021.The Division of Medicaid is submitting this SPA to be in compliance
- [MS SPA 21-0039 Targeted Case Management (TCM) for Psychiatric Residential Treatment Facility (PRTF) Level of Care (LOC) submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0039-targeted-case-management-tcm-for-psychiatric-residential-treatment-facility-prtf-level-of-care-loc-submitted-to-cms/) - State Plan Amendment (SPA) 21-0039 is being submitted to allow the Division of Medicaid (DOM) to cover and reimburse for wraparound services under the targeted case management benefit, effective July 1, 2021. The Division of Medicaid submitted MS SPA 20-0022 Mental Health Service Coverage and Reimbursement to CMS on September 30, 2020. SPA 20-0022 proposed
- [MS SPA 21-0033 Therapy Services submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0033-therapy-services-submitted-to-cms/) - State Plan Amendment (SPA) 21-0033 is being submitted to allow the Division of Medicaid (DOM) to 1) set the fees for therapy services the same as those in effect for State Fiscal Year (SFY) 2021, and 2) remove the five percent (5%) reimbursement reduction effective July 1, 2021. These changes are being made to be
- [MS SPA 21-0032 Dental and Orthodontic Services submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0032-dental-and-orthodontic-services-submitted-to-cms/) - State Plan Amendment (SPA) 21-0032 is being submitted to allow the Division of Medicaid (DOM) to 1) set the fees for dental and orthodontic services the same as those effective for State Fiscal Year (SFY) 2021, except for a five percent (5%) rate increase for diagnostic and preventative services in SFY 2022, 2023 and 2024,
- [MS SPA 21-0038 Targeted Case Management (TCM)for Individuals with Intellectual Disabilities (IDD) submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0038-targeted-case-management-tcmfor-individuals-with-intellectual-disabilities-idd-submitted-to-cms/) - State Plan Amendment (SPA) 21-0038 is being submitted to allow the Division of Medicaid (DOM) to remove the five percent (5%) reimbursement reduction effective July 1, 2021. These changes are being made to be in compliance with Miss. Code § 43-13-117, amended by MS Senate Bill 2799, effective July 1, 2021. Additional authority: Miss. Code
- [MS SPA 21-0037 Christian Science submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0037-christian-science-submitted-to-cms/) - State Plan Amendment (SPA) 21-0037 is being submitted to allow the Division of Medicaid (DOM) to 1) set the fees for Christian science services the same as those in effect for State Fiscal Year (SFY) 2021, and 2) remove the five percent (5%) reimbursement reduction effective July 1, 2021. These changes are being made to
- [MS SPA 21-0036 Respiratory Care for EPSDT Beneficiaries submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0036-respiratory-care-for-epsdt-beneficiaries-submitted-to-cms/) - State Plan Amendment (SPA) 21-0036 is being submitted to allow the Division of Medicaid (DOM) to 1) set the fees the same as those effective for State Fiscal Year (SFY) 2021, and 2) remove the five percent (5%) reimbursement reduction for respiratory care for Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Beneficiaries, effective July
- [MS SPA 21-0035 Telehealth Services submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0035-telehealth-services-submitted-to-cms/) - State Plan Amendment (SPA) 21-0035 is being submitted to allow the Division of Medicaid (DOM) to 1) set the fees for telehealth services the same as those in effect on July 1, 2020, 2) add Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs) as distant site providers, 3) add language that FQHCs, RHCs
- [MS SPA 21-0034 Midwife Services submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0034-midwife-services-submitted-to-cms/) - State Plan Amendment (SPA) 21-0034 is being submitted to allow the Division of Medicaid (DOM) to 1) set the fees for midwife services the same as those effective for State Fiscal Year (SFY) 2021, and 2) remove the five percent (5%) reimbursement reduction for midwife services effective July 1, 2021. These changes are being made
- [MS SPA 21-0031 Home Health, DME and Medical Supply submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0031-home-health-dme-and-medical-supply-submitted-to-cms/) - State Plan Amendment (SPA) 21-0031 is being submitted to allow the Division of Medicaid (DOM) to 1) set the fees for home health services in effect as of October 1, 2020, 2) set the fees for durable medical equipment and medical supplies in effect as of July 1, 2020, and 2) remove the five percent
- [MS SPA 21-0030 Hearing Aids submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0030-hearing-aids-submitted-to-cms/) - State Plan Amendment (SPA) 21-0030 is being submitted to allow the Division of Medicaid (DOM) to 1) set the fees for hearing aids the same as those effective for State Fiscal Year (SFY) 2021, and 2) remove the five percent (5%) reimbursement reduction for hearing aids, effective July 1, 2021. These changes are being made
- [MS SPA 21-0029 Family Planning Services submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0029-family-planning-services-submitted-to-cms/) - State Plan Amendment (SPA) 21-0029 is being submitted to allow the Division of Medicaid (DOM) to set the fees for family planning services the same as those in effect on July 1, 2020. These changes are being made to be in compliance with Miss. Code § 43-13-117, amended by MS Senate Bill 2799, effective July
- [MS SPA 21-0028 Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Extended Services submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0028-early-and-periodic-screening-diagnosis-and-treatment-epsdt-extended-services-submitted-to-cms/) - State Plan Amendment (SPA) 21-0028 is being submitted to allow the Division of Medicaid (DOM) to 1) set the fees for EPSDT extended services the same as those in effect on July 1, 2020, 2) remove the five percent (5%) reimbursement reduction effective July 1, 2021, and 3) add coverage and reimbursement of Mississippi Youth
- [MS SPA 21-0027 Dialysis Services submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0027-dialysis-services-submitted-to-cms/) - State Plan Amendment (SPA) 21-0027 is being submitted to allow the Division of Medicaid (DOM) to set the fees for dialysis services the same as those in effect January 1, 2021. These changes are being made to be in compliance with Miss. Code § 43-13-117, amended by MS Senate Bill 2799, effective July 1, 2021.
- [MS SPA 21-0026 Clinic Services submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0026-clinic-services-submitted-to-cms/) - State Plan Amendment (SPA) 21-0026 is being submitted to allow the Division of Medicaid (DOM) to 1) set the fees for clinic services the same as those in effect for State Fiscal Year (SFY) 2021, and 2) add language addressing cost reports that are not timely filed. These changes are being made to be in
- [MS SPA 21-0024 Rehabilitative Services submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0024-rehabilitative-services-submitted-to-cms/) - State Plan Amendment (SPA) 21-0024 Rehabilitative Services is being submitted to 1) set the fees for rehabilitative services the same as those in effect on April 1, 2020, and 2) remove the five percent (5%) reimbursement reduction effective July 1, 2021. These changes are being made to be in compliance with Miss. Code § 43-13-117,
- [MS SPA 21-0025 Chiropractor Services submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0025-chiropractor-services-submitted-to-cms/) - State Plan Amendment (SPA) 21-0025 is being submitted to allow the Division of Medicaid (DOM) to 1) set the fees for chiropractor services the same as those in effect for State Fiscal Year (SFY) 2021, and 2) remove the five percent (5%) reimbursement reduction effective July 1, 2021. These changes are being made to be
- [MS SPA 21-0023 Long-Term Care submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0023-long-term-care-submitted-to-cms/) - State Plan Amendment (SPA) 21-0023 is being submitted to allow the Division of Medicaid (DOM) to freeze all long-term care facility rates in effect July 1, 2021. These changes are being made to be in compliance with Miss. Code § 43-13-117, amended by MS Senate Bill 2799, effective July 1, 2021. Additional authority: Miss. Code
- [MS SPA 21-0022 Transportation Services submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0022-transportation-services-submitted-to-cms/) - State Plan Amendment (SPA) 21-0022 is being submitted to allow the Division of Medicaid (DOM) to 1) set the fees for transportation services the same as those in effect on July 1, 2020, and 2) remove the five percent (5%) reimbursement reduction effective July 1, 2021. These changes are being made to be in compliance
- [MS SPA 21-0021 Extended Services for Pregnant Women submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0021-extended-services-for-pregnant-women-submitted-to-cms/) - State Plan Amendment (SPA) 21-0021 is being submitted to allow the Division of Medicaid (DOM) to 1) revise coverage and payment methodology for extended services for pregnant and post-partum women who are at risk of morbidity or mortality, 2) set the fees for extended services for pregnant women the same as those in effect on
- [MS SPA 21-0018 Covered Outpatient Drugs submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0018-covered-outpatient-drugs-submitted-to-cms/) - State Plan Amendment (SPA) 21-0018 is being submitted to allow the Division of Medicaid (DOM) to 1) set the fees for covered outpatient drugs the same as those in effect on July 1, 2020, and 2) remove the five percent (5%) reimbursement reduction for physician administered drugs effective July 1, 2021. Additionally, this SPA allows
- [MS SPA 21-0020 Targeted Case Management (TCM) Early Intervention submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0020-targeted-case-management-tcm-early-intervention-submitted-to-cms/) - State Plan Amendment (SPA) 21-0020 is being submitted to allow the Division of Medicaid (DOM) to set the fees for targeted case management early intervention services the same as those in effect on July 1, 2021. These changes are being made to be in compliance with Miss. Code § 43-13-117, amended by MS Senate Bill
- [MS SPA 21-0017 Rural Health Clinic (RHC) submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0017-rural-health-clinic-rhc-submitted-to-cms/) - State Plan Amendment (SPA) 21-0017 is being submitted to allow the Division of Medicaid (DOM) to: 1) Clarify the different types of encounters and when more than one encounter is performed on the same day, 2) Add the requirements for RHC mobile units, and 3) add language to refer to Attachment 3.1-A Introductory Pages for
- [MS SPA 21-0016 Federally Qualified Health Clinic (FQHC) submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0016-federally-qualified-health-clinic-fqhc-submitted-to-cms/) - State Plan Amendment (SPA) 21-0016 is being submitted to allow the Division of Medicaid (DOM) to: 1) Clarify the different types of encounters and when reimbursement is made for more than one encounter performed on the same day, 2) Add the requirements for FQHC mobile units, and 3) add language to refer to Attachment 3.1-A
- [MS SPA 21-0015 Hospital Outpatient Services submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0015-hospital-outpatient-services-submitted-to-cms/) - State Plan Amendment (SPA) 21-0015 is being submitted to allow the Division of Medicaid (DOM) to 1) set the fees for hospital outpatient services the same as those in effect on July 1, 2021, and 2) allow Rural Hospitals that have fifty (50) or fewer licensed beds who opt to not be reimbursed using the
- [MS SPA 21-0013 Ambulatory Surgical Center submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0013-ambulatory-surgical-center-submitted-to-cms/) - State Plan Amendment (SPA) 21-0013 is being submitted to allow the Division of Medicaid (DOM) to 1) set the fees for ambulatory surgical center services the same as those in effect for State Fiscal Year (SFY) 2021, and 2) remove the five percent (5%) reimbursement reduction effective July 1, 2021. These changes are being made
- [MS SPA 21-0012 Physician Services submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0012-physician-services-submitted-to-cms/) - State Plan Amendment (SPA) 21-0012 is being submitted to allow the Division of Medicaid (DOM) 1) to set the fees for physician services the same as those effective State Fiscal Year (SFY) 2021, effective July 1, 2021, to be in compliance with Miss. Code § 43-13-117, amended by MS Senate Bill 2799, and 2) move
- [MS SPA 21-0011 Orthotics and Prosthetics submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0011-orthotics-and-prosthetics-submitted-to-cms/) - State Plan Amendment (SPA) 21-0011 is being submitted to allow the Division of Medicaid (DOM) to 1) set the fees for orthotics and prosthetics the same as those effective for State Fiscal Year (SFY) 2021, and 2) remove the five percent (5%) reimbursement reduction effective July 1, 2021. These changes are being made to be
- [Public Notice for MS SPA 21-0013 Ambulatory Surgical Center](https://medicaid.ms.gov/public-notice-for-ms-spa-12-0013-ambulatory-surgical-center/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0013 Ambulatory Surgical Center. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2021, contingent upon
- [MS SPA 21-0008 Independent Lab and X-ray Services submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0008-independent-lab-and-x-ray-services-submitted-to-cms/) - State Plan Amendment (SPA) 21-0008 is being submitted to allow the Division of Medicaid (DOM) to 1) set the fees for independent laboratory and x-ray services the same as those effective for State Fiscal Year (SFY) 2021, and 2) remove the five percent (5%) reimbursement reduction effective July 1, 2021. The changes made in this
- [MS SPA 21-0010 Other Licensed Practitioner Services submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0010-other-licensed-practitioner-services/) - State Plan Amendment (SPA) 21-0010 is being submitted to allow the Division of Medicaid (DOM) to 1) set the fees for nurse practitioner and physician assistant services the same as those in effect State Fiscal Year (SFY) 2021, and 2) remove the five percent (5%) reimbursement reduction effective July 1, 2021. These changes are being
- [MS SPA 21-0009 Podiatry submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0009-podiatry-submitted-to-cms/) - State Plan Amendment (SPA) 21-0009 Podiatry is being submitted to allow the Division of Medicaid (DOM) to remove the five percent (5%) reimbursement reduction effective July 1, 2021. The changes in this SPA are being made to be in compliance with Miss. Code § 43-13-117, amended by MS Senate Bill 2799, effective July 1, 2021.
- [Public Notice for MS SPA 21-0045 Dentures](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0045-dentures/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0045 Dentures. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2021, contingent upon approval from
- [Public Notice for MS SPA 21-0044 Eyeglasses](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0044-eyeglasses/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0044 Eyeglasses. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2021, contingent upon approval from
- [Public Notice for MS SPA 21-0042 Targeted Case Management (TCM) for Infants Under the Age of One (1)](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0042-targeted-case-management-tcm-for-infants-under-the-age-of-one-1/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0042 Targeted Case Management (TCM) for Infants Under the Age of One (1). The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and
- [Public Notice for MS SPA 21-0041 Preventive Services Vaccines](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0041-preventive-services-vaccines/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0041 Preventive Services Vaccines. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2021, contingent upon
- [Public Notice for MS SPA 21-0040 Targeted Case Management (TCM) for Chronically Mentally Ill](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0040-targeted-case-management-tcm-for-chronically-mentally-ill/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0040 Targeted Case Management (TCM) for Chronically Mentally Ill. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective
- [Public Notice for MS SPA 21-0039 Targeted Case Management (TCM) for Beneficiaries with Psychiatric Residential Treatment Facility (PRTF) Level of Care (LOC)](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0039-targeted-case-management-tcm-for-beneficiaries-with-psychiatric-residential-treatment-facility-prtf-level-of-care-loc/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0039 Targeted Case Management (TCM) for Beneficiaries with Psychiatric Residential Treatment Facility (PRTF) Level of Care (LOC). The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the
- [Public Notice for MS SPA 21-0038 Targeted Case Management (TCM) for Individuals with Intellectual Disabilities (IDD)](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0038-targeted-case-management-tcm-for-individuals-with-intellectual-disabilities-idd/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0038 Targeted Case Management (TCM) for Individuals with Intellectual Disabilities (IDD). The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services
- [Public Notice for MS SPA 21-0037 Christian Science](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0037-christian-science/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0037 Christian Science. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2021, contingent upon approval
- [Public Notice for MS SPA 21-0036 Respiratory Care for EPSDT Beneficiaries](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0036-respiratory-care-for-epsdt-beneficiaries/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0036 Respiratory Care for EPSDT Beneficiaries. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2021,
- [Public Notice for MS SPA 21-0034 Midwife Services](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0034-midwife-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0034 Midwife Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2021, contingent upon approval
- [Public Notice for MS SPA 21-0033 Therapy Services](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0033-therapy-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0033 Therapy Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2021, contingent upon approval
- [Public Notice for MS SPA 21-0032 Dental and Orthodontic Services](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0032-dental-and-orthodontic-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0032 Dental and Orthodontic Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2021, contingent
- [Public Notice for MS SPA 21-0031 Home Health, DME and Medical Supply](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0031-home-health-dme-and-medical-supply/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0031 Home Health, DME and Medical Supply. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1,
- [Public Notice for MS SPA 21-0030 Hearing Aids](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0030-hearing-aids/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0030 Hearing Aids. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2021, contingent upon approval
- [Public Notice for MS SPA 21-0029 Family Planning Services](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0029-family-planning-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0029 Family Planning Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2021, contingent upon
- [Public Notice for MS SPA 21-0027 Dialysis Services](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0027-dialysis-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0027 Dialysis Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2021, contingent upon approval
- [Public Notice for MS SPA 21-0026 Clinic Services](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0026-clinic-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0026 Clinic Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2021, contingent upon approval
- [Public Notice for MS SPA 21-0025 Chiropractor Services](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0025-chiropractor-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0025 Chiropractor Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2021, contingent upon approval
- [Public Notice for MS SPA 21-0024 Rehabilitative Services](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0024-rehabilitative-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0024 Rehabilitative Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2021, contingent upon approval
- [Public Notice for MS SPA 21-0023 Long-Term Care](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0023-long-term-care/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0023 Long-Term Care. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2021, contingent upon approval
- [Public Notice for MS SPA 21-0022 Transportation Services](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0022-transportation-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0022 Transportation Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2021, contingent upon approval
- [Public Notice for MS SPA 21-0021 Extended Services for Pregnant Women](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0021-extended-services-for-pregnant-women/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0021 Extended Services for Pregnant Women. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2021,
- [Public Notice for MS SPA 21-0020 Targeted Case Management (TCM) Early Intervention](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0020-targeted-case-management-tcm-early-intervention/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0020 Targeted Case Management (TCM) Early Intervention. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1,
- [Public Notice for MS SPA 21-0018 Covered Outpatient Drugs](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0018-covered-outpatient-drugs/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0018 Covered Outpatient Drugs. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2021, contingent upon
- [Public Notice for MS SPA 21-0017 Rural Health Clinic (RHC)](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0017-rural-health-clinic-rhc/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0017 Rural Health Clinic (RHC). The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2021, contingent
- [Public Notice for MS SPA 21-0016 Federally Qualified Health Clinic (FQHC)](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0016-federally-qualified-health-clinic-fqhc/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0016 Federally Qualified Health Clinic (FQHC). The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2021,
- [Public Notice for MS SPA 21-0015 Hospital Outpatient Services](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0015-hospital-outpatient-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0015 Hospital Outpatient Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2021 contingent upon
- [Public Notice for MS SPA 21-0012 Physician Services](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0012-physician-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0012. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2021, contingent upon approval from CMS,
- [Public Notice for MS SPA 21-0011 Orthotics and Prosthetics](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0011-orthotics-and-prosthetics/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) State Plan Amendment (SPA) 21-0011 Orthotics and Prosthetics. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July
- [Public Notice for MS SPA 21-0010 Other Licensed Practitioners](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0010-other-licensed-practitioners/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0010 Other Licensed Practitioners. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2021, contingent upon
- [Public Notice for MS SPA 21-0009 Podiatrist Services](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0009-podiatrist-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0009 Podiatrist Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2021, contingent upon approval
- [Public Notice for MS SPA 21-0008 Independent Lab and X-ray Services](https://medicaid.ms.gov/public-notice-for-ms-spa-21-0008-independent-lab-and-x-ray-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 21-0008 Independent Lab and X-ray Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2021,
- [Medicaid reimbursement rate freeze to take effect July 1, 2021](https://medicaid.ms.gov/medicaid-reimbursement-rate-freeze-to-take-effect-july-1-2021/) - In accordance with Mississippi Code Section 43-13-117 (D), as amended by Senate Bill 2799 during the 2021 Legislative Session, the Mississippi Division of Medicaid (DOM) will freeze all provider reimbursement rates at the levels in effect on July 1st of this year. This rate-freeze will remain in effect until the Legislature authorizes rate adjustments. According
- [MS SPA 21-0005 LTC Facility Add-on Payment Disaster Relief approved by CMS](https://medicaid.ms.gov/ms-spa-21-0005-ltc-facility-add-on-payment-disaster-relief-approved-by-cms/) - CMS approved MS State Plan Amendment (SPA) 21-0005 on June 23, 2021. State Plan Amendment (SPA) 21-0005 LTC Add-on Payment Disaster Relief was submitted to allow the Division of Medicaid (DOM) to reimburse all long-term care facilities licensed in Mississippi an add-on payment of $13.00 per day per beneficiary for claims for dates of service
- [Medicaid to increase rate for Wraparound services, enhancing beneficiaries’ choice of providers](https://medicaid.ms.gov/medicaid-to-increase-rate-for-wraparound-services-enhancing-beneficiaries-choice-of-providers/) - Reimbursement changes made to comply with CMS In order to comply with federal requirements, the Mississippi Division of Medicaid (DOM) is changing the way it reimburses for targeted case management for children with serious emotional disturbance (SED), known as Wraparound, and ancillary behavioral health services. In the process DOM is increasing the reimbursement rate for
- [Public Notice of Annual Public Forum for 1115(a) Family Planning Waiver](https://medicaid.ms.gov/public-notice-of-annual-public-forum-for-1115a-family-planning-waiver-3/) - Pursuant to 42 C.F.R. Section 431.420(c), a Public Forum is required annually after the implementation of the Division of Medicaid’s Family Planning Waiver. This Public Forum provides stakeholders the opportunity to provide meaningful comments on the progress of the Family Planning Waiver. The Family Planning Waiver operates under the authority of an 1115(a) waiver approved
- [Public Notice of Annual Post-Award Forum for 1115(a) Healthier Mississippi Waiver](https://medicaid.ms.gov/public-notice-of-annual-post-award-forum-for-1115a-healthier-mississippi-waiver-2/) - Pursuant to 42 C.F.R. Section 431.420(c), public notice is hereby given to the annual Post-Award Forum on the Division of Medicaid’s Healthier Mississippi Waiver. The annual Post-Award Forum provides stakeholders and the general public the opportunity to provide meaningful comment on the progress of the Healthier Mississippi Waiver. The Healthier Mississippi Waiver operates under the
- [Section 1135 Waiver termination notice submitted to HHS](https://medicaid.ms.gov/section-1135-waiver-termination-notice-submitted-to-hhs/) - The Mississippi Division of Medicaid (DOM) has submitted notice to the Secretary of Health and Human Services that DOM will end certain temporary Section 1135 waiver flexibilities, effective June 30, 2021. For more information read the attached notice.
- [MS SPA 21-0002 Physician Services approved by CMS](https://medicaid.ms.gov/ms-spa-21-0002-physician-services-approved-by-cms/) - CMS approved State Plan Amendment (SPA) 21-0002 on May 24, 2021. SPA 21-0002 was submitted to allow the Division of Medicaid (DOM) to remove the list of specific Current Procedural Terminology (CPT) codes for primary care services reimbursement, effective January 1, 2021. For more information read the approved SPA pages.
- [Public Hearing for Mississippi Administrative Code Title 23, Part 223, Rules 1.3, 1.5, 1.8, 2.5, and 6.1-6.6](https://medicaid.ms.gov/public-hearing-for-mississippi-administrative-code-title-23-part-223-rules-1-3-1-5-1-8-2-5-and-6-1-6-6/) - The Mississippi Division of Medicaid will hold a public hearing on Mississippi Administrative Code Title 23, Part 223, Rules 1.3, 1.5, 1.8, 2.5, and 6.1-6.6. The hearing will be held at 10 a.m. on Friday, June 11, 2021, via teleconference. Teleconference number 888-822-7517, Access Code: 4282244. There will be an opportunity for public comment at
- [MS SPA 21-0005 LTC Add-On Payment Disaster Relief submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0005-ltc-add-on-payment-disaster-relief-submitted-to-cms/) - State Plan Amendment (SPA) 21-0005 LTC Add-on Payment Disaster Relief is being submitted to allow the Division of Medicaid (DOM) to reimburse long-term care facilities licensed in Mississippi an add-on payment of $13.00 per day per beneficiary for claims for dates of service from January 1, 2021 through June 30, 2021. Long-term care facilities in
- [Free online service offers Medicaid providers access to patient information](https://medicaid.ms.gov/free-online-service-offers-medicaid-providers-access-to-patient-information/) - Free online service offers Medicaid providers access to patient information Health-care providers across the state have a new digital tool to help them track their Medicaid patients’ medical histories and medications with the aim of delivering high-quality and cost-effective care ­— and it’s available to them free of charge. The Mississippi Division of Medicaid (DOM)
- [Qualified providers must attest/re-attest to receive increased primary care services payments](https://medicaid.ms.gov/qualified-providers-must-attest-re-attest-to-receive-increased-primary-care-services-payments/) - Pursuant to Miss. Code Ann. §§ 43-13-117, 43-13-121, the Mississippi Division of Medicaid (DOM) was granted the authority to continue reimbursing eligible providers at 100 percent (100%) of the Medicare Physician Fee Schedule for certain primary care Evaluation and Management (E&M) and Vaccine Administration codes. To receive the increased payment for dates of service (DOS)
- [Medicaid Vital Signs - June-December 2020](https://medicaid.ms.gov/medicaid-vital-signs-june-december-2020/) - This update of the Medicaid Vital Signs dashboard contains enrollment and expenditure data from June through December of 2020. Launched in early 2019, Vital Signs displays key Mississippi Medicaid metrics allowing anyone to quickly check certain Medicaid statistics and follow recent program trends. Most of the information presented in Medicaid Vital Signs will be updated
- [Public Notice for SPA 21-0007 All Patient Refined Diagnosis Related Groups (APR-DRG) Reimbursement](https://medicaid.ms.gov/public-notice-for-spa-21-0007-all-patient-refined-diagnosis-related-groups-apr-drg-reimbursement-2/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA). The Division of Medicaid (DOM), in the Office of the Governor, is submitting SPA 21-0007 All Patient Refined Diagnosis Related Groups (APR-DRG) Reimbursement to update the hospital inpatient payment methodology with an effective date
- [Medicaid to update all Claim Adjustment Reason Codes and Remittance Advice Reason Codes](https://medicaid.ms.gov/medicaid-to-update-all-claim-adjustment-reason-codes-and-remittance-advice-reason-codes/) - The Mississippi Division of Medicaid will update all Claim Adjustment Reason Codes (CARC) and Remittance Advice Reason Codes (RARC) effective May 24, 2021. These codes are available for review as “CARC and RARC values used by Mississippi Division of Medicaid” located on the Envision Provider Resources page at: https://www.ms-medicaid.com/msenvision/accesscbt.do.
- [Public Notice for SPA 21-0007 All Patient Refined Diagnosis Related Groups (APR-DRG) Reimbursement](https://medicaid.ms.gov/public-notice-for-spa-21-0007-all-patient-refined-diagnosis-related-groups-apr-drg-reimbursement/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA). The Division of Medicaid, in the Office of the Governor, is submitting SPA 21-0007 All Patient Refined Diagnosis Related Groups (APR-DRG) Reimbursement to update the hospital inpatient payment methodology with an effective date of
- [Public Notice for SPA 20-0022 Mental Health Coverage and Reimbursement](https://medicaid.ms.gov/public-notice-for-spa-20-0022-mental-health-coverage-and-reimbursement-2/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a reimbursement change to Intensive Community Outreach and Recovery Teams (ICORT) services as submitted in Medicaid State Plan Amendment (SPA) 20-0022 Mental Health Services Coverage and Reimbursement. The Division of Medicaid, in the Office of the Governor, is proposing this
- [Public Notice for SPA 20-0023 Medication Assisted Treatment](https://medicaid.ms.gov/public-notice-for-spa-20-0023-medication-assisted-treatment-2/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a reimbursement change to Opioid Treatment Programs (OTPs) services as submitted in Medicaid State Plan Amendment (SPA) 20-0023 Medication Assisted Treatment. The Division of Medicaid, in the Office of the Governor, is proposing this change effective April 1, 2021, contingent
- [MS SPA 20-0026 Attorney General Certification Signature approved by CMS](https://medicaid.ms.gov/ms-spa-20-0026-attorney-general-certification-signature-approved-by-cms/) - State Plan Amendment (SPA) 20-0026 was approved by CMS on March 4, 2021 to allow the Division of Medicaid (DOM) to replace the Attorney General certification signature with the current Attorney General Certification signature for Lynn Fitch. For more information read the approved SPA pages.
- [MS SPA 20-0024 Physician Upper Payment Limit (UPL) approved by CMS](https://medicaid.ms.gov/ms-spa-20-0024-physician-upper-payment-limit-upl-approved-by-cms/) - The Centers for Medicare and Medicaid Services (CMS) approved State Plan Amendment (SPA) 20-0024 Physician Upper Payment Limit (UPL) on March 12, 2021. SPA 20-0024 was submitted to allow the Division of Medicaid to update the initial Medicare equivalent of the average commercial rate (ACR) ratio, effective January 1, 2021. For more information read the approved
- [MS SPA 20-0028 Dental Reimbursement Update approved by CMS](https://medicaid.ms.gov/ms-spa-20-0028-dental-reimbursement-update-approved-by-cms/) - The Centers for Medicare and Medicaid Services approved MS SPA 20-0028 Dental Reimbursement Update on March 11, 2021. This SPA was submitted in order to comply with federal Medicaid regulations. 42 C.F.R. § 447.201 requires the Division of Medicaid to submit a SPA describing the policy and methods used in setting payment rates for each
- [MS SPA 21-0002 Physician Services submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0002-physician-services-submitted-to-cms/) - State Plan Amendment (SPA) 21-0002 is being submitted to allow the Division of Medicaid to remove the list of specific CPT codes, effective January 1, 2021. For more information, read the submitted SPA pages.
- [MS SPA 21-0001 COVID-19 Vaccine Administration Reimbursement Emergency Submission submitted to CMS](https://medicaid.ms.gov/ms-spa-21-0001-covid-19-vaccine-administration-reimbursement-emergency-submission-submitted-to-cms/) - State Plan Amendment (SPA) 21-0001 is being submitted to allow the Division of Medicaid (DOM) to reimburse all Mississippi Medicaid pharmacies, physicians, and non-physician practitioners 100% of the Medicare rate for the administration of an FDA-approved COVID-19 vaccine during the public health emergency (PHE). The Division of Medicaid will reimburse Mississippi Medicaid enrolled Federally Qualified
- [Medicaid streamlines process for election of the hospice benefit](https://medicaid.ms.gov/medicaid-streamlines-process-for-election-of-the-hospice-benefit/) - In an effort to streamline the hospice-election process and reduce unnecessary burdens on beneficiaries and providers, the Mississippi Division of Medicaid (DOM) has updated and simplified the notification forms for the election of the hospice benefit. Please see the specifics listed below of both the updated requirement of dually eligible beneficiaries along with changes to
- [Medicaid Vital Signs - January-May 2020](https://medicaid.ms.gov/medicaid-vital-signs-january-may-2020/) - This update of the Medicaid Vital Signs dashboard contains enrollment and expenditure data from January through May of 2020. Launched in early 2019, Vital Signs displays key Mississippi Medicaid metrics allowing anyone to quickly check certain Medicaid statistics and follow recent program trends. Most of the information presented in Medicaid Vital Signs will be updated
- [Reeves Administration announces temporary Medicaid changes in response to coronavirus outbreak](https://medicaid.ms.gov/reeves-administration-announces-temporary-medicaid-changes-in-response-to-coronavirus-outbreak/) - Telehealth Services Extended, 1135 Waiver Requested In response to the coronavirus outbreak, the Mississippi Division of Medicaid (DOM) will expand its coverage of telehealth services throughout the state in alignment with Governor Tate Reeves’ recommendations on leveraging telemedicine to care for patients while limiting unnecessary travel, clinic visits and possible exposure. Effective immediately through May
- [Mississippi Medicaid extends coverage of enhanced telehealth services](https://medicaid.ms.gov/mississippi-medicaid-extends-coverage-of-enhanced-telehealth-services/) - As the state continues to combat the COVID-19 outbreak, the Mississippi Division of Medicaid (DOM) will extend its coverage of enhanced telehealth services through the end of the public health emergency. First announced by Governor Tate Reeves on March 19, DOM’s Emergency Telehealth Policy was originally effective through May 31, 2020, but now will continue
- [Extension of Appendix K - CMS Approved January 19, 2021](https://medicaid.ms.gov/extension-of-appendix-k-cms-approved-january-19-2021/) - This Appendix K is additive to the approved Appendix K. The change included is to extend the effective date of all flexibilities outlined in previously approved Appendix K’s to six (6) months following the expiration of the public health emergency. For more information, read the Appendix K Extension.
- [Medicaid guidance on billing for COVID-19 diagnostic tests](https://medicaid.ms.gov/medicaid-guidance-on-billing-for-covid-19-diagnostic-tests/) - The Mississippi Division of Medicaid is working to add new procedure codes that can be used by providers and laboratories to bill for certain Coronavirus Disease 2019 (COVID-19) diagnostic tests to increase the testing and tracking of new cases. The Healthcare Common Procedure Coding System (HCPCS) codes U0001 and U0002 were developed by the Centers
- [MS SPA 20-0013 Vaccines approved by CMS](https://medicaid.ms.gov/ms-spa-20-0013-vaccines-approved-by-cms/) - CMS approved State Plan Amendment (SPA) 20-0013 Vaccines on December 23, 2020, effective September 1, 2020. SPA 20-0013 was submitted to allow the Division of Medicaid to: Change the reimbursement methodology of vaccine administration by a licensed pharmacist, employed by a Mississippi Medicaid pharmacy provider, working within the scope of their pharmacy license to a
- [MS SPA 20-0028 Dental Reimbursement Update submitted to CMS](https://medicaid.ms.gov/ms-spa-20-0028-dental-reimbursement-update-submitted-to-cms/) - This SPA has been submitted in order to comply with federal Medicaid regulations. 42 C.F.R. § 447.201 requires the Division of Medicaid to submit a SPA describing the policy and methods used in setting payment rates for each type of service included in the Mississippi State Plan. For more information, read the submitted SPA pages.
- [MS SPA 20-0024 Physician Upper Payment Limit (UPL) submitted to CMS](https://medicaid.ms.gov/ms-spa-20-0024-physician-upper-payment-limit-upl-submitted-to-cms/) - State Plan Amendment (SPA) 20-0024 Physician Upper Payment Limit (UPL) has been submitted to allow the Division of Medicaid to update the initial Medicare equivalent of the average commercial rate (ACR) ratio, effective January 1, 2021. For more information, read the submitted SPA pages.
- [MS SPA 20-0026 Attorney General Certification Signature submitted to CMS](https://medicaid.ms.gov/ms-spa-20-0026-attorney-general-certification-signature-submitted-to-cms/) - State Plan Amendment (SPA) 20-0026 was submitted to CMS to allow the Division of Medicaid (DOM) to replace the Attorney General certification signature with the current Attorney General Certification signature for Lynn Fitch. For more information, read the submitted SPA pages.
- [Medicaid presents lower fiscal year 2019 appropriation request](https://medicaid.ms.gov/medicaid-presents-lower-fiscal-year-2019-appropriation-request/) - On Sept. 22, the Mississippi Division of Medicaid (DOM) executive director presented the budget request for fiscal year 2019 to the Joint Legislative Budget Committee. The agency is requesting an appropriation of $984 million in state funds. The fiscal year 2019 initial appropriation request is lower than the previous requests for the last three years.
- [Steve Stanic named Deputy Administrator and Chief Information Technology Officer](https://medicaid.ms.gov/steve-stanic-named-deputy-administrator-and-chief-information-technology-officer/) - The Mississippi Division of Medicaid has named Steve Stanic as the agency’s Deputy Administrator and Chief Information Technology Officer. Stanic previously served as Vice President/CIO of Mississippi Baptist Health Systems. In his new role, Stanic will be charged with advancing information technology strategy and delivery across a government agency with an annual budget of over
- [Sam Atkinson named Deputy Administrator for Accountability and Compliance](https://medicaid.ms.gov/sam-atkinson-named-deputy-administrator-for-accountability-and-compliance/) - The Mississippi Division of Medicaid has named Sam Atkinson as the agency’s Deputy Administrator for Accountability and Compliance. Atkinson, who previously served as Director of Audit Response Teams and Special Projects for the Office of State Auditor, will report to Drew Snyder, the Division of Medicaid’s executive director. In her new role, Atkinson will oversee
- [Public Notice for SPA 20-0024 Physician Upper Payment Limit (UPL)](https://medicaid.ms.gov/public-notice-for-spa-20-0024-physician-upper-payment-limit-upl/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA). The Division of Medicaid, in the Office of the Governor, is submitting SPA 20-0024 Physician Upper Payment Limit (UPL). Effective January 1, 2021 and contingent upon approval from the Centers for Medicare and Medicaid
- [Public Notice for SPA 20-0028 Dental Reimbursement Update](https://medicaid.ms.gov/public-notice-for-spa-20-0028-dental-reimbursement-update/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 20-0028 Dental Reimbursement Update. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective January 1, 2021, contingent upon
- [CMS approved MS SPA 20-0009 Third Party Liability](https://medicaid.ms.gov/cms-approved-ms-spa-20-0009-third-party-liability/) - CMS approved State Plan Amendment (SPA) 20-0009 on November 20, 2020. SPA 20-0009 was submitted to allow the Division of Medicaid (DOM) to add language to include the cost avoidance of prenatal claims in compliance with the Bipartisan Budget Act of 2018, update the language describing data exchanges with other agencies, add the process for
- [Medicaid director of pharmacy awarded the 2017 Spirit of Pharmacy Award](https://medicaid.ms.gov/medicaid-director-of-pharmacy-awarded-the-2017-spirit-of-pharmacy-award/) - Terri Kirby, director of Pharmacy for the Mississippi Division of Medicaid (DOM), has been awarded the 2017 Spirit of Pharmacy Award from the Mississippi Pharmacists Association for her work, including overseeing the implementation of a new statewide reimbursement methodology as required by the Centers for Medicare and Medicaid Services. Presented by Executive Director Peter Stokes,
- [MS SPA 20-0023 Medication Assisted Treatment (MAT) submitted to CMS](https://medicaid.ms.gov/ms-spa-20-0023-medication-assisted-treatment-mat-submitted-to-cms/) - State Plan Amendment (SPA) 20-0023 Medication Assisted Treatment (MAT) was submitted to CMS add coverage of Medication Assisted Treatment for beneficiaries diagnosed with opioid addiction provided by Opioid Treatment Programs certified by the Department of Mental Health in compliance with the SUPPORT Act, effective October 1, 2020. For more information, read the submitted SPA pages.
- [CMS approved MS SPA 20-0021 Out-of-State Transplant Rates](https://medicaid.ms.gov/cms-approved-ms-spa-20-0021-out-of-state-transplant-rates/) - CMS approved MS SPA 20-0021 Out-of-State Transplant Rates on November 10, 2020. State Plan Amendment (SPA) 20-0021 was submitted to allow the Division of Medicaid (DOM) to update the out-of-state transplant rates as published in the Milliman U.S. Organ and Tissue Transplant Cost Estimates and Discussion effective July 1, 2020. For more information read the
- [CMS approved MS SPA 20-0006 Autism Spectrum Disorder (ASD) Reimbursement](https://medicaid.ms.gov/cms-approved-ms-spa-20-0006-autism-spectrum-disorder-asd-reimbursement/) - CMS approved MS SPA 20-0006 Autism Spectrum Disorder (ASD) Reimbursement on October 21, 2020. State Plan Amendment (SPA) 20-0006 Autism Spectrum Disorder (ASD) Reimbursement was submitted to allow the Division of Medicaid (DOM) to remove the annual Autism rate updates and specifies that Autism rates will remain the same as those effective July 1, 2019.
- [CMS approved MS SPA 20-0016 Emergency Ground Ambulance Reimbursement](https://medicaid.ms.gov/cms-approved-ms-spa-20-0016-emergency-ground-ambulance-reimbursement/) - CMS approved MS SPA 20-0016 Emergency Ground Ambulance Reimbursement on November 9, 2020. SPA 20-0016 was submitted to allow the Division of Medicaid to revise the reimbursement methodology for emergency ground ambulance transportation. Emergency ground ambulance transportation base rate and mileage will be reimbursed based on the lesser of the provider’s usual and customary charge
- [CMS approved MS SPA 20-0002 Private Duty Nursing (PDN) and Personal Care Services (PCS)](https://medicaid.ms.gov/cms-approved-ms-spa-20-0002-private-duty-nursing-pdn-and-personal-care-services-pcs/) - CMS approved State Plan Amendment (SPA) 20-0002 Private Duty Nursing (PDN) and Personal Care Services (PCS) on October 19, 2020. MS SPA 20-0002 was submitted to add coverage and reimbursement of PDN and PCS for Early and Periodic Screening, Diagnosis and Treatment (EPSDT)-eligible beneficiaries to the State Plan, effective July 1, 2020. For more information
- [CMS approved MS SPA 20-0005 Physician Administered Drugs](https://medicaid.ms.gov/cms-approved-ms-spa-20-0005-physician-administered-drugs/) - CMS approved MS State Plan Amendment (SPA) 20-0005 on October 14, 2020. SPA 20-0005 Physician Administered Drugs was submitted to allow the Division of Medicaid (DOM) to revise the fee schedule update from quarterly to annually, clarify if there is no Average Sales Price (ASP) or Medicare Addendum B OPPS fee schedule that a fee
- [COVID-19 In-Person Visitation Aid Civil Money Penalty (CMP) Grant Opportunity](https://medicaid.ms.gov/coronavirus-disease-2019-covid-19-in-person-visitation-aid-civil-money-penalty-cmp-grant-opportunity/) - On September 17, 2020, CMS announced the development of a COVID-19 In-Person Visitation Aid Application Template for nursing homes to apply for CMP grants for in-person visitation aids. The purpose of this grant opportunity is to allow nursing home residents to safely engage in in-person visits. This template enables states to approve COVID-19 grant applications
- [Provider webinars set for November, December](https://medicaid.ms.gov/provider-webinars-set-for-november-december/) - Providers are invited to attend a series of webinar workshops set for November and December covering a range of topics that encompass fee-for-service Medicaid, MississippiCAN and CHIP. Office directors, managers, coders practitioners and billing staff at encouraged to attend. View the schedule and sign up at: https://medicaid.ms.gov/wp-content/uploads/2020/10/2020-Provider-Workshop-Webinar.pdf
- [DOM to hold fee-for-service provider education webinars](https://medicaid.ms.gov/dom-to-hold-provider-education-webinars/) - Attendees must register by Friday, Oct. 23 The Mississippi Division of Medicaid (DOM) and its fiscal agent Conduent will host fee-for-service educational provider workshops virtually this month, with webinars scheduled for Oct. 27 and Oct. 29. The webinars will cover common billing topics regarding the Envision Web Portal, medical reviews, telehealth policy and more. Attendees
- [2019 Provider Workshops to take place](https://medicaid.ms.gov/2019-provider-workshops-to-take-place/) - The Division of Medicaid, in conjunction with its contractors Conduent, Alliant UM/QIO, and the MSCAN plans – Magnolia Health, Molina Healthcare and UnitedHealthcare Community Plan, will conduct “FREE” Medicaid Provider Workshops June 11, 2019 through July 30, 2019 at varied locations throughout the state. These workshops are designed to provide information and changes related to
- [MS SPA 20-0009 Third Party Liability submitted to CMS](https://medicaid.ms.gov/ms-spa-20-0009-third-party-liability-submitted-to-cms/) - State Plan Amendment (SPA) 20-0009 is being submitted to allow the Division of Medicaid (DOM) to add language to include the cost avoidance of prenatal claims in compliance with the Bipartisan Budget Act of 2018, update the language describing data exchanges with other agencies, add the process for providers to request an override of the
- [Public Notice for SPA 20-0013 Vaccines](https://medicaid.ms.gov/public-notice-for-spa-20-0013-vaccines/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 20-0013 Vaccines. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective September 1, 2020, contingent upon approval from
- [MS SPA 20-0022 Mental Health Services Coverage and Reimbursement submitted to CMS](https://medicaid.ms.gov/ms-spa-20-0022-mental-health-services-coverage-and-reimbursement-submitted-to-cms/) - State Plan Amendment (SPA) 20-0022 is being submitted to include: a) Replacing Intensive Outpatient Psychiatric (IOP) services with Intensive Community Outreach Teams (ICORT), b) Reimbursing ICORT services at the current IOP rate, c) Including reimbursement language for Early and Periodic Screening, Diagnosis and Treatment (EPSDT) mental health services which the rates are not being revised,
- [MS SPA 20-0013 Vaccines submitted to CMS](https://medicaid.ms.gov/ms-spa-20-0013-vaccines-submitted-to-cms/) - State Plan Amendment (SPA) 20-0013 Vaccines, effective September 1, 2020, is being submitted to allow the Division of Medicaid to: Change the reimbursement methodology of vaccine administration by a licensed pharmacist, employed by a Mississippi Medicaid pharmacy provider, working within the scope of their pharmacy license to a fee calculated at 100% of the Medicare
- [Public Notice for SPA 20-0022 Mental Health Coverage and Reimbursement](https://medicaid.ms.gov/public-notice-for-spa-20-0022-mental-health-coverage-and-reimbursement/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 20-0022 Mental Health Coverage and Reimbursement. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective September 1, 2020,
- [CMS approved the TBI/SCI Waiver Renewal effective October 1, 2020](https://medicaid.ms.gov/cms-approved-the-tbi-sci-waiver-renewal-effective-october-1-2020/) - The Centers for Medicare and Medicaid Services (CMS) approved the following Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) Waiver renewal, effective October 1, 2020. For more information, read the approved waiver pages.
- [Public Notice for SPA 20-0023 Medication Assisted Treatment](https://medicaid.ms.gov/public-notice-for-spa-20-0023-medication-assisted-treatment/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 20-0023 Medication Assisted Treatment. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective October 1, 2020, contingent upon
- [Telehealth procedure codes updated](https://medicaid.ms.gov/telehealth-procedure-codes-updated/) - Temporary Telehealth Procedure Codes Updated The Mississippi Division of Medicaid (DOM) has updated the Medicaid reimbursement rates for audio-only telephone procedure codes 99441-99443 to align with new rates released by the Centers for Medicare and Medicaid Services (CMS). The effective date is March 1, 2020, for the new rates reflected in the chart below and
- [CMS approved SPA 20-0019 Community Mental Health Center (CMHC) Emergency Interim Payments](https://medicaid.ms.gov/cms-approved-spa-20-0019-community-mental-health-center-cmhc-emergency-interim-payments/) - CMS approved State Plan Amendment (SPA) 20-0019 on September 15, 2020. State Plan Amendment (SPA) 20-0019 is being submitted to allow the Division of Medicaid (DOM) to make interim payments based on fee-for-service (FFS) utilization only to the fourteen (14) Community Mental Health Centers (CMHCs) that have had a decline in utilization due to the
- [CMS approved SPA 20-0003 All Patient Refined Diagnosis Related Groups (APR-DRG) Reimbursement](https://medicaid.ms.gov/cms-approved-spa-20-0003-all-patient-refined-diagnosis-related-groups-apr-drg-reimbursement/) - CMS approved State Plan Amendment (SPA) 20-0003 on September 10, 2020. SPA 20-0003 was submitted to update the hospital inpatient payment methodology with an effective date of July 1, 2020. For more information read the approved SPA pages.
- [CMS approved MS SPA 20-0018 Graduate Medical Education Payments](https://medicaid.ms.gov/cms-approved-ms-spa-20-0018-graduate-medical-education-payments/) - CMS approved State Plan Amendment (SPA) 20-0018 on September 2, 2020. SPA 20-0018 was submitted to allow the Division of Medicaid (DOM) to address calculations for GME payments for a hospital during a cap building period effective June 1, 2020. For more information read the approved SPA pages.
- [MS SPA 20-0008 Federally Qualified Health Center (FQHC) Services submitted to CMS](https://medicaid.ms.gov/ms-spa-20-0008-federally-qualified-health-center-fqhc-services-submitted-to-cms/) - State Plan Amendment (SPA) 20-0008 Federally Qualified Health Center (FQHC) Services, effective August 1, 2020, is being submitted to allow the Division of Medicaid to: Clarify the different types of encounters and when reimbursement is made for more than one encounter performed on the same day, Add requirements for FQHC mobile units, Add coverage for
- [MS SPA 20-0007 Rural Health Center (RHC) Services submitted to CMS](https://medicaid.ms.gov/ms-spa-20-0007-rural-health-center-rhc-services-submitted-to-cms/) - State Plan Amendment (SPA) 20-0007 Rural Health Clinic (RHC) Services, effective August 1, 2020, is being submitted to allow the Division of Medicaid: Clarify the different types of encounters and when reimbursement is made for more than one encounter performed on the same day, Add requirements for RHC mobile units, Add coverage for a fee-for-service
- [MS SPA 20-0021 Out-of-State Transplant Rates submitted to CMS](https://medicaid.ms.gov/ms-spa-20-0021-out-of-state-transplant-rates-submitted-to-cms/) - State Plan Amendment (SPA) 20-0021 is being submitted to allow the Division of Medicaid (DOM) to update the out-of-state transplant rates as published in the Milliman U.S. Organ and Tissue Transplant Cost Estimates and Discussion effective July 1, 2020. For more information, read the submitted SPA pages.
- [CMS approved State Plan Amendment (SPA) 20-0004 LTC Cost Report Filings effective April 1, 2020](https://medicaid.ms.gov/cms-approved-state-plan-amendment-spa-20-0004-ltc-cost-report-filings-effective-april-1-2020/) - CMS approved State Plan Amendment (SPA) 20-0004 LTC Cost Report Filings on August 31, 2020. SPA 20-0004 was submitted to allow the Division of Medicaid (DOM) to revise the method for submitting cost reports and any supporting data from hard copy to electronic upload, and specifies the handling of capitalized assets valued at less than
- [Medicaid increases reimbursement for emergency ground ambulance services ](https://medicaid.ms.gov/medicaid-increases-reimbursement-for-emergency-ground-ambulance-services/) - Collaboration allows for rates to be recalculated Working in cooperation with the Mississippi State Department of Health (MSDH), the Mississippi Division of Medicaid (DOM) is increasing the reimbursement rate for emergency ground ambulance transportation. Previously these rates were calculated at 70% of the Medicare rate. A collaborative agreement with MSDH will make it possible for
- [CMS approved MS SPA 20-0017 Inpatient Hospital Cost Report Submittals effective April 1, 2020](https://medicaid.ms.gov/cms-approved-ms-spa-20-0017-inpatient-hospital-cost-report-submittals-effective-april-1-2020/) - CMS approved State Plan Amendment (SPA) 20-0017 Inpatient Hospital Cost Report Submittals on August 31, 2020. SPA 20-0017 was submitted to allow the Division of Medicaid (DOM) to revise the method for submitting cost reports and any supporting data from hard copy to electronic upload effective April 1, 2020. For more information read the approved
- [Public Notice of Annual Public Forum for 1115(a) Family Planning Waiver](https://medicaid.ms.gov/public-notice-of-annual-public-forum-for-1115a-family-planning-waiver-2/) - Pursuant to 42 C.F.R. Section 431.420(c), a Public Forum is required annually after the implementation of the Division of Medicaid’s Family Planning Waiver. This Public Forum provides stakeholders the opportunity to provide meaningful comments on the progress of the Family Planning Waiver. The Family Planning Waiver operates under the authority of an 1115(a) waiver approved
- [Public Notice of Annual Post-Award Forum for 1115(a) Healthier Mississippi Waiver](https://medicaid.ms.gov/public-notice-of-annual-post-award-forum-for-1115a-healthier-mississippi-waiver/) - Pursuant to 42 C.F.R. Section 431.420(c), public notice is hereby given to the annual Post-Award Forum on the Division of Medicaid's Healthier Mississippi Waiver. The annual Post-Award Forum provides stakeholders and the general public the opportunity to provide meaningful comment on the progress of the Healthier Mississippi Waiver. The Healthier Mississippi Waiver operates under the
- [CMS approved State Plan Amendment (SPA) 20-0001 Durable Medical Equipment (DME) and Medical Supply Reimbursement effective April 1, 2020](https://medicaid.ms.gov/cms-approved-state-plan-amendment-spa-20-0001-durable-medical-equipment-dme-and-medical-supply-reimbursement-effective-april-1-2020/) - CMS approved State Plan Amendment (SPA) 20-0001 Durable Medical Equipment (DME) and Medical Supply Reimbursement on August 27, 2020. SPA 20-0001 was submitted to allow the Division of Medicaid to include a reimbursement methodology for certain durable medical equipment (DME) and medical supplies that are not on the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and
- [Attention Providers: Texas, Louisiana residents displaced by Hurricane Laura](https://medicaid.ms.gov/attention-providers-texas-louisiana-residents-displaced-by-hurricane-laura/) - Please be aware that many Texas and Louisiana residents may have evacuated to Mississippi because of Hurricane Laura and may remain displaced for the near future. If a patient presents a Texas or Louisiana Medicaid card, and you have questions concerning beneficiary eligibility and/or claim submission, please reach out to the specific state’s Medicaid program.
- [MS SPA 20-0016 Emergency Ground Ambulance Reimbursement submitted to CMS](https://medicaid.ms.gov/ms-spa-20-0016-emergency-ground-ambulance-reimbursement-submitted-to-cms/) - State Plan Amendment (SPA) 20-0016 Emergency Ground Ambulance Reimbursement is being submitted to allow the Division of Medicaid to revise the reimbursement methodology for emergency ground ambulance transportation, effective July 1, 2020. For more information, read the submitted SPA pages.
- [Medicaid extends school-based emergency telehealth coverage](https://medicaid.ms.gov/medicaid-extends-school-based-emergency-telehealth-coverage/) - With the start of a new school year in the midst of the COVID-19 pandemic, the Mississippi Division of Medicaid (DOM) has extended its emergency telehealth coverage to include schools as temporary originating site providers. The move makes it possible for schools without school nurses or school-based clinics to access telehealth services. Effective Aug. 1,
- [MS SPA 20-0002 Private Duty Nursing (PDN) and Personal Care Services (PCS) submitted to CMS](https://medicaid.ms.gov/ms-spa-20-0002-private-duty-nursing-pdn-and-personal-care-services-pcs-submitted-to-cms/) - State Plan Amendment (SPA) 20-0002 Private Duty Nursing (PDN) and Personal Care Services (PCS) is being submitted to add coverage and reimbursement of PDN and PCS for Early and Periodic Screening, Diagnosis and Treatment (EPSDT)-eligible beneficiaries to the State Plan, effective July 1, 2020. For more information, read the submitted SPA pages.
- [MS SPA 20-0005 Physician Administered Drugs](https://medicaid.ms.gov/ms-spa-20-0005-physician-administered-drugs/) - State Plan Amendment (SPA) 20-0005 is being submitted to allow the Division of Medicaid (DOM) to revise the fee schedule update from quarterly to annually, clarify if there is no Average Sales Price (ASP) or Medicare Addendum B OPPS fee schedule that a fee will be calculated using the Wholesale Acquisition Cost (WAC) pricing, and
- [MS SPA 20-0006 Autism Spectrum Disorder (ASD) Reimbursement](https://medicaid.ms.gov/ms-spa-20-0006-autism-spectrum-disorder-asd-reimbursement/) - State Plan Amendment (SPA) 20-0006 Autism Spectrum Disorder (ASD) Reimbursement is being submitted to allow the Division of Medicaid (DOM) to remove the annual Autism rate updates and specifies that Autism rates will remain the same as those effective July 1, 2019. This State Plan Amendment (SPA) is effective July 1, 2020. For more information,
- [Public Notice for SPA 20-0008 Federally Qualified Health Center (FQHC) Services](https://medicaid.ms.gov/public-notice-for-spa-20-0008-federally-qualified-health-center-fqhc-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 20-0008 Federally Qualified Health Center (FQHC) Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective August 1,
- [Public Notice for SPA 20-0007 Rural Health Clinic (RHC) Services](https://medicaid.ms.gov/public-notice-for-spa-20-0007-rural-health-clinic-rhc-services-2/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 20-0007 Rural Health Clinic (RHC) Services. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective August 1, 2020,
- [CMS approved MS SPA 20-0013-CHIP Benchmark Coverage effective November 1, 2019](https://medicaid.ms.gov/cms-approved-ms-spa-20-0013-chip-benchmark-coverage-effective-november-1-2019/) - CMS approved SPA 20-0013-CHIP Benchmark Coverage on July 28, 2020. SPA 20-0013-CHIP Benchmark Coverage allows the Division of Medicaid (DOM) to maintain Secretary-approved coverage but switch to “other” Secretary-approved coverage at 6.1.4.7. This change in the “benchmark” is to simplify the state’s managed care contract review process by specifying in the CHIP State Plan that
- [MS SPA 20-0014-CHIP COVID-19 Eligibility and Cost-Sharing during an Emergency](https://medicaid.ms.gov/ms-spa-20-0014-chip-covid-19-eligibility-and-cost-sharing-during-an-emergency/) - The Centers for Medicare and Medicaid Services (CMS) approved SPA 20-0014-CHIP COVID-19 Eligibility and Cost-Sharing During an Emergency on July 22, 2020. SPA 20-0014-CHIP allows the Division of Medicaid to implement temporary adjustments to enrollment and redetermination during Governor or federally-declared disasters and waive certain cost-sharing during the COVID-19 emergency effective March 18, 2020. For
- [MS SPA 20-0015-CHIP submitted to CMS](https://medicaid.ms.gov/ms-spa-20-0015-chip-submitted-to-cms/) - Children’s Health Insurance Program State Plan Amendment (SPA) 20-0015-CHIP Behavioral Health is being submitted to allow the Division of Medicaid to include mental health coverage as a mandatory benefit for all CHIP beneficiaries. Mandatory coverage will include services necessary to prevent, diagnose and treat a broad range of mental health symptoms and disorders, including substance
- [MS SPA 20-0019 Community Mental Health Center (CMHC) Emergency Interim Payments submitted to CMS](https://medicaid.ms.gov/ms-spa-20-0019-community-mental-health-center-cmhc-emergency-interim-payments-submitted-to-cms/) - State Plan Amendment (SPA) 20-0019 is being submitted to allow the Division of Medicaid (DOM) to make interim payments based on fee-for-service (FFS) utilization only to the fourteen (14) Community Mental Health Centers (CMHCs) that have had a decline in utilization due to the COVID-19 pandemic, effective April 1, 2020. For more information, read the
- [Public Notice for SPA 20-0002 Private Duty Nursing (PDN) and Personal Care Services (PCS)](https://medicaid.ms.gov/public-notice-for-spa-20-0002-private-duty-nursing-pdn-and-personal-care-services-pcs/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 20-0002 Private Duty Nursing (PDN) and Personal Care Services (PCS). The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS)
- [CMS approved State Plan Amendment (SPA) 20-0014 1915(i) Community Support Program (CSP) Emergency effective April 1, 2020](https://medicaid.ms.gov/cms-approved-state-plan-amendment-spa-20-0014-1915i-community-support-program-csp-emergency-effective-april-1-2020/) - The Centers for Medicare and Medicaid Services approved SPA 20-0014 on July 15, 2020. SPA 20-0014 addresses CSP service delivery limitations during the COVID-19 emergency. For more information read the approved SPA pages.
- [CMS approved Addendum to Appendix K submitted on July 1, 2020](https://medicaid.ms.gov/cms-approved-addendum-to-appendix-k-submitted-on-july-1-2020/) - This Addendum updates K-2-m to address compliance audit activities and edits Section A to add Case Management providers to the provider types for Personal Protective Equipment. For more information, read the attached Addendum.
- [MS SPA 20-0003 All Patient Refined Diagnosis Related Groups (APR-DRG) Reimbursement submitted to CMS](https://medicaid.ms.gov/ms-spa-20-0003-all-patient-refined-diagnosis-related-groups-apr-drg-reimbursement-submitted-to-cms/) - SPA 20-0003 All Patient Refined Diagnosis Related Groups (APR-DRG) Reimbursement is being submitted to update the hospital inpatient payment methodology with an effective date of July 1, 2020 contingent upon approval from the Centers for Medicare and Medicaid Services (CMS). For more information, read the submitted SPA pages.
- [CMS approved State Plan Amendment (SPA) 20-0011 COVID-19 Cost Sharing Waiver effective March 1, 2020](https://medicaid.ms.gov/cms-approved-state-plan-amendment-spa-20-0011-covid-19-cost-sharing-waiver-effective-march-1-2020/) - The Centers for Medicare and Medicaid Services approved SPA 20-0011 on June 30, 2020. SPA 20-0011 waives cost sharing for all beneficiaries, regardless of the ultimate diagnosis, for testing services and treatments for COVID-19, including vaccines, specialized equipment, and therapies effective March 1, 2020. For more information read the approved SPA pages.
- [CHIP SPA 20-0014 COVID-19 Eligibility and Cost-Sharing During an Emergency submitted to CMS](https://medicaid.ms.gov/childrens-health-insurance-program-chip-state-plan-amendment-spa-20-0014-covid-19-eligibility-and-cost-sharing-during-an-emergency/) - Children’s Health Insurance Program (CHIP) State Plan Amendment (SPA) 20-0014 Eligibility and Cost-Sharing During an Emergency is being submitted to allow the Division of Medicaid to implement temporary adjustments to enrollment and redetermination during Governor or federally-declared disasters and waive certain cost-sharing during the COVID-19 emergency effective March 18, 2020. For more information, read the
- [Public Notice for SPA 20-0021 Out-of-State Transplant Rates](https://medicaid.ms.gov/public-notice-for-spa-20-0021-out-of-state-transplant-rates/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 20-0021 Out-of-State Transplant Rates. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2020, contingent upon
- [Public Notice for SPA 20-0006 Autism Spectrum Disorder (ASD) Reimbursement](https://medicaid.ms.gov/public-notice-for-spa-20-0006-autism-spectrum-disorder-asd-reimbursement/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 20-0006 Autism Spectrum Disorder (ASD) Reimbursement. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2020,
- [Public Notice for SPA 20-0005 Physician Administered Drugs](https://medicaid.ms.gov/public-notice-for-spa-20-0005-physician-administered-drugs/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 20-0005 Physician Administered Drugs. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2020, contingent upon
- [Public Notice for SPA 20-0018 Graduate Medical Education (GME) Reimbursement](https://medicaid.ms.gov/public-notice-for-spa-20-0018-graduate-medical-education-gme-reimbursement/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 20-0018 Graduate Medical Education (GME) Reimbursement. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective June 1, 2020,
- [Public Notice for SPA 20-0016 Emergency Ground Ambulance Reimbursement](https://medicaid.ms.gov/public-notice-for-spa-20-0016-emergency-ground-ambulance-reimbursement/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 20-0016 Emergency Ground Ambulance Reimbursement. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective June 1, 2020, contingent
- [MS SPA 20-0018 Graduate Medical Education Payments submitted to CMS](https://medicaid.ms.gov/ms-spa-20-0018-graduate-medical-education-payments-submitted-to-cms/) - State Plan Amendment (SPA) 20-0018 is being submitted to allow the Division of Medicaid (DOM) to address calculations for GME payments for a hospital during a cap building period effective June 1, 2020. For more information, read the submitted SPA pages.
- [MS SPA 20-0004 Long Term Care (LTC) Cost Report Filings submitted to CMS](https://medicaid.ms.gov/ms-spa-20-0004-long-term-care-ltc-cost-report-filings-submitted-to-cms/) - State Plan Amendment (SPA) 20-0004 Long Term Care (LTC) Cost Report Filings is being submitted to allow the Division of Medicaid (DOM) to revise the method for submitting cost reports and any supporting data from hard copy to electronic upload, and specifies the handling of capitalized assets valued at less than $5,000 each and related
- [MS SPA 20-0017 Inpatient Hospital Cost Report Submittals submitted to CMS](https://medicaid.ms.gov/ms-spa-20-0017-inpatient-hospital-cost-report-submittals-submitted-to-cms/) - State Plan Amendment (SPA) 20-0017 Inpatient Hospital Cost Report Submittals is being submitted to allow the Division of Medicaid (DOM) to revise the method for submitting cost reports and any supporting data from hard copy to electronic upload effective April 1, 2020. For more information, read the submitted SPA pages.
- [MS SPA 20-0011 COVID-19 Cost Sharing Waiver submitted to CMS](https://medicaid.ms.gov/ms-spa-20-0011-covid-19-cost-sharing-waiver-submitted-to-cms/) - State Plan Amendment (SPA) 20-0011 COVID-19 Cost Sharing Waiver is being submitted to waive cost sharing for all beneficiaries, regardless of the ultimate diagnosis, for testing services and treatments for COVID-19, including vaccines, specialized equipment, and therapies, effective March 1, 2020. For more information, read the submitted SPA pages.
- [Public Notice for SPA 20-0003 All Patient Refined Diagnosis Related Groups (APR-DRG) Reimbursement](https://medicaid.ms.gov/spa-20-0003-all-patient-refined-diagnosis-related-groups-apr-drg-reimbursement/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA). The Division of Medicaid, in the Office of the Governor, is submitting SPA 20-0003 All Patient Refined Diagnosis Related Groups (APR-DRG) Reimbursement to update the hospital inpatient payment methodology with an effective date of
- [Communicative Technology CMP Grant Opportunity - Updated](https://medicaid.ms.gov/communicative-technology-cmp-grant-opportunity/) - On April 24, 2020, CMS announced that they had developed a Communication Technology Application Template for nursing homes. This template enables states to approve COVID-19 grant applications for the purpose of communication technology. The communication technology grants will allow nursing home residents to engage in virtual social and telehealth visits. Facilities may use up to
- [MS SPA 20-0014 1915(i) Community Support Program (CSP) Emergency Filing submitted to CMS](https://medicaid.ms.gov/ms-spa-20-0014-1915i-community-support-program-csp-emergency-filing-submitted-to-cms/) - State Plan Amendment (SPA) 20-0014 Community Support Program (CSP) Emergency Filing is being submitted to allow the Division of Medicaid to address CSP service delivery limitations during the COVID-19 emergency, effective March 1, 2020. For more information, read the submitted SPA pages.
- [Effectiveness of Title 23: Medicaid, Part 223, Chapter 4 and 5, Rules 4.1-4.7, 4.9, 5.1-5.7, 5.9 delayed](https://medicaid.ms.gov/effectiveness-of-title-23-medicaid-part-223-chapter-4-and5-rules-4-1-4-7-4-9-5-1-5-7-5-9-delayed/) - Due to COVID-19, the Division of Medicaid is delaying the effectiveness of Title 23: Medicaid, Part 223, Chapter 4: Private Duty Nursing, Rules 4.1-4.7, 4.9, and Chapter 5: Personal Care Services, Rules 5.1-5.7, 5.9 which was filed as final on March 26, 2020, system number 24809. The new effective date is July 1, 2020. For
- [CMS approved State Plan Amendment (SPA) 20-0015 Telehealth Emergency Template effective March 1, 2020](https://medicaid.ms.gov/cms-approved-state-plan-amendment-spa-20-0015-telehealth-emergency-template-effective-march-1-2020/) - The Centers for Medicare and Medicaid Services approved SPA 20-0015 on May 7, 2020. SPA 20-015 allows for flexibilities regarding telehealth services during a state of emergency as declared by either the Governor of Mississippi or the President of the United States effective March 1, 2020 For more information read the approved SPA pages.
- [Cost-Sharing Waived for COVID-19 Related Services](https://medicaid.ms.gov/cost-sharing-waived-for-covid-19-related-services/) - Attention All Providers: Cost-Sharing Waived for COVID-19 Related Services In order to comply with Section 6008(b)(4) of the Families First Coronavirus Response Act, the Division of Medicaid (DOM) is suspending cost-sharing for COVID-19-related testing, treatment, and services, including vaccines, prescription medications, specialized equipment and therapies, regardless of ultimate diagnosis, starting with dates of service (DOS) on
- [Mississippi hospitals to receive emergency accelerated payments from Medicaid](https://medicaid.ms.gov/mississippi-hospitals-to-receive-emergency-accelerated-payments-from-medicaid/) - Supplemental payments to be advanced in May In an effort to help Mississippi hospitals combat the COVID-19 pandemic, Governor Tate Reeves has announced that the Mississippi Division of Medicaid (DOM) is accelerating supplemental payments to hospitals, making almost $160 million in funds quickly available where the most intensive treatment is being performed. Hospitals received $92
- [TBI/SCI Waiver Renewal and 1915(b)(4) renewal application submitted to CMS](https://medicaid.ms.gov/tbi-sci-waiver-renewal-and-1915b4-renewal-application-submitted-to-cms/) - The Division of Medicaid has submitted to the Centers for Medicare and Medicaid Services (CMS) the following Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) Waiver renewal and 1915(b)(4) renewal application. For more information, read the application and proposed waiver pages. Posted May 1, 2020
- [CMS approves Mississippi Medicaid request to increase access to needed in-home supports for those in HCBS programs](https://medicaid.ms.gov/cms-approves-mississippi-medicaid-request-to-increase-access-to-needed-in-home-supports-for-those-in-hcbs-programs/) - Home-delivered meals, in-home providers among flexibilities granted The Centers for Medicare and Medicaid Services (CMS) has approved the Mississippi Division of Medicaid’s Appendices K: Emergency Preparedness and Response in response to the COVID-19 outbreak for the following 1915(c) Home and Community-Based (HCBS) Waivers: Assisted Living, Elderly & Disabled, Independent Living, Traumatic Brain Injury/Spinal Cord Injury and
- [CMS approves DOM’s Appendices K: Emergency Preparedness and Response](https://medicaid.ms.gov/cms-approves-doms-appendices-k-emergency-preparedness-and-response-2/) - The Centers for Medicare and Medicaid Services (CMS) has approved the Mississippi Division of Medicaid’s Appendices K: Emergency Preparedness and Response in response to the COVID-19 outbreak for the following 1915(c) Home and Community-Based (HCBS) Waivers: Assisted Living, Elderly & Disabled, Independent Living, Traumatic Brain Injury/Spinal Cord Injury and Intellectual Disabilities/Developmental Disabilities. For more information, find
- [CMS approves Appendix K: Emergency Preparedness and Response for ID/DD waiver](https://medicaid.ms.gov/cms-approves-appendix-k-emergency-preparedness-and-response-for-id-dd-waiver/) - The Centers for Medicare and Medicaid Services (CMS) has approved the below Appendix K: Emergency Preparedness and Response in response to the COVID-19 outbreak for the Intellectual Disabilities/Developmental Disabilities (ID/DD) Waiver. For more information, read the approved Appendix K.
- [Appendix K: Emergency Preparedness and Response for ID/DD waiver submitted to CMS](https://medicaid.ms.gov/appendix-k-emergency-preparedness-and-response-for-id-dd-waiver-submitted-to-cms/) - The Division of Medicaid has submitted Appendix K: Emergency Preparedness and Response in response to the COVID-19 outbreak for the Intellectual Disabilities/Developmental Disabilities (ID/DD) Waiver. For more information, read the draft Appendix K.
- [MS SPA 19-0021 Pediatric Congenital Heart Surgery](https://medicaid.ms.gov/ms-spa-19-0021-pediatric-congenital-heart-surgery/) - State Plan Amendment (SPA) 19-0021 Pediatric Congenital Heart Surgery, which included the coverage requirements for out-of-state pediatric congenital heart surgery, was disapproved by the Centers for Medicare and Medicaid (CMS) on April 8, 2020. For more information, click here.
- [Mississippi Medicaid Establishes Clinical Data Connection with Baptist Memorial Health Care](https://medicaid.ms.gov/mississippi-division-of-medicaid-establishes-clinical-data-connection-with-baptist-memorial-health-care/) - Exchange allows for greater access to patient information The Mississippi Division of Medicaid now has an electronic connection with Baptist Memorial Health Care, allowing the two organizations to exchange clinical data about Medicaid beneficiaries. Clinicians at Baptist Memorial now have access to critical information about a Medicaid patient’s medications and allergies moments after the patient
- [CMS approves DOM's Appendices K: Emergency Preparedness and Response](https://medicaid.ms.gov/cms-approves-doms-appendices-k-emergency-preparedness-and-response/) - The Centers for Medicare and Medicaid Services (CMS) has approved the Mississippi Division of Medicaid's Appendices K: Emergency Preparedness and Response in response to the COVID-19 outbreak for the following 1915(c) Home and Community-Based (HCBS) Waivers: Assisted Living, Elderly & Disabled, Independent Living, and Traumatic Brain Injury/Spinal Cord Injury. For more information, find the documents
- [Mississippi Medicaid seeks approval to increase access to needed in-home supports for those in HCBS programs](https://medicaid.ms.gov/mississippi-medicaid-seeks-approval-to-increase-access-to-needed-in-home-supports-for-those-in-hcbs-programs/) - Provisions address home-delivered meals, in-home providers In response to the coronavirus outbreak, the Mississippi Division of Medicaid (DOM) is working to increase availability of home-delivered meals and in-home providers for individuals enrolled in home and community based programs. Earlier this week, DOM submitted requests to the Centers for Medicare and Medicaid Services (CMS) known as
- [Effectiveness of Title 23: Medicaid, Part 223 delayed](https://medicaid.ms.gov/effectiveness-of-title-23-medicaid-part-223-delayed/) - Due to COVID-19, the Division of Medicaid is delaying the effectiveness of Title 23: Medicaid, Part 223, Chapter 4: Private Duty Nursing, Rules 4.1-4.7, 4.9, and Chapter 5: Personal Care Services, Rules 5.1-5.7, 5.9 which was filed as final on February 26, 2020, system number 24765. The new effective date is June 1, 2020. View
- [Appendix K: Emergency Preparedness and Response submitted to CMS](https://medicaid.ms.gov/appendix-k-emergency-preparedness-and-response-submitted-to-cms/) - The Division of Medicaid has submitted to the Centers for Medicare and Medicaid Services (CMS) Appendix K: Emergency Preparedness and Response in response to the COVID-19 outbreak for the following 1915(c) Home and Community-Based (HCBS) Waivers: Assisted Living, Elderly & Disabled, Independent Living, and Traumatic Brain Injury/Spinal Cord Injury. Each Appendix K also has a
- [Public Notice for SPA 20-0010 Telehealth Emergency Waiver](https://medicaid.ms.gov/public-notice-for-spa-20-0010-telehealth-emergency-waiver/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 20-0010 Telehealth Emergency Waiver. This SPA will assist beneficiaries to receive a wider range of health care services from Mississippi Medicaid enrolled providers without having to travel to a health care facility to reduce the
- [Mississippi Medicaid to delay hearings amid  COVID-19 response](https://medicaid.ms.gov/mississippi-medicaid-to-delay-fair-hearings-amid-covid-19-response/) - Due to the Coronavirus Disease 2019 (COVID-19) outbreak and the state’s efforts in responding the public health emergency, the Division of Medicaid (DOM) is pursuing waiver authority from CMS related to the scheduling of Medicaid Fair Hearings and the issuing of Fair Hearing decisions. Accordingly, DOM is temporarily postponing the scheduling of Medicaid Fair Hearings
- [Mississippi Medicaid takes steps in response to outbreak](https://medicaid.ms.gov/mississippi-medicaid-takes-steps-in-response-to-outbreak/) - In response to the coronavirus outbreak, the Mississippi Division of Medicaid is restricting public access to regional offices, effective immediately. RO staff members are to maintain normal business hours and must be available to the public by phone, mail and email. Telephone interviews will be substituted for the required in-person interview for institutional categories. The
- [SPA 20-0001 Durable Medical Equipment and Medical Supply Reimbursement submitted to CMS](https://medicaid.ms.gov/spa-20-0001-durable-medical-equipment-and-medical-supply-reimbursement-submitted-to-cms/) - State Plan Amendment (SPA) 20-0001 Durable Medical Equipment (DME) and Medical Supply Reimbursement is being submitted to allow the Division of Medicaid to include a reimbursement methodology for certain durable medical equipment (DME) and medical supplies that are not on the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) fee schedule, effective March 1,
- [Public Notice for 1915(c) Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) Waiver renewal](https://medicaid.ms.gov/public-notice-for-1915b4-traumatic-brain-injury-spinal-cord-injury-tbi-sci-waiver-renewal/) - Pursuant to 42 C.F.R. Section 441.304(e)-(f), public notice is hereby given to the submission of the Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) Waiver renewal. The Division of Medicaid, in the Office of the Governor, will submit this proposed waiver renewal to the Centers for Medicare and Medicaid Services (CMS) for the TBI/SCI Waiver effective July
- [Public Notice for SPA 20-0001 Durable Medical Equipment (DME) and Medical Supply Reimbursement](https://medicaid.ms.gov/public-notice-for-spa-20-0001-durable-medical-equipment-dme-and-medical-supply-reimbursement/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 20-0001 Durable Medical Equipment (DME) and Medical Supply Reimbursement. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective
- [Attention:  Durable Medical Equipment Providers](https://medicaid.ms.gov/attention-durable-medical-equipment-providers/) - In response to public comments for State Plan Amendment (SPA) 20-0001 Durable Medical Equipment (DME) and Medical Supply Reimbursement, the codes below will be removed from the proposed DME fee schedule. Effective March 1, 2020, DOM will continue to reimburse these codes through manual pricing. Please refer to the initial public notice and proposed fee
- [CHIP SPA 19-0011 MHPAEA approved by CMS](https://medicaid.ms.gov/chip-spa-19-0011-mhpaea-approved-by-cms/) - Children's Health Insurance Program (CHIP) State Plan Amendment (SPA)19-0011 Mental Health Parity and Addiction Equity Act (MHPAEA) was approved by Centers for Medicare and Medicaid Services (CMS) to allow the Division of Medicaid (DOM) to demonstrate compliance with the Mental Health Parity and Addiction Equity Act (MHPAEA) final rule as it relates to the Children’s
- [SPA 20-0013 CHIP Benchmark Coverage submitted to CMS](https://medicaid.ms.gov/chip-spa-20-0013-chip-benchmark-coverage-submitted-to-cms/) - Children's Health Insurance Program (CHIP) State Plan Amendment (SPA) 20-0013-CHIP Benchmark Coverage is being submitted to allow the Division of Medicaid (DOM) to maintain Secretary-approved coverage but switch to “other” Secretary-approved coverage at 6.1.4.7. This change in the “benchmark” is to simplify the state’s managed care contract review process by specifying in the CHIP State
- [SPA 19-0002 Prescribed Pediatric Extended Care (PPEC) approved by CMS](https://medicaid.ms.gov/spa-19-0002-prescribed-pediatric-extended-care-ppec-approved-by-cms/) - State Plan Amendment (SPA) 19-0002 Prescribed Pediatric Extended Care (PPEC), effective January 1, 2020, has been approved by the Centers for Medicare and Medicaid Services (CMS) to allow the Division of Medicaid to add coverage and reimbursement of PPEC services for Early and Periodic Screening, Diagnosis and Treatment (EPSDT)-eligible beneficiaries to the State Plan. For
- [Medicaid's September Vital Signs](https://medicaid.ms.gov/medicaids-september-vital-signs/) - The September 2019 update of the Medicaid Vital Signs dashboard continues to examine how the Mississippi Division of Medicaid’s coordinated care organizations (CCOs) have performed in managing certain common disease states among their members. The CCOs are required to report HEDIS data to the Division on a regular basis. HEDIS, which stands for Healthcare Effectiveness
- [Pharmacy providers required to report pharmacy permit renewals to MS Medicaid](https://medicaid.ms.gov/pharmacy-providers-required-to-report-pharmacy-permit-renewals-to-ms-medicaid/) - Pharmacy providers are required to obtain a pharmacy permit from the Mississippi Board of Pharmacy for businesses or locations where pharmacy services are provided, and they must renew that permit with the Board on a biennial basis. Mississippi Medicaid-enrolled pharmacy providers who have a deadline of Dec. 31, 2019, to renew their pharmacy permits with
- [MS SPA 19-0002 Prescribed Pediatric Extended Care (PPEC) submitted to CMS](https://medicaid.ms.gov/ms-spa-19-0002-prescribed-pediatric-extended-care-ppec-submitted-to-cms/) - State Plan Amendment (SPA) 19-0002 Prescribed Pediatric Extended Care (PPEC) is being submitted to add coverage and reimbursement of PPEC services for Early and Periodic Screening, Diagnosis and Treatment (EPSDT)-eligible beneficiaries to the State Plan, effective January 1, 2020. For more information read the submitted SPA pages.
- [MS SPA 19-0022 Drug Utilization Review (DUR) Requirements submitted to CMS](https://medicaid.ms.gov/ms-spa-19-0022-drug-utilization-review-dur-requirements-submitted-to-cms/) - State Plan Amendment (SPA) MS SPA 19-0022 Drug Utilization Review (DUR) Requirements is being submitted to demonstrate that the Division of Medicaid is in compliance with the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act effective October 1, 2019. For more information view the submitted SPA pages.
- [Elderly and Disabled (E&D) Waiver Amendment approved by CMS](https://medicaid.ms.gov/elderly-and-disabled-ed-waiver-amendment-approved-by-cms/) - The Elderly and Disabled (E&D) Waiver amendment was approved by Centers for Medicare and Medicaid Services (CMS), Effective October 1, 2019. For more information read the approved Waiver amendment.
- [CHIP SPA 18-0010 Health Services Initiatives approved by CMS](https://medicaid.ms.gov/chip-spa-18-0010-health-services-initiatives-approved-by-cms/) - Children's Health Insurance Program (CHIP) State Plan Amendment (SPA)18-0010 was approved by Centers for Medicare and Medicaid Services (CMS) to allow the Division of Medicaid (DOM) to cover vision services for low-income children throughout the state at certain Mississippi schools when provided by qualified CHIP providers, effective October 1, 2019. For more information read the
- [SPA 19-0019 Graduate Medical Education approved by CMS](https://medicaid.ms.gov/spa-19-0019-graduate-medical-education-approved-by-cms/) - State Plan Amendment (SPA) 19-0019 Graduate Medical Education (GME) has been approved by the Centers for Medicare and Medicaid Services (CMS) to revise the calculation of direct graduate medical education (GME) costs for Mississippi hospitals with an accredited and Medicare approved teaching program, as determined by the Division of Medicaid, effective October 1, 2019. For
- [Medicaid's August Vital Signs](https://medicaid.ms.gov/medicaids-august-vital-signs/) - The August 2019 update of the Medicaid Vital Signs dashboard continues to examine how the Mississippi Division of Medicaid’s coordinated care organizations (CCOs) have performed in managing certain common disease states among their members. The CCOs are required to report HEDIS data to the Division on a regular basis. HEDIS, which stands for Healthcare Effectiveness
- [Medicaid policy change targets access to care](https://medicaid.ms.gov/medicaid-policy-change-targets-access-to-care/) - Collaboration with Office of Mississippi Physician Workforce aims to boost primary care residency training The Mississippi Division of Medicaid (DOM) has joined forces with the Office of Mississippi Physician Workforce (OMPW) to strengthen its support for physician residency training programs, a move that could create dozens of new training slots around the state in the
- [SPA 19-0018 Treatment of Resources approved by CMS](https://medicaid.ms.gov/spa-19-0018-treatment-of-resources-approved-by-cms/) - State Plan Amendment (SPA) 19-0018 Treatment of Resources has been approved to allow the Division of Medicaid to use Supplemental Security Income (SSI) rules in the treatment of vehicles for purposes of resource eligibility. One vehicle is totally excluded for adult applicants or recipients, if used for transportation. The value of other vehicles, not excluded
- [Independent Living Waiver Amendment approved by CMS](https://medicaid.ms.gov/independent-living-waiver-amendment-approved-by-cms/) - The Centers for Medicare and Medicaid Services (CMS) has approved the 2019 Independent Living (IL) Waiver Amendment. For more information, read the approved waiver pages.
- [Xerox business process services to become Conduent](https://medicaid.ms.gov/xerox-business-process-services-to-become-conduent/) - Xerox, the current fiscal agent of the Mississippi Division of Medicaid (DOM), earlier this year announced its plan to separate into two independent, publicly-traded companies. Once separated, Xerox will focus exclusively on its Document Technology and Document Outsourcing businesses, and the company will retain the brand name Xerox. The operations related to DOM and its
- [Long Term Care 1915(c) Waiver Provider Orientation](https://medicaid.ms.gov/long-term-care-1915c-waiver-provider-orientation/) - The Office of Long Term Care is responsible for ensuring that all providers of 1915(c) home and community based waiver services for the following waivers meet enrollment requirements as documented in the CMS approved waiver applications. Elderly & Disabled Waiver Assisted Living Waiver Independent Living Waiver Traumatic Brain Injury/Spinal Cord Injury Waiver Agencies may currently
- [SPA 19-0020 All Patient Refined-Diagnosis Related Groups (APR-DRG) Reimbursement has been approved by CMS](https://medicaid.ms.gov/spa-19-0020-all-patient-refined-diagnosis-related-groups-apr-drg-reimbursement-has-been-approved-by-cms/) - State Plan Amendment (SPA) 19-0020 All Patient Refined-Diagnosis Related Groups (APR-DRG) Reimbursement has been approved by the Centers for Medicare and Medicaid Services (CMS) to allow the Division of Medicaid to make the following changes, effective July 1, 2019: 1) The following APR-DRG parameters will be updated for discharges on and after July 1, 2019:
- [Independent Living (IL) Waiver Amendment Submitted to CMS](https://medicaid.ms.gov/independent-living-il-waiver-amendment-submitted-to-cms/) - The Division of Medicaid has submitted the 2019 Independent Living (IL) Waiver Amendment to the Centers for Medicare and Medicaid Services (CMS). For more information, read the proposed waiver pages. Posted September 30, 2019
- [Elderly and Disabled (E&D) Waiver Amendment Submitted to CMS](https://medicaid.ms.gov/elderly-and-disabled-ed-waiver-renewal-submitted-to-cms/) - The Division of Medicaid has submitted the 2019 Elderly and Disabled Waiver Amendment to the Centers for Medicare and Medicaid Services (CMS). For more information, read the proposed waiver pages. Posted September 30, 2019
- [SPA 19-0021 Pediatric Congenital Heart Surgery submitted to CMS](https://medicaid.ms.gov/spa-19-0021-pediatric-congenital-heart-surgery/) - State Plan Amendment (SPA) 19-0021 Pediatric Congenital Heart Surgery is being submitted to include the coverage requirements for out-of-state pediatric congenital heart surgery, effective September 1, 2019. For more information, read the submitted SPA pages.
- [Medicaid's July Vital Signs](https://medicaid.ms.gov/medicaids-july-vital-signs/) - The July 2019 update of the Medicaid Vital Signs dashboard continues last month's examination of how the Mississippi Division of Medicaid’s coordinated care organizations (CCOs) have performed in managing certain common disease states among their members. The CCOs are required to report HEDIS data to the Division on a regular basis. HEDIS, which stands for
- [Reminder: New CHIP contracts to take effect November 1, 2019](https://medicaid.ms.gov/reminder-new-chip-contracts-to-take-effect-november-1-2019/) - On Nov. 1, the Mississippi Division of Medicaid (DOM) will implement new three-year contracts for the Children’s Health Insurance Program (CHIP). Although DOM’s coordinated care program, MississippiCAN, includes three care coordination organizations (CCOs), CHIP will continue to be administered by two vendors because it has a smaller number of members. A little over 46,000 Mississippi
- [Public Notice for SPA 19-0023 Private Duty Nursing (PDN)](https://medicaid.ms.gov/public-notice-for-spa-19-0023-private-duty-nursing-pdn/) - As of Sept. 11, 2019, the Mississippi Division of Medicaid will not be submitting this proposed State Plan Amendment to the Centers for Medicare and Medicaid Services (CMS) at this time. Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 19-0023 Private Duty
- [Public Notice for SPA 19-0002 Prescribed Pediatric Extended Care Center (PPEC)](https://medicaid.ms.gov/public-notice-for-spa-19-0002-prescribed-pediatric-extended-care-center-ppec/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 19-0002 Prescribed Pediatric Extended Care Center (PPEC). The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective October 1,
- [MS SPA 19-0020 Graduate Medical Education submitted to CMS](https://medicaid.ms.gov/ms-spa-19-0020-graduate-medical-education-submitted-to-cms/) - Mississippi State Plan Amendment (SPA) 19-0019 Graduate Medical Education (GME) is being submitted to revise the calculation of direct graduate medical education (GME) costs for Mississippi hospitals with an accredited and Medicare approved teaching program, as determined by the Division of Medicaid, effective October 1, 2019. For more information read the submitted draft pages.
- [SPA 19-0013 Outpatient Prospective Payment System (OPPS) Reimbursement has been approved by CMS](https://medicaid.ms.gov/spa-19-0013-outpatient-prospective-payment-system-opps-reimbursement-has-been-approved-by-cms/) - State Plan Amendment (SPA) 19-0013 Outpatient Prospective Payment System (OPPS) Reimbursement has been approved to update hospital outpatient reimbursement as follows, effective July 1, 2019: 1. Remove specific diagnosis codes related to Never Events and refer to the diagnosis code descriptions, 2. Use the Medicare outpatient Addendum B as of January 1 of each year
- [Public Notice for 1915 (c) Elderly and Disabled (E&D) Waiver Amendment](https://medicaid.ms.gov/public-notice-for-1915-c-elderly-and-disabled-ed-waiver-amendment/) - Pursuant to 42 C.F.R. Section 441.304(f), public notice is hereby given to the submission of the Elderly and Disabled (E&D) Waiver amendment. The Division of Medicaid, in the Office of the Governor, will submit this proposed waiver amendment to the Centers for Medicare and Medicaid Services (CMS) for the E&D Waiver effective October 1, 2019.
- [Public Notice for 1915 (c) Independent Living (IL) Waiver Amendment](https://medicaid.ms.gov/public-notice-for-1915-c-independent-living-il-waiver-amendment/) - Pursuant to 42 C.F.R. Section 441.304(f), public notice is hereby given to the submission of the Independent Living (IL) Waiver amendment. The Division of Medicaid, in the Office of the Governor, will submit this proposed waiver amendment to the Centers for Medicare and Medicaid Services (CMS) for the IL Waiver effective October 1, 2019. For
- [Medicaid's June Vital Signs](https://medicaid.ms.gov/medicaids-june-vital-signs/) - The June 2019 update of the Medicaid Vital Signs dashboard expands on previous iterations by taking a look at how the Mississippi Division of Medicaid's coordinated care organizations (CCOs) have performed in managing certain common disease states among their members. The CCOs are required to report HEDIS data to the Division on a regular basis.
- [SPA 18-0015 DSH Payments approved by CMS](https://medicaid.ms.gov/spa-18-0015-dsh-payments-approved-by-cms/) - State Plan Amendment (SPA) 18-0015 Disproportionate Share Hospital (DSH) Payments has been approved which updates the hospital DSH program effective October 1, 2018, to: 1. Continue to include GME approved costs, 2. Modify language to clearly state that Medicare and third party payor cost and payments would be included the DSH UCC, 3. Clarify that
- [Medicaid to implement new CHIP contracts, effective Nov. 1, 2019](https://medicaid.ms.gov/medicaid-to-implement-new-chip-contracts-effective-nov-1-2019/) - CHIP members can select plan during open enrollment On Nov. 1, the Mississippi Division of Medicaid (DOM) will implement new three-year contracts for the Children’s Health Insurance Program (CHIP). Although DOM’s coordinated care program, MississippiCAN, includes three care coordination organizations (CCOs), CHIP will continue to be administered by two vendors because it has a smaller
- [Alliant Health Solutions now processing Medicaid prior authorizations](https://medicaid.ms.gov/alliant-um-qio-transition-to-take-effect-aug-1-2019/) - Effective Aug. 1, 2019, Alliant Health Solutions is now performing prior authorization reviews for the Mississippi Division of Medicaid as the agency’s new Utilization Management/Quality Improvement Organization (UM/QIO) vendor. All prior authorization reviews in process before Aug. 1 will be completed by eQHealth Solutions as part of the transition to Alliant. Therefore any requests submitted
- [MS SPA 19-0020 APR-DRG Reimbursement submitted to CMS](https://medicaid.ms.gov/ms-spa-19-0020-apr-drg-reimbursement-submitted-to-cms/) - Mississippi State Plan Amendment (SPA) 19-0020 All Patient Refined-Diagnosis Related Groups (APR-DRG) Reimbursement is being submitted to make the following changes, effective July 1, 2019: 1) The following APR-DRG parameters will be updated for discharges on and after July 1, 2019: The base price will change from $6,585 in State Fiscal Year (SFY) 2019 to
- [Public Notice for SPA 19-0019 Graduate Medical Education (GME)](https://medicaid.ms.gov/public-notice-for-spa-19-0019-graduate-medical-education-gme/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 19-0019 Graduate Medical Education (GME). The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective October 1, 2019, contingent
- [CHIP SPA 19-0012 Managed Care approved by CMS](https://medicaid.ms.gov/chip-spa-19-0012-managed-care-approved-by-cms/) - Children’s Health Insurance Program (CHIP) State Plan Amendment (SPA) 19-0012 Managed Care has been approved by the Centers of Medicare and Medicaid (CMS) to be in compliance with the final Medicaid and CHIP managed care regulations published May 6, 2016. The effective date of MS SPA 19-0012-CHIP is July 1, 2018. For more information read
- [Public Notice of Annual Public Forum for 1115(a) Family Planning Waiver](https://medicaid.ms.gov/public-notice-of-annual-public-forum-for-1115a-family-planning-waiver/) - Pursuant to 42 C.F.R. Section 431.420(c), a Public Forum is required annually after the implementation of the Division of Medicaid’s Family Planning Waiver. This Public Forum provides stakeholders the opportunity to provide meaningful comments on the progress of the Family Planning Waiver. The Family Planning Waiver operates under the authority of an 1115(a) waiver approved
- [Medicaid's May Vital Signs](https://medicaid.ms.gov/medicaids-may-vital-signs/) - As part of an ongoing effort to increase program transparency, the Mississippi Division of Medicaid developed the Medicaid Vital Signs dashboard, which was launched on Jan. 8, 2019. Medicaid Vital Signs displays key Mississippi Medicaid metrics in one easy-to-reference visual package. This new report allows anyone to quickly check specific Medicaid statistics and follow recent
- [SPA 19-0013 OPPS Reimbursement submitted to CMS](https://medicaid.ms.gov/opps-reimbursement-submitted-to-cms/) - State Plan Amendment (SPA) 19-0013 Outpatient Prospective Payment System (OPPS) Reimbursement is being submitted to update hospital outpatient reimbursement as follows, effective July 1, 2019: 1. Remove specific diagnosis codes related to Never Events and refer to the diagnosis code descriptions, 2. Use the Medicare outpatient Addendum B as of January 1 of each year
- [SPA 19-0011 PASRR in Nursing Facilities submitted to CMS](https://medicaid.ms.gov/spa-19-0011-pasrr-in-nursing-facilities-submitted-to-cms/) - State Plan Amendment (SPA) 19-0011 Preadmission Screening and Annual Resident Review (PASRR) in Nursing Facilities (NF) is being submitted to allow the Division of Medicaid to replace the term “mental retardation” with “intellectual and developmental disability (IDD)”, effective July 1, 2019. For more information read the submitted draft pages.
- [MS SPA 19-0018 Treatment of Resources submitted to CMS](https://medicaid.ms.gov/ms-spa-19-0018-treatment-of-resources/) - State Plan Amendment (SPA) 19-0018 Treatment of Resources is being submitted with a proposed effective date of July 1, 2019. SPA 19-0018 will allow qualified Medicaid eligibles who are receiving Social Security Income (SSI) benefits, and are under the age of nineteen (19), to continue to exclude two (2) automobiles. Those qualified beneficiaries that are
- [Children's Health Insurance Program (CHIP) State Plan Amendment (SPA) 19-0012 Managed Care](https://medicaid.ms.gov/childrens-health-insurance-program-chip-state-plan-amendment-spa-19-0012-managed-care/) - Children's Health Insurance Program (CHIP) State Plan Amendment (SPA) 19-0012 Managed Care has been submitted to be in compliance with the final Medicaid and CHIP managed care regulations published May 6, 2016. The effective date of the CHIP SPA is July 1, 2018. For more information, please read draft pages.
- [Public Notice for SPA 19-0020 All Patient Refined-Diagnosis Related Groups (APR-DRG) Reimbursement](https://medicaid.ms.gov/public-notice-for-spa-19-0020-all-patient-refined-diagnosis-related-groups-apr-drg-reimbursement/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA). The Division of Medicaid, in the Office of the Governor, is submitting SPA 19-0020 All Patient Refined Diagnosis Related Groups (APR-DRG) Reimbursement to update the hospital inpatient payment methodology with an effective date of
- [MS SPA 19-0014 Utilization Review (UR) in ICF/IIDs submitted to CMS](https://medicaid.ms.gov/ms-spa-19-0014-utilization-review-ur-in-icf-iids-submitted-to-cms/) - State Plan Amendment (SPA) 19-0014 Utilization Review (UR) in Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IIDs) is being submitted to allow the Division of Medicaid to change control of the utilization of ICF/IIDs from the Mississippi State Department of Health (MSDH) to the contracted Utilization Management/Quality Improvement Organization (UM/QIO), effective September 1, 2019.
- [Public Notice for SPA 19-0012 All Patient Refined Diagnosis Related Groups (APR-DRG)](https://medicaid.ms.gov/public-notice-for-spa-19-0012-all-patient-refined-diagnosis-related-groups-apr-drg/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA). The Division of Medicaid, in the Office of the Governor, is submitting SPA 19-0012 All Patient Refined Diagnosis Related Groups (APR-DRG) Reimbursement to update the hospital inpatient payment methodology with an effective date of
- [Public Notice for SPA 19-0013 Outpatient Prospective Payment System (OPPS)](https://medicaid.ms.gov/public-notice-for-spa-19-0013-outpatient-prospective-payment-system-opps/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA 19-0013) Outpatient Prospective Payment System (OPPS) Reimbursement. The Division of Medicaid, in the Office of the Governor, is submitting the proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1,
- [Medicaid's April Vital Signs](https://medicaid.ms.gov/medicaids-april-vital-signs/) - As part of an ongoing effort to increase program transparency, the Mississippi Division of Medicaid developed the Medicaid Vital Signs dashboard, which was launched on Jan. 8, 2019. Medicaid Vital Signs displays key Mississippi Medicaid metrics in one easy-to-reference visual package. This new report allows anyone to quickly check specific Medicaid statistics and follow recent
- [Alliant Health Solutions to replace eQHealth Solutions as Medicaid UM/QIO vendor](https://medicaid.ms.gov/alliant-health-solutions-to-replace-eqhealth-solutions-as-medicaid-um-qio-vendor/) - Beginning Aug. 1, 2019, Alliant Health Solutions will begin performing prior authorization reviews as the Mississippi Division of Medicaid (DOM) transitions to a new Utilization Management/Quality Improvement Organization (UM/QIO) vendor. Alliant was awarded the new UM/QIO contract earlier this year, and will replace the current vendor, eQHealth Solutions, to review and process prior authorizations for
- [SPA 19-0009 Transitional Medical Assistance (TMA) approved by CMS](https://medicaid.ms.gov/spa-19-0009-transitional-medical-assistance-tma-approved-by-cms/) - State Plan Amendment (SPA) 19-0009 Transitional Medical Assistance (TMA) has been approved by the Centers for Medicare and Medicaid services (CMS) to allow the Division of Medicaid to include language for a less restrictive transitional medical assistance (TMA) reporting allowed under Section 1931 of the Social Security Act (SSA). The Division of Medicaid has processed
- [Public Notice for SPA 19-0015 Medicare Crossover Payments](https://medicaid.ms.gov/public-notice-for-spa-19-0015-medicare-crossover-payments/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 19-0015 Medicare Crossover Payments. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2019, contingent upon
- [SPA 19-0006 Post-Eligibility Treatment of Income approved by CMS](https://medicaid.ms.gov/spa-19-0006-post-eligibility-treatment-of-income-approved-by-cms/) - State Plan Amendment (SPA) 19-0006 Post-Eligibility Treatment of Income has been approved by the Centers for Medicare and Medicaid Services to allow the Division of Medicaid to include in the state plan post-eligibility treatment of income deductions by institutionalized individuals for amounts of incurred expenses for medical or remedial care that are not subject to
- [SPA 19-0010 Dental and Orthodontic Reimbursement approved by CMS](https://medicaid.ms.gov/spa-19-0010-dental-and-orthodontic-reimbursement-approved-by-cms/) - State Plan Amendment (SPA) 19-0010 Dental and Orthodontic Reimbursement has been approved by the Centers for Medicare and Medicaid Services (CMS), effective March 1, 2019, to allow the Division of Medicaid to: 1. Revise the reimbursement methodology for dental and orthodontic services as the lesser of: a) The provider’s usual and customary charge, b) A
- [SPA 19-0001 Targeted Case Management (TCM) for Beneficiaries With Intellectual and/or Developmental Disabilities (IDD) in Community-Based Settings](https://medicaid.ms.gov/spa-19-0001-targeted-case-management-tcm-for-beneficiaries-with-intellectual-and-or-developmental-disabilities-idd-in-community-based-settings/) - State Plan Amendment (SPA) 19-0001 Targeted Case Management (TCM) for Beneficiaries With Intellectual and/or Developmental Disabilities (IDD) in Community-Based Settings, with a proposed effective date of January 1, 2019, has been approved by the Centers for Medicare and Medicaid Services (CMS). The SPA includes the following changes: a) Adding Autism Spectrum Disorder (ASD) as a
- [Medicaid's March Vital Signs](https://medicaid.ms.gov/medicaids-march-vital-signs/) - As part of an ongoing effort to increase program transparency, the Mississippi Division of Medicaid developed the Medicaid Vital Signs dashboard, which was launched on Jan. 8, 2019. Medicaid Vital Signs displays key Mississippi Medicaid metrics in one easy-to-reference visual package. This new report allows anyone to quickly check specific Medicaid statistics and follow recent
- [SPA 19-0003 Non-Emergency Transportation (NET) Broker Contract approved by CMS](https://medicaid.ms.gov/spa-19-0003-non-emergency-transportation-net-broker-approved-by-cms/) - State Plan Amendment (SPA) 19-0003 Non-Emergency Transportation (NET) Broker Contract has been approved by the Centers for Medicare and Medicaid Services (CMS) which corresponds with the new NET Broker contract operational effective date of February 1, 2019. This SPA includes the following changes: a) Updating the reimbursement methodology to reflect the new NET Broker Contract,
- [CHIP SPA 19-0011 Mental Health Parity and Addiction Equity Act submitted to CMS](https://medicaid.ms.gov/chip-spa-19-0011-mental-health-parity-and-addiction-equity-act-submitted-to-cms/) - Children's Health Insurance Program (CHIP) State Plan Amendment (SPA) 19-0011 Mental Health Parity and Addiction Equity Act (MHPAEA) has been submitted to the Centers for Medicare and Medicaid Services (CMS) to demonstrate compliance with the Mental Health Parity and Addiction Equity Act (MHPAEA) final rule as it relates to the Children's Health Insurance Program (CHIP),
- [SPA 19-0004 Prescription Drug Limit Increase submitted to CMS](https://medicaid.ms.gov/spa-19-0004-prescription-drug-limit-increase-submitted-to-cms/) - State Plan Amendment (SPA) 19-0004 Prescription Drug Limit Increase is being submitted to allow the Division of Medicaid to increase the prescription drug limit from five (5) to six (6) per month, effective July 1, 2019. For more information read the submitted draft pages.
- [Medicaid's February Vital Signs](https://medicaid.ms.gov/medicaids-february-vital-signs/) - As part of an ongoing effort to increase program transparency, the Mississippi Division of Medicaid developed the Medicaid Vital Signs dashboard, which was launched on Jan. 8, 2019. Medicaid Vital Signs displays key Mississippi Medicaid metrics in one easy-to-reference visual package. This new report allows anyone to quickly check specific Medicaid statistics and follow recent
- [Medicaid to increase monthly prescription drugs, yearly home health visits](https://medicaid.ms.gov/medicaid-to-increase-monthly-prescription-drugs-yearly-home-health-visits/) - Service increases to take effect July 1, 2019 The Mississippi Division of Medicaid (DOM) will soon cover more prescription drugs per month and more home health visits per year for Medicaid beneficiaries, marking the second phase of the Medicaid EASE Initiative. First announced in December of last year, the Medicaid EASE Initiative – Enhancing Access
- [SPA 19-0005 Home Health Visit Increase](https://medicaid.ms.gov/spa-19-0005-home-health-visit-increase/) - State Plan Amendment (SPA) 19-0005 Home Health Visit Increase has been approved to allow the Division of Medicaid to increase the number of home health visits from twenty five (25) visits to thirty-six (36) visits per state fiscal year (SFY) and to clarify the provider appeals process to include reconsideration prior to an administrative hearing
- [MS SPA 19-0010 Dental and Orthodontic Reimbursement submitted to CMS](https://medicaid.ms.gov/ms-spa-19-0010-dental-and-orthodontic-reimbursement-submitted-to-cms/) - State Plan Amendment (SPA) 19-0010 Dental and Orthodontic Reimbursement, with a proposed effective date of July 1, 2019, has been submitted to allow the Division of Medicaid: 1. To revise the reimbursement methodology for dental and orthodontic services as the lesser of: a) The provider’s usual and customary charge, b) A fee from the Mississippi Medicaid statewide
- [Civil Money Penalty Grant Training](https://medicaid.ms.gov/civil-money-penalty-grant-training/) - The Division of Medicaid and Mississippi State Department of Health Division of Licensure and Certification are hosting a free, one-day educational seminar for nursing home providers and other individuals or organizations interested in applying for a Civil Money Penalty (CMP) Grant. Several speakers experienced in the nursing home industry will share their expertise and perspectives
- [Public Notice of Annual Post-Award Forum on the Healthier Mississippi Waiver](https://medicaid.ms.gov/public-notice-of-annual-post-award-forum-on-the-healthier-mississippi-waiver/) - Pursuant to 42 C.F.R. Section 431.420(c), public notice is hereby given to the annual Post-Award Forum on the Division of Medicaid’s Healthier Mississippi Waiver. The annual Post-Award Forum provides stakeholders and the general public the opportunity to provide meaningful comment on the progress of the Healthier Mississippi Waiver. The Healthier Mississippi Waiver operates under the
- [Medicaid's January Vital Signs](https://medicaid.ms.gov/medicaids-january-vital-signs/) - As part of an ongoing effort to increase program transparency, the Mississippi Division of Medicaid developed the Medicaid Vital Signs dashboard, which was launched on Jan. 8, 2019. Medicaid Vital Signs displays key Mississippi Medicaid metrics in one easy-to-reference visual package. This new report allows anyone to quickly check specific Medicaid statistics and follow recent
- [SPA 19-0009 Transitional Medical Assistance (TMA) submitted to CMS](https://medicaid.ms.gov/spa-19-0009-transitional-medical-assistance-tma-submitted-to-cms/) - State Plan Amendment (SPA) 19-0009 Transitional Medical Assistance (TMA) has been submitted to allow the Division of Medicaid to include language for a less restrictive transitional medical assistance (TMA) reporting allowed under Section 1931 of the Social Security Act (SSA). The Division of Medicaid has processed TMA in this manner since 1997 but this provision
- [SPA 19-0001 Targeted Case Management submitted to CMS](https://medicaid.ms.gov/spa-19-0001-targeted-case-management-submitted-to-cms/) - State Plan Amendment (SPA) 19-0001 Targeted Case Management (TCM) for Beneficiaries With Intellectual and/or Developmental Disabilities (IDD) in Community-Based Settings, with a proposed effective date of January 1, 2019, has been submitted to allow the Division of Medicaid to: Add Autism Spectrum Disorder (ASD) as a covered diagnosis, Remove the needs-based criteria, Revise the qualifications
- [SPA 19-0003 NET Broker Contract submitted to CMS](https://medicaid.ms.gov/spa-19-0003-net-broker-contract-submitted-to-cms/) - State Plan Amendment (SPA) 19-0003 Non-Emergency Transportation (NET) Broker Contract has been submitted to correspond with the new NET Broker contract operational effective date of February 1, 2019. This SPA includes the following changes: a) Updating the reimbursement methodology to reflect the new NET Broker Contract, b) Adding non-emergency air transportation services to the NET
- [SPA 19-0006 Post-Eligibility Treatment of Income submitted to CMS](https://medicaid.ms.gov/spa-19-0006-post-eligibility-treatment-of-income-submitted-to-cms/) - State Plan Amendment (SPA) 19-0006 Post-Eligibility Treatment of Income has been submitted to allow the Division of Medicaid to include in the state plan post-eligibility treatment of income deductions by institutionalized individuals for amounts of incurred expenses for medical or remedial care that are not subject to payment by the Division of Medicaid or other
- [SPA 19-0005 Home Health Visit Increase submitted to CMS](https://medicaid.ms.gov/spa-19-0005-home-health-visit-increase-submitted-to-cms/) - State Plan Amendment (SPA) 19-0005 Home Health Visit Increase has been submitted to allow the Division of Medicaid to increase the number of home health visits from twenty five (25) visits to thirty-six (36) visits per state fiscal year (SFY) and to clarify the provider appeals process to include reconsideration prior to an administrative hearing
- [ABLE savings accounts for eligible individuals with disabilities available soon](https://medicaid.ms.gov/able-savings-accounts-for-eligible-individuals-with-disabilities-available-soon/) - Mississippi ABLE accounts are tax-advantaged savings accounts for individuals with disabilities. Income earned in the accounts is not taxed if spent on qualified disability-related expenses. Contributions can be made to an account by anyone and may qualify for a state tax deduction. The accounts can be used for daily transactions, as well as for long-term
- [Public Notice for SPA 19-0010 Dental and Orthodontic Reimbursement](https://medicaid.ms.gov/public-notice-for-spa-19-0010-dental-and-orthodontic-reimbursement/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA) 19-0010 Dental and Orthodontic Reimbursement. The Division of Medicaid, in the Office of the Governor, is submitting the proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective March 1, 2019, contingent
- [SPA 18-0011 Physician Administered Drugs (PAD) approved by CMS](https://medicaid.ms.gov/spa-18-0011-physician-administered-drugs-pad-approved-by-cms/) - State Plan Amendment (SPA) 18-0011 Physician Administered Drugs (PADs) has been approved to allow the Division of Medicaid to reimburse for certain PADs under the pharmacy benefit to improve beneficiary access. These certain PADs are currently referred to as Clinician Administered Drug and Implantable Drug System Devices (CADDs) and include, but are not limited to,
- [Medicaid's December Vital Signs](https://medicaid.ms.gov/medicaids-december-vital-signs/) - As part of an ongoing effort to increase program transparency, the Mississippi Division of Medicaid developed the Medicaid Vital Signs dashboard, which was launched on Jan. 8, 2019. Medicaid Vital Signs displays key Mississippi Medicaid metrics in one easy-to-reference visual package. This new report allows anyone to quickly check specific Medicaid statistics and follow recent
- [SPA 18-0020 Physician Visit Limit Increase approved by CMS](https://medicaid.ms.gov/spa-18-0020-physician-visit-limit-increase-approved-by-cms/) - State Plan Amendment (SPA) 18-0020 Physician Visit Limit Increase has been approved to allow the Division of Medicaid to increase the physician office and outpatient hospital visit limit from twelve (12) to sixteen (16) per state fiscal year for both psychiatric and non-psychiatric services. These are two (2) separate service limits and both will be
- [Public Notice for SPA 19-0003 NET Broker Contract](https://medicaid.ms.gov/public-notice-for-spa-19-0003-net-broker-contract/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA) 19-0003 Non-Emergency Transportation (NET) Broker Contract. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective February 1, 2019,
- [Medicaid's November Vital Signs](https://medicaid.ms.gov/medicaids-november-vital-signs/) - As part of an ongoing effort to increase program transparency, the Mississippi Division of Medicaid developed the Medicaid Vital Signs dashboard, which displays key Mississippi Medicaid metrics in one easy-to-reference visual package. This new report allows anyone to quickly check specific Medicaid statistics and follow recent program trends. Most of the information presented in Medicaid
- [Training, informational opportunities set for OPPS date bundling](https://medicaid.ms.gov/training-informational-opportunities-set-for-opps-date-bundling/) - When the second phase of a new claims processing system took effect in 2015 at the Mississippi Division of Medicaid (DOM), like any complex computer program it had some bugs that needed to be worked out. In this case, the error in the system related to reimbursable outpatient services that qualify for date bundling –
- [Medicaid workshops set to educate beneficiaries](https://medicaid.ms.gov/medicaid-workshops-set-to-educate-beneficiaries/) - The Mississippi Division of Medicaid (DOM) has scheduled educational workshops to be held this fall around the state to help Medicaid beneficiaries get the most out of the services they qualify for, as well as to promote the overall health of Mississippians. Between Oct. 26 and Dec. 8, DOM’s Office of Client Relations (OCR), with assistance
- [Providers encouraged to RSVP for Medicaid fee-for-service workshops](https://medicaid.ms.gov/providers-encouraged-to-rsvp-for-medicaid-fee-for-service-workshops/) - Beginning Sept. 19, the Mississippi Division of Medicaid (DOM) will host seven workshops around the state aimed to informing and updating health-care providers about fee-for-service Medicaid. The Medicaid Evolution Fee-For-Service Workshops will cover a range of topics that relate to all provider types enrolled in the Mississippi Medicaid program. Representatives with DOM’s Office of Client Relations
- [Providers must subscribe to continue to receive Provider Bulletin publication](https://medicaid.ms.gov/providers-must-subscribe-to-continue-to-receive-provider-bulletin-publication/) - The Mississippi Division of Medicaid (DOM) wants to ensure all enrolled providers, in addition to medical and health-care associations are receiving the most recent policy changes and agency updates. One of the ways DOM communicates this information is through the Provider Bulletin. The Provider Bulletin is a publication aimed at informing providers and other health-care
- [Subscribe to continue to receive the Provider Bulletin publication](https://medicaid.ms.gov/subscribe-to-continue-to-receive-provider-bulletin-publication/) - Effective January 2018, the Mississippi Division of Medicaid (DOM) will no longer auto-mail the quarterly publications of the provider bulletin. Providers may still download the bulletin by visiting the Envision web portal. Providers also have the option to subscribe (for FREE) and receive the provider bulletin via hard copy print (through postal mail), e-newsletter or
- [SPA 18-0013 RHC Physician Administered Drugs (PAD) approved by CMS](https://medicaid.ms.gov/spa-18-0013-rural-health-clinic-rhc-physician-administered-drugs-pad-2/) - State Plan Amendment (SPA) 18-0013 Rural Health Clinic (RHC) Physician Administered Drugs (PADs) has been approved to allow the Division of Medicaid to reimburse an RHC the encounter rate for the administration of certain categories of physician administered drugs (PADs), referred to as Clinician Administered Drug and Implantable Drug System Devices (CADDs), reimbursed under the
- [SPA 18-0012 FQHC Physician Administered Drugs (PAD) approved by CMS](https://medicaid.ms.gov/spa-18-0012-fqhc-physician-administered-drugs-pad-approved-by-cms/) - State Plan Amendment (SPA) 18-0012 Federally Qualified Health Center (FQHC) Physician Administered Drugs (PADs) has been approved to allow the Division of Medicaid to reimburse an FQHC the encounter rate for the administration of certain categories of physician administered drugs (PADs), referred to as Clinician Administered Drug and Implantable Drug System Devices (CADDs), reimbursed under
- [SPA 18-0020 Physician Visit Limit Increase submitted to CMS](https://medicaid.ms.gov/spa-18-0020-physician-visit-limit-submitted-to-cms/) - State Plan Amendment (SPA) 18-0020 Physician Visit Limit Increase has been submitted to allow the Division of Medicaid to increase the physician office and outpatient hospital visit limit from twelve (12) to sixteen (16) per state fiscal year for both psychiatric and non-psychiatric services. These are two (2) separate service limits and both will be
- [Public Notice for SPA 19-0001 TCM for Beneficiaries with Intellectual and/or Developmental Disabilities in CBS](https://medicaid.ms.gov/spa-19-0001-tcm-for-beneficiaries-with-intellectual-and-or-developmental-disabilities-in-cbs-submitted-to-cms/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA) 19-0001 Targeted Case Management (TCM) for Beneficiaries with Intellectual and/or Developmental Disabilities (IDD) in Community-Based Settings. The Division of Medicaid, in the Office of the Governor, is submitting the proposed SPA to the Centers
- [Latorre becomes new Mississippi Medicaid Medical Director](https://medicaid.ms.gov/latorre-becomes-new-mississippi-medicaid-medical-director/) - Latorre brings unique perspective as Mississippi Division of Medicaid’s first full-time medical director Dr. Carlos Latorre earned two degrees in geology and worked at the U.S. Army Corps of Engineers, Engineer Research and Development Center (ERDC) in Vicksburg for six years before deciding he really wanted to study medicine. Now, after seven years of experience
- [Medicaid helps 551 beneficiaries transition back into community settings](https://medicaid.ms.gov/medicaid-helps-551-beneficiaries-transition-back-into-community-settings/) - Bridge to Independence project improves quality of life Rodney Jordan was always on the move, always on his feet. His work as a sous chef landed him in restaurant kitchens in cities stretching from New Orleans to Chicago. Never one to settle in one place, Jordan’s other passion for service would eventually lead him to
- [DOM employees share their memories on anniversary of Hurricane Katrina](https://medicaid.ms.gov/dom-employees-share-their-memories-on-anniversary-of-hurricane-katrina/) - Thirteen years ago Hurricane Katrina made landfall on the Mississippi Gulf Coast on Aug. 29, 2005, and changed the lives of millions of people. Three years ago on the 10th anniversary, two Mississippi Division of Medicaid employees shared their stories of how the storm personally impacted them and made the agency stronger as a result. (Originally
- [Medicaid EASE Initiative aims to improve access to needed services](https://medicaid.ms.gov/medicaid-ease-initiative-aims-to-improve-access-to-needed-services/) - Increasing physician visit limits first in series of 2019 enhancements Effective Jan. 1, 2019, the Mississippi Division of Medicaid (DOM) is increasing the number of physician visits it covers for Medicaid beneficiaries, the first of a series of changes the agency plans to roll out in the coming year. The move is part of the
- [SPA 18-0015 DSH Payments submitted to CMS](https://medicaid.ms.gov/spa-18-0015-dsh-payments-submitted-to-cms/) - State Plan Amendment (SPA) 18-0015 Disproportionate Share Hospital (DSH) Payments has been submitted to update the hospital DSH program effective October 1, 2018: 1. To clarify: a) The treatment of hospital assessments on hospital cost reports according to the entire Section 2122 of the Medicare Provider Reimbursement Manual 15-1, b) Medicaid costs include Graduate Medical Education (GME)
- [SPA 18-0014 EPSDT approved by CMS](https://medicaid.ms.gov/spa-18-0014-epsdt-approved-by-cms/) - Mississippi State Plan Amendment (SPA) 18-0014 Early and Periodic Screening, Diagnosis and Treatment (EPSDT) has been approved to revise language to reflect the February 2017 changes in the Fourth (4th) Addition of the Bright Futures/American Academy of Pediatrics (AAP) Periodicity Schedule, effective October 1, 2018. This SPA removes the specific screenings as required by the
- [SPA 18-0018 MSCAN approved by CMS](https://medicaid.ms.gov/spa-18-0018-mscan-approved-by-cms/) - State Plan Amendment (SPA) 18-0018 Mississippi Coordinated Access Network (MississippiCAN) has been approved to allow the Division of Medicaid to include Psychiatric Residential Treatment Facility (PRTF) services as covered and reimbursed by the Coordinated Care Organizations (CCOs). For more information, read the approved SPA pages.
- [2018 Fall Provider Workshops for MSCAN and CHIP](https://medicaid.ms.gov/2018-fall-provider-workshops-for-mscan-and-chip/) - The Division of Medicaid, in conjunction with its contractors Conduent, eQHealth and the MSCAN plans – Magnolia Health, Molina Healthcare and UnitedHealthcare Community Plan, will conduct Provider Workshops November 27, 2018 through December 12, 2018, at varied location across the state. The purpose of these two-day Workshops is to provide updates and changes related to
- [Public Notice for SPA 18-0015 Disproportionate Share Hospital (DSH) Payments](https://medicaid.ms.gov/public-notice-for-spa-18-0015-disproportionate-share-hospital-dsh-payments/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given for the submission of a Medicaid State Plan Amendment (SPA) 18-0015 Disproportionate Share Hospital (DSH) Payments. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective October 1, 2018,
- [SPA 18-0007 OPPS Reimbursement approved by CMS](https://medicaid.ms.gov/spa-18-0007-opps-reimbursement-approved-by-cms/) - State Plan Amendment (SPA) 18-0007 Outpatient Prospective Payment System (OPPS) Reimbursement has been approved to allow the Division of Medicaid (DOM) to remove the five percent (5%) assessment of outpatient hospital services and clarify the Outpatient Prospective Payment System (OPPS) payment methodology effective July 1, 2018. For more information, read the approved SPA pages.
- [SPA 18-0018 Mississippi Coordinated Access Network (MississippiCAN)](https://medicaid.ms.gov/spa-18-0018-mississippi-coordinated-access-network-mississippican/) - State Plan Amendment (SPA) 18-0018 Mississippi Coordinated Access Network (MississippiCAN) has been submitted to allow the Division of Medicaid to include Psychiatric Residential Treatment Facility (PRTF) services as covered and reimbursed by the Coordinated Care Organizations (CCOs). This SPA also adds 1915(i) Community Support Program (CSP) Services to the list of services that are not
- [SPA 18-0014 Early and Periodic Screening, Diagnosis and Treatment (EPSDT)](https://medicaid.ms.gov/spa-18-0014-early-and-periodic-screening-diagnosis-and-treatment-epsdt/) - State Plan Amendment (SPA) 18-0014 Early and Periodic Screening, Diagnosis and Treatment (EPSDT) has been submitted to to revise language to reflect the February 2017 changes in the Fourth (4th) Addition of the Bright Futures/American Academy of Pediatrics (AAP) Periodicity Schedule, effective October 1, 2018. This SPA removes the specific screenings as required by the
- [SPA 18-0005 LTC Updates #2 approved by CMS](https://medicaid.ms.gov/spa-18-0005-ltc-updates-2-approved-by-cms/) - State Plan Amendment (SPA) 18-0005 Long-Term Care (LTC) Updates #2 has been submitted to allow the following, effective July 1, 2018: Revise the number of allowed therapeutic leave days for nursing facilities (NFs) and intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs) as required by Senate Bill 2836, remove stock transactions as a change
- [SPA 18-0004 APR-DRG Reimbursement approved by CMS](https://medicaid.ms.gov/spa-18-0004-apr-drg-reimbursement-approved-by-cms/) - Mississippi State Plan Amendment (SPA) 18-0004 All Patient Refined Diagnosis Related Groups (APR-DRG) Reimbursement has been approved by the Centers for Medicare and Medicaid Services (CMS) to allow the Division of Medicaid (DOM) to to update the reimbursement of hospital inpatient services reimbursement effective July 1, 2018. For more information, read the approved SPA pages.
- [SPA 18-0010 Transportation approved by CMS](https://medicaid.ms.gov/spa-18-0010-transportation-approved-by-cms/) - State Plan Amendment (SPA) 18-0010 Transportation has been approved to update the reimbursement methodology for transportation services and place information regarding coverage and payment of transportation services on the appropriate pages, effective August 1, 2018. For more information, view the approved SPA pages.
- [340B Mandatory Billing Policy](https://medicaid.ms.gov/340b-mandatory-billing-policy/) - Mandatory billing policy change for 340B purchased drugs takes effect November 1, 2018 Effective November 1, 2018, the Division of Medicaid (DOM) is implementing a mandatory billing policy whereby providers must identify 340B purchased drugs on claims. This billing policy is in response to the Centers for Medicare and Medicaid Services (CMS) requirement that DOM
- [Public Notice for SPA 18-0018 Mississippi Coordinated Access Network (MSCAN)](https://medicaid.ms.gov/public-notice-for-spa-18-0018-mississippi-coordinated-access-network-mscan/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA) 18-0018 Mississippi Coordinated Access Network (MSCAN). The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective October 1, 2018,
- [Reminder: Important MSCAN, CHIP billing changes for pharmacy providers](https://medicaid.ms.gov/reminder-important-mscan-chip-billing-changes-for-pharmacy-providers/) - Reminder: BIN/PCN changes for MSCAN and CHIP plans effective Oct. 1, 2018 The Mississippi Division of Medicaid (DOM) has required the MississippiCAN Coordinated Care Organizations (CCOs) to obtain unique Bank Identification (BIN), now known as Issuer Identification Number (IIN), and Processor Control Number (PCN) combinations. The purpose of this requirement is to enable pharmacy providers
- [Assisted Living (AL) Waiver Renewal approved by CMS](https://medicaid.ms.gov/assisted-living-al-waiver-renewal-approved-by-cms/) - The Centers for Medicare ad Medicaid Services (CMS) has approved the Assisted Living (AL) waiver effective October 1, 2018. For more information, please read the approved AL waiver.
- [Notice of Oral Proceeding](https://medicaid.ms.gov/notice-of-oral-proceeding-2/) - Notice of oral proceeding for Title 23: Medicaid, Part 209: Durable Medical Equipment, Medical Appliances and Medical Supplies, Chapter 1: Durable Medical Equipment and Medical Appliances, Rule 1.35: Oxygen and Oxygen Related Equipment. A filing was submitted to the Secretary of State on 9/21/2018 for an oral proceeding in response to public comments for filing system
- [SPA 18-0006 1915(i) Community Support Program approved by CMS](https://medicaid.ms.gov/spa-18-0006-1915i-community-support-program-approved-by-cms/) - State Plan Amendment (SPA) 18-0006 1915(i) Community Support Program (CSP) has been approved to renew the 1915(i) state plan services, due to expire October 31, 2018, to the Centers for Medicare and Medicaid (CMS) in compliance with 42 C.F.R. § 441.745, effective November 1, 2018. For more information, read the approved SPA pages.
- [SPA 18-0008 Rehabilitation Option requested to be withdrawn](https://medicaid.ms.gov/spa-18-0008-rehabilitation-option-requested-to-be-withdrawn/) - The Division of Medicaid has requested to formally withdraw MS State Plan Amendment (SPA) 18-0008 Rehabilitation Option. SPA 18-0008 had been submitted to allow the Division of Medicaid to refer to the Mississippi Department of Mental Health’s (DMH’s) Operational Standards for specific qualifications of practitioners/individuals and allow Autism Spectrum Disorder (ASD) services to be provided
- [Medicaid presents lowest budget request in six years](https://medicaid.ms.gov/medicaid-presents-lowest-budget-request-in-six-years/) - The Mississippi Division of Medicaid (DOM) executive director presented the budget request for fiscal year 2020 to the Joint Legislative Budget Committee on Sept. 17, 2018. The agency is requesting an appropriation of $954.5 million in state funds, which is $29 million less than the initial budget request for fiscal year 2019. The agency’s fiscal
- [SPA 18-0009 Indian Health Services Encounter Limit approved by CMS](https://medicaid.ms.gov/spa-18-0009-indian-health-services-encounter-limit-approved-by-cms/) - State Plan Amendment (SPA) 18-0009 Indian Health Services (IHS) Encounter Limit has been approved by the Centers for Medicare and Medicaid Services to allow the Division of Medicaid to reimburse IHS up to five (5) outpatient visits per beneficiary per calendar day for professional services at the most current applicable rates published in the Federal
- [Intellectual Disabilities/Developmental Disabilities (ID/DD) Waiver approved](https://medicaid.ms.gov/intellectual-disabilities-developmental-disabilities-id-dd-waiver-approved/) - The Centers for Medicare ad Medicaid Services (CMS) has approved the Intellectual Disabilities/Developmental Disabilities (ID/DD) waiver effective July 1, 2018.
- [Residential Life: Assisted Living Waiver serves unique role in the care of Mississippians](https://medicaid.ms.gov/residential-life-assisted-living-waiver-serves-unique-role-in-the-care-of-mississippians/) - Program supports independence within the community By Dee Dee Hill’s count, she has suffered 103 broken bones in her life. Born with brittle bone disease and struggling with long-time respiratory problems, Dee Dee says if she coughs too hard or rolls over in bed the wrong way, she’s likely to break something. She’s also had four heart
- [MS SPA 18-0008 Rehabilitation Option](https://medicaid.ms.gov/ms-spa-18-0008-rehabilitation-option-to-the-proposed-spa-page/) - State Plan Amendment (SPA) 18-0008 Rehabilitation Option is being submitted to allow the Division of Medicaid to refer to the Mississippi Department of Mental Health’s (DMH’s) Operational Standards for the specific qualifications of practitioners/individuals and allow Autism Spectrum Disorder (ASD) services to be provided and reimbursed through a Community Mental Health Center/Private Mental Health Center
- [MS SPA 18-0011 Physician Administered Drugs (PAD)](https://medicaid.ms.gov/ms-spa-18-0011-physician-administered-drugs-pad/) - State Plan Amendment (SPA) 18-0011 Physician Administered Drugs (PADs) is being submitted to allow the Division of Medicaid to reimburse for certain PADs under the pharmacy benefit to improve beneficiary access. These certain PADs are currently referred to as Clinician Administered Drug and Implantable Drug System Devices (CADDs) and include, but are not limited to,
- [SPA 18-0013 Rural Health Clinic (RHC) Physician Administered Drugs (PAD)](https://medicaid.ms.gov/spa-18-0013-rural-health-clinic-rhc-physician-administered-drugs-pad/) - State Plan Amendment (SPA) 18-0013 Rural Health Clinic (RHC) Physician Administered Drugs (PADs) is being submitted to allow the Division of Medicaid to allow RHC’s to receive reimbursement outside of the encounter rate for the administration, insertion and removal of physician administered drugs that are reimbursed through the pharmacy benefit, effective July 1, 2018. For
- [SPA 18-0012 Federally Qualified Health Center (FQHC) Physician Administered Drugs (PAD)](https://medicaid.ms.gov/spa-18-0012-federally-qualified-health-center-fqhc-physician-administered-drugs-pad/) - State Plan Amendment (SPA) 18-0012 Federally Qualified Health Center (FQHC) Physician Administered Drugs (PADs) is being submitted to allow the Division of Medicaid to reimburse FQHC’s outside of the encounter rate for the administration, insertion and removal of certain PADs that are reimbursed through the pharmacy benefit, effective July 1, 2018. For more information, read
- [SPA 18-0005 Long-Term Care (LTC) Updates #2](https://medicaid.ms.gov/spa-18-0005-long-term-care-ltc-updates-2/) - State Plan Amendment (SPA) 18-0005 Long-Term Care (LTC) Updates #2 has been submitted to allow the following, effective July 1, 2018: Revise the number of allowed therapeutic leave days for nursing facilities (NFs) and intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs) as required by Senate Bill 2836, remove stock transactions as a change
- [Public Hearing for SPA 18-0005 LTC Updates #2](https://medicaid.ms.gov/public-hearing-for-spa-18-0005-ltc-updates-2/) - The Mississippi Division of Medicaid will hold a public hearing on State Plan Amendment (SPA) 18-0005 Long-Term Care (LTC) Updates #2. The hearing will be held on Thursday, August 2, 2018 at 10:00 a.m. at the Woolfolk State Office Building, Room 145, 501 N. West St. Jackson, MS 39201. There will be an opportunity for
- [Non-Emergency Ambulance Transportation Q&A](https://medicaid.ms.gov/non-emergency-ambulance-transportation-qa/) - The removal of long-term care (LTC) residents from the Non-Emergency Transportation (NET) Broker program has been delayed until February 1, 2019. September 9, 2018, the removal of language allowing NET ambulance services provided to LTC residents to be billed directly to the Mississippi Division of Medicaid will be effective. For more information read the question
- [SPA 18-0010 Transportation submitted to CMS](https://medicaid.ms.gov/spa-18-0010-transportation/) - State Plan Amendment (SPA) 18-0010 Transportation is being submitted to update the reimbursement methodology for transportation services and place information regarding coverage and payment of transportation services on the appropriate pages, effective August 1, 2018. For more information, read the submitted pages.
- [SPA 17-0001 Home Health Services approved by CMS](https://medicaid.ms.gov/spa-17-0001-home-health-services-approved-by-cms/) - State Plan Amendment (SPA) 17-0001 Home Health Services is being submitted to require (1) a face-to-face visit with a physician or authorized non-physician practitioner prior to the initiation of home health visits or provision of durable medical equipment (DME) and appliances, (2) to require the provision of home health services in any setting in which
- [DME Provider Frequently Asked Questions](https://medicaid.ms.gov/dme-provider-frequently-asked-questions/) - On May 11, 2018, providers were given notice regarding reimbursement for medical supplies, equipment and appliances ordered by non-physician practitioners that takes effect September 1, 2018. For more information read DME Provider Frequently Asked Questions (FAQs).
- [Independent Living Waiver approved](https://medicaid.ms.gov/independent-living-waiver-approved/) - The Centers for Medicare ad Medicaid Services (CMS) has approved the Independent Living Waiver effective July 1, 2017.
- [Public Notice for SPA 18-0005 Long-Term Care (LTC) Updates](https://medicaid.ms.gov/public-notice-for-spa-18-0005-long-term-care-ltc-updates/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA) 18-0005 Long-Term Care (LTC) Updates #2. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2018,
- [Public Hearing for SPA 18-0010 Transportation](https://medicaid.ms.gov/notice-of-hearing-for-spa-18-0010-transportation/) - The Mississippi Division of Medicaid will hold a public hearing on State Plan Amendment (SPA) 18-0010 Transportation. The hearing will be held on Friday, August 3, 2018 at 10:00 a.m. at the Woolfolk State Office Building, Room 145, 501 N. West St. Jackson, MS 39201. There will be an opportunity for public comment at the
- [Public Notice for SPA 18-0010 Transportation](https://medicaid.ms.gov/public-notice-for-spa-18-0010-transportation/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA) 18-0010 Transportation. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective August 1, 2018, contingent upon approval from
- [Medicaid postpones implementation of NET reimbursement change till Feb. 1, 2019](https://medicaid.ms.gov/medicaid-postpones-implementation-of-net-reimbursement-change-till-feb-1-2019/) - The Mississippi Division of Medicaid (DOM) had recently proposed that beginning Aug. 1, 2018, long-term care facilities would be responsible for arranging and paying for non-emergency transportation (NET) services for their residents and list those costs on their cost reports for reimbursement. The implementation of this change has been postponed until Feb. 1, 2019, the
- [SPA 18-0007 OPPS Reimbursement submitted to CMS](https://medicaid.ms.gov/spa-18-0007-opps-reimbursement-submitted-to-cms/) - Mississippi State Plan Amendment (SPA) 18-0007 Outpatient Prospective Payment System (OPPS) Reimbursement has been submitted to allow the Division of Medicaid (DOM) to remove the five percent (5%) assessment of outpatient hospital services, clarify the Outpatient Prospective Payment System (OPPS) payment methodology, and add the reimbursement methodology for Long Acting Reversible Contraceptives (LARCs) effective July
- [Notice of Oral Proceeding](https://medicaid.ms.gov/notice-of-oral-proceeding/) - Notice of Oral Proceeding for Title 23, Part 201, Transportation, Chapter 1: Emergency Transportation, Rule 1.7: Ambulance Transport of Nursing Facility Residents by Ambulance; Chapter 2: Non-Emergency Transportation (NET)Broker Program, Rule 2.4: Transport of Nursing Facility Residents by NET. A filing was submitted to the Secretary of State on 7/18/2018 for an oral proceeding in
- [Public Notice for SPA 18-0004 APR-DRG Reimbursement](https://medicaid.ms.gov/public-notice-for-spa-18-0004-apr-drg-reimbursement/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA). The Division of Medicaid, in the Office of the Governor, is submitting SPA 18-0004 All Patient Refined Diagnosis Related Groups (APR-DRG) Reimbursement to update the hospital inpatient payment methodology with an effective date of
- [Implementation and Operation Services for the Mississippi Medicaid Enterprise Solution and Fiscal Agent Services: RFP #20131025](https://medicaid.ms.gov/implementation-and-operation-services-for-the-mississippi-medicaid-enterprise-solution-and-fiscal-agent-services-rfp-20131025/) - Implementation and Operation Services for the Mississippi Medicaid Enterprise Solution and Fiscal Agent Services – RFP #20131025 Responding Offerors The following Offerors have submitted proposals for MES RFP #20131025: HP Enterprise Services, Plano, TX Xerox State Healthcare, LLC, Atlanta, GA Appendix Documents Appendix A - Contract Template Appendix B - Proposal Exceptions Appendix C -
- [Non-emergency transportation IFB #20180511 proposal and award information](https://medicaid.ms.gov/non-emergency-transportation-ifb-20180511-proposal-and-award-information/) - The following Offerors submitted bids in response to IFB #20180511: LogistiCare Solutions, LLC, Atlanta, GA Medical Transportation Management, Inc., St. Louis, MO Southeasttrans, Inc., Atlanta, GA The following Offeror has been awarded the contract for IFB #20180511: Medical Transportation Management, Inc., St. Louis, MO Visit the Procurement webpage for more information.
- [Public Notice for SPA 18-0012 Federally Qualified Health Center (FQHC) Physician Administered Drugs](https://medicaid.ms.gov/public-notice-for-spa-18-0012-federally-qualified-health-center-fqhc-physician-administered-drugs/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA). The Division of Medicaid, in the Office of the Governor, is submitting SPA 18-0012 Federally Qualified Health Center (FQHC) Physician Administered Drugs. Effective July 1, 2018 and contingent upon approval from the Centers for
- [Public Notice for SPA 18-0013 Rural Health Clinic (RHC) Physician Administered Drugs](https://medicaid.ms.gov/public-notice-for-spa-18-0013-rural-health-clinic-rhc-physician-administered-drugs/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA). The Division of Medicaid, in the Office of the Governor, is submitting SPA 18-0013 Rural Health Clinic (RHC) Physician Administered Drugs. Effective July 1, 2018, and contingent upon approval from the Centers for Medicare
- [Public Notice for SPA 18-0011 Physician Administered Drugs](https://medicaid.ms.gov/public-notice-for-spa-18-0011-physician-administered-drugs/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA). The Division of Medicaid, in the Office of the Governor, is submitting SPA 18-0011 Physician Administered Drugs. Effective July 1, 2018, and contingent upon approval from the Centers for Medicare and Medicaid Services (CMS),
- [Public Notice for SPA 18-0007 Outpatient Prospective Payment System (OPPS) Reimbursement](https://medicaid.ms.gov/public-notice-for-spa-18-0007-outpatient-prospective-payment-system-opps-reimbursement/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA 18-0007) Outpatient Prospective Payment System (OPPS) Reimbursement. Effective July 1, 2018 and contingent upon approval from the Centers for Medicare and Medicaid Services (CMS), the Division of Medicaid will remove the five percent (5%)
- [Assisted Living Waiver Renewal Submitted to CMS](https://medicaid.ms.gov/assisted-living-waiver-renewal-submitted-to-cms/) - The Division of Medicaid has submitted to the Centers for Medicare and Medicaid Services (CMS) the following Intellectual Disabilities/Developmental Disabilities (ID/DD) Waiver renewal. For more information, read the proposed waiver pages. Posted June 28, 2018
- [Additional guidance regarding the ordering of medical equipment, supplies and appliances](https://medicaid.ms.gov/additional-guidance-regarding-the-ordering-of-medical-equipment-supplies-and-appliances/) - The Division of Medicaid shares the concerns of providers who believe the physician order requirement in 42 C.F.R. § 440.70 may pose an additional barrier to needed services and care. The agency is actively working with Centers for Medicare and Medicaid Services (CMS) and other stakeholders to address these concerns. According to written guidance, CMS
- [Public Notice for DOM's Managed Care Quality Strategy Report](https://medicaid.ms.gov/public-notice-for-doms-managed-care-strategy-quality-report/) - Pursuant to 42 C.F.R. Section 438.340(c), public notice is hereby given to the Division of Medicaid’s Managed Care Quality Strategy Report. A copy of the proposed Managed Care Quality Strategy Report will be available in each county health department office and in the Department of Human Services office in Issaquena County for review. A hard
- [SPA 18-0009 IHS Encounter Limits submitted to CMS](https://medicaid.ms.gov/spa-18-0009-ihs-encounter-limits-submitted-to-cms/) - Mississippi State Plan Amendment (SPA) 18-0009 Indian Health Services (IHS) Encounter Limit has been submitted to allow the Division of Medicaid to reimburse IHS up to five (5) outpatient visits per beneficiary per calendar day for professional services at the most current applicable rates published in the Federal Register or Federal Register Notices effective June
- [APR-DRG update informational webinars available](https://medicaid.ms.gov/apr-drg-update-informational-webinars-available/) - The Mississippi Division of Medicaid (DOM) is offering three APR-DRG update informational webinars. The sessions will show results from the previous year of the DRG payment method, outline the changes for Year 7, and provide billing and documentation tips. DOM strongly encourages each hospital to participate in one of the sessions. To register for one of
- [Public Notice for the HMW Post-Award Forum](https://medicaid.ms.gov/public-notice-for-the-hmw-post-award-forum/) - Pursuant to 42 C.F.R. Section 431.420(c), public notice is hereby given to the annual Post Award Forum on the Division of Medicaid’s Healthier Mississippi Waiver. The annual Post-Award Forum provides stakeholders and the general public the opportunity to provide meaningful comment on the progress of the Healthier Mississippi Waiver. The Healthier Mississippi Waiver operates under
- [Public Notice for the FPW Post-Award Forum](https://medicaid.ms.gov/public-notice-for-the-fpw-post-award-forum/) - Pursuant to 42 C.F.R. Section 431.420(c), a Post-Award Forum is required six months after the implementation of the Division of Medicaid’s Family Planning Waiver. This Post-Award Forum provides stakeholders the opportunity to provide meaningful comments on the progress of the Family Planning Waiver. The Family Planning Waiver operates under the authority of an 1115(a) waiver
- [ID/DD 1915(c) Waiver Renewal submitted to CMS](https://medicaid.ms.gov/public-notice-for-intellectual-disabilities-developmental-disabilities-id-dd-1915c-waiver-renewal/) - The Medicaid Home and Community-Based Services (HCBS) waiver program is authorized in §1915(c) of the Social Security Act. The program permits a State to furnish an array of home and community-based services that assist Medicaid beneficiaries to live in the community and avoid institutionalization. The State has broad discretion to design its waiver program to
- [Public Notice for the ID/DD Waiver Renewal](https://medicaid.ms.gov/public-notice-for-the-id-dd-waiver-renewal/) - Pursuant to 42 C.F.R. Section 441.304(e)-(f), public notice is hereby given to the submission of the Intellectual Disabilities/Developmental Disabilities (ID/DD) Waiver Renewal. The Division of Medicaid, in the Office of the Governor, will submit this proposed renewal to the Centers for Medicare and Medicaid Services (CMS) for the ID/DD Waiver effective July 1, 2018, contingent
- [Clarification: Physician visit and prescription drug limits to remain in place July 1, 2018](https://medicaid.ms.gov/clarification-physician-visit-and-prescription-drug-limits-to-remain-in-place-july-1-2018/) - During the 2018 session of the Mississippi Legislature, a number of amendments were made to the law governing the types of care and services reimbursed by the Mississippi Division of Medicaid (DOM). Senate Bill 2836 provided a variety of new flexibilities to DOM, including the removal of the statutory cap on physician visits per year
- [March of Dimes joins with Medicaid to reduce preterm births in Mississippi](https://medicaid.ms.gov/march-of-dimes-joins-with-medicaid-to-reduce-preterm-births-in-mississippi/) - Medicaid awarded grant for project targeting Clay County By promoting the use of progesterone and encouraging birth spacing among women with a history of prior preterm births, the Mississippi Division of Medicaid (DOM) and the March of Dimes hope to curtail the rate of preterm births in Mississippi. The March of Dimes awarded DOM a grant
- [Medicaid working to address changes to the ordering of medical equipment, supplies and appliances](https://medicaid.ms.gov/medicaid-working-to-address-changes-to-the-ordering-of-medical-equipment-supplies-and-appliances/) - The Centers for Medicare and Medicaid Services (CMS) has recently required that the Mississippi Division of Medicaid (DOM) update its 2006 state plan language to comport with 42 C.F.R. § 440.70, which explicitly permits only a physician to order medical equipment, supplies and appliances. In May, pursuant to the CMS communication, DOM announced that it
- [Medicaid partners with others to support recovery efforts](https://medicaid.ms.gov/medicaid-partners-with-others-to-support-recovery-efforts/) - Last weekend, southern regions of Mississippi suffered damage from severe weather and tornadoes, resulting in Gov. Phil Bryant declaring a state of emergency and President Donald Trump designating four counties federal disaster areas: Forrest, Lamar, Lauderdale and Perry counties. The Mississippi Emergency Management Agency (MEMA) is continually reporting recovery updates such as fatalities, injuries, home
- [Driven by results: Coordinated care to reach new milestone](https://medicaid.ms.gov/driven-by-results-coordinated-care-to-reach-new-milestone/) - The 2017 legislative session is drawing to a close, and coordinated care has been one of the many budgetary factors lawmakers looked at closely as they consider the funding needs of the Mississippi Division of Medicaid (DOM). DOM’s coordinated care program, the Mississippi Coordinated Access Network (MississippiCAN), has grown to play an increasingly important role
- [DOM fosters strong ties with Choctaw Health Center](https://medicaid.ms.gov/dom-fosters-strong-ties-with-choctaw-health-center/) - March 8, 2015, was a momentous occasion for the Pearl River Community of the Mississippi Band of Choctaw Indians (MBCI). On an unusually frigid spring day filled with freezing rain, administrators and health-care professionals moved into the community’s brand new, 180,000 square-foot Choctaw Health Center. Two years later, that health center represents the heart of
- [Clarification: Mississippi Division of Medicaid transparent with information](https://medicaid.ms.gov/clarification-mississippi-division-of-medicaid-transparent-with-information/) - The Mississippi Division of Medicaid (DOM) routinely submits detailed travel information to the Department of Finance and Administration (DFA) for processing and makes every effort to fulfill Gov. Phil Bryant’s commitment to transparency in government spending. Transparency Mississippi does not accurately reflect the amount of travel documentation DOM submits to DFA. Neither Executive Director David
- [Medicaid explains the MississippiCAN procurement process and PSCRB review](https://medicaid.ms.gov/medicaid-explains-the-mississippican-procurement-process-and-pscrb-review/) - In February of 2017, the Mississippi Division of Medicaid (DOM) issued a request for proposals (RFP) to re-procure contracts for the coordinated care program, MississippiCAN. After conducting a procurement process, which included consensus scoring and oral presentations, three contracts were awarded on June 15. Unfortunately, there has been a lot of confusion and misinformation surrounding
- [Medicaid recovers $8.6 million in fiscal year 2017](https://medicaid.ms.gov/medicaid-recovers-8-6-million-in-fiscal-year-2017/) - For fiscal year 2017, the Mississippi Division of Medicaid (DOM) recovered in excess of $8.6 million through various audits of medical claims paid to health-care providers. Recouping funds can result from a range of factors that involve the payment or responsibilities of providers or beneficiaries, or even outright fraud, such as billing for health services
- [Mississippi Division of Medicaid responds to MississippiCAN contract protests](https://medicaid.ms.gov/mississippi-division-of-medicaid-responds-to-mississippican-contract-protests/) - The Mississippi Division of Medicaid (DOM) has issued its final agency decisions regarding the protests of the MississippiCAN contracts. In February of 2017, DOM announced a request for proposals (RFP) to re-procure MississippiCAN contracts for the coordinated care program. Seven companies submitted responses. On June 15, after a thorough procurement process, the agency awarded contracts
- [MississippiCAN contracts move forward after PSCRB meeting](https://medicaid.ms.gov/mississippican-contracts-move-forward-after-pscrb-meeting/) - On Sept. 19, 2017, the Personal Service Contract Review Board (PSCRB) staff recommended approval of the MississippiCAN contracts during their regularly scheduled meeting. The PSCRB did not take action on the contracts, nor did they object to them, and as a result the statute, Mississippi Code Section 25-9-120 (4), provides that the contracts "shall be
- [Mississippi Division of Medicaid Exchanges Clinical Data in Real-Time with Hattiesburg Clinic](https://medicaid.ms.gov/mississippi-division-of-medicaid-exchanges-clinical-data-in-real-time-with-hattiesburg-clinic/) - The second data exchange connection in the U.S. aims to improve care for Medicaid patients Jackson, Miss. (November 14, 2017) – The Mississippi Division of Medicaid (DOM) has worked with Hattiesburg Clinic to establish an automated system for sharing clinical data in real time, equipping clinicians with enhanced medical-history information about their Medicaid patients within
- [Public Notice for SPA 18-0009 Indian Health Services Encounter Limit](https://medicaid.ms.gov/public-notice-for-spa-18-0009-indian-health-services-encounter-limit/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of State Plan Amendment (SPA) 18-0009 Indian Health Services (IHS) Encounter Limit. The Division of Medicaid, in the Office of the Governor, will submit this proposed SPA to the Centers for Medicare and Medicaid Services (CMS) effective June 1, 2018, contingent
- [Medicaid pharmacy program saves $4.6 million in first year](https://medicaid.ms.gov/medicaid-pharmacy-program-saves-4-6-million-in-first-year/) - In its first year of implementation, a new pharmacy program at the Mississippi Division of Medicaid (DOM) aimed at ensuring the effective use of complex, expensive medications has already prevented $4.6 million in unnecessary spending. DOM launched the Complex Pharmacy Care Program (CPCP) in October of 2016, a concept that devotes a Mississippi-licensed pharmacist to
- [Public Notice for the Assisted Living (AL) Waiver Renewal](https://medicaid.ms.gov/public-notice-for-the-assisted-living-al-waiver-renewal/) - Pursuant to 42 C.F.R. Section 441.304(f), public notice is hereby given to the submission of a Medicaid Assisted Living (AL) Waiver Renewal. The Division of Medicaid, in the Office of the Governor, will submit this proposed renewal to the Centers for Medicare and Medicaid Services (CMS) for the AL Waiver effective October 1, 2018. For
- [Qualified Providers need to attest/re-attest to receive increased primary care services payments](https://medicaid.ms.gov/qualified-providers-need-to-attest-re-attest-to-receive-increased-primary-care-services-payments/) - Pursuant to Miss. Code Ann. §§ 43-13-117, 43-13-121, the Mississippi Division of Medicaid (DOM) was granted the authority to continue reimbursing eligible providers at 100 percent (100%) of the Medicare Physician Fee Schedule for certain primary care Evaluation and Management (E&M) and Vaccine Administration codes. Effective July 1, 2018, reimbursement of certain primary care services
- [Attention providers: Medicaid only covers medical supplies, equipment ordered by a physician](https://medicaid.ms.gov/attention-providers-medical-supplies-equipment-and-appliances-only-covered-when-ordered-by-a-physician/) - In accordance with 42 C.F.R. § 440.70, only medical supplies, equipment and appliances ordered by a physician are covered and reimbursed under the Medicaid program. As a result of discussions with the Centers for Medicare and Medicaid Services (CMS) regarding proposed State Plan Amendment (SPA) 17-0001 Home Health Services, the Division of Medicaid was instructed
- [SPA 18-0006 1915(i) Community Support Program (CSP) submitted to CMS](https://medicaid.ms.gov/spa-18-0006-1915i-community-support-program-csp-submitted-to-cms/) - State Plan Amendment (SPA) 18-0006 1915(i) Community Support Program (CSP) is being submitted to request renewal of the 1915(i) state plan services, due to expire October 31, 2018, to the Centers for Medicare and Medicaid (CMS) in compliance with 42 C.F.R. § 441.745, effective November 1, 2018. For more information, read the draft SPA pages.
- [Public Notice for SPA 18-0006 1915(i) Community Support Program (CSP)](https://medicaid.ms.gov/public-notice-for-spa-18-0006-1915i-community-support-program-csp/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of State Plan Amendment (SPA 18-0006) 1915(i) Community Support Program (CSP) renewal. The Division of Medicaid, in the Office of the Governor, will submit this proposed renewal to the Centers for Medicare and Medicaid Services (CMS) for the 1915(i) Community Support
- [SPA 18-0003 Medicaid Administration submitted to CMS](https://medicaid.ms.gov/spa-18-0003-medicaid-administration-submitted-to-cms/) - State Plan Amendment (SPA) 18-0003 Medicaid Administration is being submitted to allow the Mississippi Division of Medicaid (DOM), the single state agency, to update the organizational structure and administration of the Medicaid program effective January 1, 2018. Pursuant to 42 C.F.R. § 431.10, 431.11, 431.50 and 42 CFR § 430.12(b), The Mississippi Division of Medicaid
- [72-hour emergency Rx supply billing directions](https://medicaid.ms.gov/72-hour-emergency-rx-supply-billing-directions/) - Emergency Supply Procedures Payer - MS Medicaid: Pharmacy fee for service claims only. 72 hour supply is to be used any time a PA is not available and when Rx must be filled. Pharmacist should use professional judgment regarding whether or not there is an immediate need every time 72 hour option is used. Contact: Change
- [Civil Money Penalty Grant applications being accepted](https://medicaid.ms.gov/civil-money-penalty-grant-applications-being-accepted/) - Nursing home providers and stakeholders are encouraged to submit Civil Money Penalty (CMP) grant applications for the development and implementation of quality improvement initiatives that directly or indirectly benefit nursing facility residents. Enrollment Details Effective June 1, 2016, the Division of Medicaid (DOM) will accept CMP Grant Applications. There is no longer a deadline to
- [SPA 18-0001 LTC Updates submitted to CMS](https://medicaid.ms.gov/spa-18-0001-ltc-updates-submitted-to-cms/) - State Plan Amendment (SPA) 18-0001 Long Term Care (LTC) Updates is being submitted by the Division of Medicaid (DOM) to: Modify the reimbursement methodology by adding respiratory therapy expenses as an allowable cost pursuant to 42 C.F.R. § 483.65. Clarify DOM's intent to exclude reimbursement of hospital taxes through long-term care facility (LTC) rates. Clarify the
- [SPA 18-0002 Physician UPL submitted to CMS](https://medicaid.ms.gov/spa-18-0002-physician-upl-submitted-to-cms/) - State Plan Amendment (SPA) 18-0002 Physician Upper Payment Limit (UPL) is being submitted to allow the Division of Medicaid to update the initial Medicare equivalent of the average commercial rate (ACR) ratio, effective January 1, 2018. Pursuant to the Social Security Act § 1902(a)(30) and 42 CFR §§ 447.10, 447.204 and Miss. Code Ann. §
- [MSCAN Pharmacy reimbursement errors: Important information for pharmacy providers](https://medicaid.ms.gov/mscan-pharmacy-reimbursement-errors-important-information-for-pharmacy-providers/) - The Mississippi Coordinated Access Network (MSCAN) Coordinated Care Organizations (CCOs) must reimburse network providers in accordance with Division of Medicaid (DOM) policies. The DOM Office of Pharmacy has received inquiries from pharmacy providers concerning MSCAN reimbursement and remittance advice statements. The Magnolia Health Plan’s and UnitedHealthcare Community Plan’s Pharmacy Benefit Managers (PBMs), Envolve Pharmacy Solutions
- [Public Notice for SPA 18-0001 Long-Term Care Updates](https://medicaid.ms.gov/public-notice-for-spa-18-0001-long-term-care-updates/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA). Effective January 1, 2018, the Division of Medicaid, in the Office of the Governor, is submitting SPA 18-0001 Long-Term Care (LTC) Updates, Transmittal #18-0001. Public Comments on SPA 18-0001 Long-Term Care (LTC) Updates For
- [CMS approves Mississippi Medicaid proposal for MHAP hospital payments](https://medicaid.ms.gov/cms-approves-mississippi-medicaid-proposal-for-mhap-hospital-payments/) - The Mississippi Division of Medicaid (DOM) has received approval from the Centers for Medicare and Medicaid Services (CMS) for the first year of a required ten-year transitional plan for Mississippi Hospital Access Program (MHAP) payments. This approval ensures MHAP payments to hospitals will continue uninterrupted through fiscal year (FY) 2018 as DOM works with stakeholders
- [MHAP Preprint submitted to CMS](https://medicaid.ms.gov/mhap-preprint-submitted-to-cms/) - On Oct. 31, the Mississippi Division of Medicaid (DOM) submitted a Section 438.6(c) Preprint document to the Centers for Medicare and Medicaid (CMS). The preprint proposal will allow the continuation of MHAP payments to hospitals through the end of fiscal year (FY) 2018. The proposal is a necessary first step to ensure compliance with recent
- [CHIP SPA #10 submitted to CMS](https://medicaid.ms.gov/chip-spa-10-submitted-to-cms/) - Children's Health Insurance Program (CHIP) State Plan Amendment (SPA) #10 is being submitted to expand vision services to low-income children throughout the state by allowing the Division of Medicaid (DOM) to contract with a non-profit CHIP participating provider to offer these services on-site at certain Mississippi schools, effective January 1, 2018. Read CHIP SPA #10 for more
- [Family Planning Waiver demonstration extension request approved by CMS](https://medicaid.ms.gov/family-planning-waiver-demonstration-extension-request-approved-by-cms/) - The Family Planning Waiver demonstration extension request has been approved by the Centers for Medicare and Medicaid (CMS) effective January 1, 2018 through December 31, 2027. Please review the Standard Terms and Conditions (STC) for more information.
- [Family Planning Waiver demonstration extension request](https://medicaid.ms.gov/family-planning-waiver-demonstration-extension-request/) - Pursuant to 42 C.F.R. Section 431.408, public notice is hereby given to the submission of a Medicaid proposed demonstration renewal request of the Family Planning Waiver (FPW), effective January 1, 2018 through December 31, 2022. The current, extension of the Mississippi Family Planning Waiver 1115 Research and Demonstration Waiver 11-W-00157/4 will expire on December 31,
- [Pharmacists required to provide license and permit  renewal information](https://medicaid.ms.gov/pharmacists-required-to-provide-license-and-permit-renewal-information/) - The Mississippi Division of Medicaid (DOM) requires enrolled providers to be in good standing with all applicable regulatory authorities. Pharmacists are required to update their provider information with license renewal information, received from the Mississippi Board of Pharmacy, with the DOM fiscal agent, Conduent. Many Mississippi Board of Pharmacy permits are set to expire on
- [Cost Effectiveness Study Report for Mississippi Coordinated Access Network (MississippiCAN)](https://medicaid.ms.gov/cost-effectiveness-study-report-for-mississippi-coordinated-access-network-mississippican/) - The Mississippi Division of Medicaid (DOM) engaged Myers and Stauffer LC (Myers and Stauffer) to coordinate a cost effectiveness study of the Mississippi Medicaid managed care program known as MississippiCAN. DOM used existing agency contractors to prepare various components of the study. For more information, please view the entire report.
- [Public Notice for SPA 18-0002 Physician Upper Payment Limit](https://medicaid.ms.gov/public-notice-for-spa-18-0002-physician-upper-payment-limit/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA). The Division of Medicaid, in the Office of the Governor, is submitting SPA 18-0002 Physician Upper Payment Limit (UPL). Effective January 1, 2018 and contingent upon approval from the Centers for Medicare and Medicaid
- [Changes to Preferred Drug List to take effect Jan. 1, 2018](https://medicaid.ms.gov/changes-to-preferred-drug-list-to-take-effect-jan-1-2018/) - The Mississippi Division of Medicaid’s (DOM) Universal Preferred Drug List (PDL) underwent an annual review on Nov. 2, 2017. The revisions brought about by this annual review will become effective on Jan. 1, 2018. The Universal PDL is effective for Medicaid fee-for-service, MississippiCAN and Children’s Health Insurance Program (CHIP) beneficiaries. Medicaid enrolled providers and need
- [SPA 17-0015 DME and Medical Supply Reimbursement submitted to CMS](https://medicaid.ms.gov/spa-17-0015-dme-and-medical-supply-reimbursement-submitted-to-cms/) - State Plan Amendment (SPA) 17-0015 has been submitted to allow the Division of Medicaid to revise the payment methodology for DME and medical supplies effective November 9, 2017. SPA 17-0015 Durable Medical Equipment (DME) and Medical Supply Reimbursement proposed pages
- [MS Medicaid Workforce Training Initiative 1115 Waiver Demonstration Application submitted to CMS](https://medicaid.ms.gov/ms-medicaid-workforce-training-initiative-1115-waiver-demonstration-application-submitted-to-cms/) - MS Medicaid Workforce Training Initiative 1115 Waiver Demonstration Application has been submitted to the Centers for Medicare and Medicaid Services (CMS) on December 14, 2017. This proposed 1115 waiver demonstration will allow the Division of Medicaid to identify individuals eligible for workforce training opportunities and assist them with accessing workforce training, and garner enhanced federal
- [Medicaid Workforce Training Initiative 1115 Demonstration Waiver Application](https://medicaid.ms.gov/medicaid-workforce-training-initiative-1115-demonstration-waiver-application/) - Pursuant to 42 C.F.R. Section 431.408, public notice is hereby given to the submission of a application for The Medicaid Workforce Training Initiative 1115 Demonstration Waiver. Full Public Notice for the Medicaid Workforce Training Initiative 1115 Demonstration Waiver Medicaid Workforce Training Initiative 1115 Demonstration Waiver Application - Revised Nov. 9, 2017 Medicaid Workforce Training Initiative 1115
- [Program Concept Paper: Mississippi Transitional Payments, Directed Payments, and the Quality Incentive Payment Program](https://medicaid.ms.gov/program-concept-paper-mississippi-transitional-payments-directed-payments-and-the-quality-incentive-payment-program/) - On Oct. 31, the Mississippi Division of Medicaid (DOM) submitted a proposal for the Mississippi Hospital Access Program (MHAP) to the Centers for Medicare and Medicaid (CMS). This program concept proposal details DOM’s plan to transition MHAP payments to hospitals from transitional (or pass-through) payments to directed payments by phasing out the transitional payments. DOM
- [EPSDT Bright Futures Fourth Edition Updates](https://medicaid.ms.gov/epsdt-bright-futures-fourth-edition-updates/) - The American Academy of Pediatrics (AAP) recently released Bright Futures Guidelines for Health Supervision of Infants, Children and Adolescents, 4th, Edition. A summary of the changes can be found on the Bright Futures website. In the coming month, effective Aug. 1, 2017, to comply with Bright Futures recommendations the Mississippi Division of Medicaid (DOM) will
- [SPA 17-0004 Tribal Notification Requirements submitted to CMS](https://medicaid.ms.gov/spa-17-0004-tribal-notification-requirements-submitted-to-cms/) - State Plan Amendment (SPA) 17-0004 is being submitted to allow the Division of Medicaid (DOM) to remove specific staff names of Mississippi Division of Medicaid and Mississippi Band of Choctaw Indians personnel and to revise the notification time frame to thirty (30) days for State Plan Amendments effective October 1, 2017. For more information, view
- [Public Notice for SPA 17-0015 Durable Medical Equipment and Medical Supply Reimbursement](https://medicaid.ms.gov/public-notice-for-spa-17-0015-durable-medical-equipment-and-medical-supply-reimbursement/) - State Plan Amendment (SPA) 17-0015 Durable Medical Equipment (DME) and Medical Supply Reimbursement is being submitted to allow the Division of Medicaid to revise the payment methodology for DME and medical supplies effective November 9, 2017. Learn more by reading the public notice and draft pages, SPA 17-0015 DME and Medical Supply Reimbursement. Public Comments
- [Healthier MS Waiver Renewal Application submission](https://medicaid.ms.gov/healthier-ms-waiver-renewal-application-submission/) - The Division of Medicaid submitted to the Centers for Medicare and Medicaid Services (CMS) the Healthier Mississippi Waiver Renewal Application on September 28, 2017.
- [The Centers for Medicare and Medicaid Services awards grant to improve maternal and infant health outcomes](https://medicaid.ms.gov/the-centers-for-medicare-and-medicaid-services-awards-grant-to-improve-maternal-and-infant-health-outcomes/) - On Sept. 10, the Mississippi Division of Medicaid (DOM) was one of 13 states and one U.S. territory awarded a four-year grant to improve maternal and infant health outcomes in Medicaid and Children’s Health Insurance Program (CHIP) populations from the Centers for Medicare and Medicaid Services (CMS). The Maternal and Infant Health Initiative is designed
- [Federal upper limits impact pharmacy reimbursement](https://medicaid.ms.gov/federal-upper-limits-impact-pharmacy-reimbursement/) - In accordance with the Centers for Medicare and Medicaid Services (CMS) Final Rule, implemented at 42 CFR §447.514, the April 2016 revised federal upper limit (FUL) prices will be used in current pharmacy reimbursement methodology beginning on April 11, 2016. Find more information about the FUL final rule on the CMS website.
- [The Centers for Medicare and Medicaid Services establishes new procedure-to-procedure associated modifiers](https://medicaid.ms.gov/the-centers-for-medicare-and-medicaid-services-establishes-new-procedure-to-procedure-associated-modifiers/) - The Centers for Medicare and Medicaid Services establishes new procedure-to-procedure associated modifiers Four new HCPCS modifiers are being established for claims with dates of service on or after Jan. 1, 2015. They are: XE Separate encounter: a service that is distinct because it occurred during a separate encounter XP Separate practitioner: a service that is
- [1915(c) and 1915(i) Home and Community-Based (HCB) Setting Transition Plan Summary and Timeline](https://medicaid.ms.gov/1915c-and-1915i-home-and-community-based-hcb-setting-transition-plan-summary-and-timeline/) - 1915(c) and 1915(i) Home and Community-Based (HCB) Setting Transition Plan Summary and Timeline On Jan. 16, 2014, the Centers for Medicare and Medicaid Services (CMS) issued a final rule, effective March 17, 2014, which amends the requirements for qualities of home and community-based (HCB) settings. These requirements reflect CMS’s intent that individuals receive services and supports
- [1915(c) and 1915(i) Home and Community-Based (HCB) Setting Transition Plan and Timeline](https://medicaid.ms.gov/1915c-and-1915i-home-and-community-based-hcb-setting-transition-plan-and-timeline/) - 1915(c) and 1915(i) Home and Community-Based (HCB) Setting Transition Plan and Timeline Background On Jan. 16, 2014, the Centers for Medicare and Medicaid Services (CMS) issued a final rule, effective March 17, 2014, which amends the requirements for qualities of home and community-based (HCB) settings. These requirements reflect CMS’s intent that individuals receive services and
- [Extension of deadline to submit EPSDT Provider Agreement](https://medicaid.ms.gov/extension-of-deadline-to-submit-epsdt-provider-agreement/) - Effective November 1, 2015, Mississippi Division of Medicaid (DOM) received Centers for Medicare and Medicaid Services (CMS) approval of State Plan Amendment (SPA) 15-017 Early and Periodic Screening, Diagnosis and Treatment (EPSDT). SPA 15-017 requires DOM EPDST providers adhere to the American Academy of Pediatrics Bright Futures periodicity schedule for physical, mental, psychosocial and/or behavioral
- [1915(c) and 1915(i) Home and Community-Based (HCB) Setting Transition Plan and Timeline](https://medicaid.ms.gov/1915c-and-1915i-home-and-community-based-hcb-setting-transition-plan-and-timeline-2/) - On Jan. 16, 2014, the Centers for Medicare and Medicaid Services (CMS) issued a final rule, effective March 17, 2014, which amends the requirements for qualities of home and community-based (HCB) settings. These requirements reflect CMS’s intent that individuals receive services and supports in settings that are integrated in and support full access to the
- [Pharmacy reimbursement: Revised reprocessing schedule](https://medicaid.ms.gov/pharmacy-reimbursement-revised-reprocessing-schedule/) - The Mississippi Division of Medicaid (DOM) has heard pharmacy providers’ concerns and adjusted the claims reprocessing schedule originally noted in the Late Breaking News, sent on Aug. 3, 2017, titled “Pharmacy Reimbursement/Reprocessing”. The dates noted in the schedule reflect that reprocessing will be performed over 10 months, rather than five months as originally scheduled. Automatic pharmacy
- [Medicaid’s coordinated care program continues to evolve and expand](https://medicaid.ms.gov/medicaids-coordinated-care-program-continues-to-evolve-and-expand/) - The Mississippi Division of Medicaid’s (DOM) coordinated care program, MississippiCAN, is now six years old and continues to grow and develop. Integrating a coordinated care model within Medicaid agencies has been a rising trend across the country for at least 20 years, and it is an approach supported by the Centers for Medicare and Medicaid
- [Elderly and Disabled Waiver approved](https://medicaid.ms.gov/elderly-and-disabled-waiver-approved/) - The Centers for Medicare ad Medicaid Services (CMS) has approved the Elderly and Disabled Waiver effective July 1, 2017.
- [NET End Stage Renal Disease RFP #20170512-1 proposal and award information](https://medicaid.ms.gov/net-end-stage-renal-disease-rfp-20170512-1-proposal-and-award-information/) - The following Offeror’s submitted proposals in response to RFP #20170512-1: Access2Care, LLC, Greenwood Village, CO. LeFleur Transportation, Ridgeland, MS. LogistiCare Solutions, LLC, Atlanta, GA. Medical Transportation Management, Inc., Lake St. Louis, MO. Southeastrans, Inc., Atlanta, GA. Veyo, San Diego, CA. The following Offeror has been awarded the contract for RFP #20170512-1: LeFleur Transportation, Ridgeland, MS.
- [NET RFP #20170512 proposal and award information](https://medicaid.ms.gov/net-rfp-20170512-proposal-and-award-information/) - The following Offeror’s submitted proposals in response to RFP #20170512: Access2Care, LLC, Greenwood Village, CO. LeFleur Transportation, Ridgeland, MS. LogistiCare Solutions, LLC, Atlanta, GA. Medical Transportation Management, Inc., Lake St. Louis, MO. Southeastrans, Inc., Atlanta, GA. Veyo, San Diego, CA. The following Offeror has been awarded the contract for RFP #20170512: LeFleur Transportation, Ridgeland, MS.
- [Pharmacy reimbursement changes and SPA 17-0002 approval](https://medicaid.ms.gov/pharmacy-reimbursement-changes/) - A new pharmacy reimbursement methodology for the Mississippi Division of Medicaid (DOM) impacts both fee-for-service and MississippiCAN pharmacy claims. On Feb. 1, 2016, the Centers for Medicare and Medicaid Services (CMS) published 42 CFR, Part 447: Medicaid Program Covered Outpatient Drugs with final comments (CMS-2345-FC). This rule addresses regulations that pertain to reimbursement for covered
- [Qualified providers may receive increased primary care services payments](https://medicaid.ms.gov/qualified-providers-may-receive-increased-primary-care-services-payments/) - Qualified providers may receive increased primary care services payments During the 2014 legislative session, the Mississippi Division of Medicaid (DOM) was granted the authority to continue reimbursing eligible providers, as determined by the Patient Protection and Affordable Care Act (ACA), for certain primary care services at 100 percent of the rate established under Medicare. DOM submitted
- [Qualified Obstetric/Gynecological Providers need to self-attest to receive increased primary care services payments](https://medicaid.ms.gov/qualified-obstetricgynecological-providers-need-to-self-attest-to-receive-increased-primary-care-services-payments/) - Pursuant to Miss. Code Ann. §§ 43-13-117, 43-13-121, the Mississippi Division of Medicaid (DOM) was granted authority to continue reimbursing eligible providers, as determined by the Patient Protection and Affordable Care Act (PPACA), for an increased payment for certain primary care Evaluation and Management (E&M) and Vaccine Administration codes. Pursuant to HB 1560, effective July
- [Qualified providers need to self-attest to receive increased primary care services payments](https://medicaid.ms.gov/qualified-providers-need-to-self-attest-to-receive-increased-primary-care-services-payments-2/) - Pursuant to Miss. Code Ann. §§ 43-13-117, 43-13-121, the Mississippi Division of Medicaid (DOM) was granted authority to continue reimbursing eligible providers, as determined by the Patient Protection and Affordable Care Act (PPACA), for an increased payment for certain primary care Evaluation and Management (E&M) and Vaccine Administration codes. DOM is extending the deadline for
- [MississippiCAN provider workshops](https://medicaid.ms.gov/mississippican-provider-workshops/) - The Division of Medicaid Coordinated Care, in conjunction with Magnolia Health Plan and UnitedHealthcare Community Plan, will conduct MississippiCAN Provider Workshops July 8 - July 24, 2014 at locations throughout the state. Office directors, office managers, coders and billing staff are encouraged to attend. The following topics will be covered: MississippiCAN Changes Eligibility Verification Provider
- [Qualified providers need to self-attest to receive increased primary care services payments](https://medicaid.ms.gov/qualified-providers-need-to-self-attest-to-receive-increased-primary-care-services-payments/) - Qualified providers need to self-attest to receive increased primary care services payments During the 2014 legislative session, the Mississippi Division of Medicaid (DOM) was granted the authority to continue reimbursing eligible providers, as determined by the Patient Protection and Affordable Care Act (ACA), for certain primary care services at 100 percent of the rate established
- [2015 Provider workshops for MississippiCAN and CHIP scheduled](https://medicaid.ms.gov/2015-provider-workshops-for-mississippican-and-chip-scheduled/) - 2015 Provider workshops for MississippiCAN and CHIP scheduled The Division of Medicaid Office of Coordinated Care, in conjunction with Magnolia Health and UnitedHealthcare Community Plan, are conducting MississippiCAN Provider Workshops scheduled for June 8 through August 4 at locations throughout the state. Please view the agenda, schedule and locations below. Office directors, office managers, coders and
- [Eligible OB/GYNs must self-attest to receive enhanced payments](https://medicaid.ms.gov/eligible-obgyns-must-self-attest-to-receive-enhanced-payments/) - Obstetricians and gynecologists (OB/GYNs) enrolled as Mississippi Medicaid providers are eligible for higher payments for certain services. In order to receive those enhanced payments they must complete the required form attesting that they qualify as specialists in those fields. The Mississippi Division of Medicaid (DOM) will continue to reimburse at 100 percent of the Medicare
- [2017 Provider workshops for MississippiCAN and CHIP scheduled](https://medicaid.ms.gov/2017-provider-workshops-for-mississippican-and-chip-scheduled/) - The Mississippi Division of Medicaid Office of Coordinated Care, in conjunction with Magnolia Health and UnitedHealthcare Community Plan, will conduct Provider Workshops from May 31 through September 6, 2017 at locations throughout the state. Office directors, office managers, coders and billing staff are encouraged to attend. Please bring copies of claims or any issues your
- [Healthier MS Waiver demonstration extension request](https://medicaid.ms.gov/healthier-ms-waiver-demonstration-extension-request/) - Pursuant to 42 C.F.R. Section 431.408, public notice is hereby given to the submission of a Medicaid proposed demonstration renewal request of the Healthier Mississippi Waiver (HMW), effective October 1, 2018, through September 30, 2023. The Division of Medicaid is requesting no changes with this renewal request. HMW has operated since 2006. The current temporary
- [Update for Pharmacy Reimbursement SPA 17-0002](https://medicaid.ms.gov/update-for-pharmacy-reimbursement-spa-17-0002/) - The Mississippi Division of Medicaid (DOM) submitted State Plan Amendment (SPA) 17-0002 Pharmacy Reimbursement to the Centers for Medicare and Medicaid Services (CMS) on March 15, 2017. On June 1, 2017, DOM received a request for additional information (RAI) letter from CMS for SPA 17-0002. DOM provided a formal response to the RAI letter on
- [Medicaid update for 340B pharmacy providers](https://medicaid.ms.gov/medicaid-update-for-340b-pharmacy-providers/) - The Mississippi Division of Medicaid (DOM) is further delaying 340B billing policy implementation pending Centers for Medicare and Medicaid Services (CMS) approval of State Plan Amendment (SPA) 17-0002. DOM will notify providers of the implementation date following CMS approval. Providers should continue preparing for implementation. DOM plans to host an informational stakeholder call in the
- [Public notice for SPA 17-0003 Screening, Brief Intervention, and Referral to Treatment (SBIRT) Services](https://medicaid.ms.gov/public-notice-for-spa-17-0003-screening-brief-intervention-and-referral-to-treatment-sbirt-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA). The Division of Medicaid, in the Office of the Governor, is submitting SPA 17-0003 Screening, Brief Intervention, and Referral to Treatment (SBIRT) Services. Effective July 1, 2017 and contingent upon approval from the Centers
- [MississippiCAN RFP #20170203 proposal and award information](https://medicaid.ms.gov/mississippican-rfp-20170203-proposal-and-award-information/) - The following Offerors submitted proposals in response to RFP #20170203: Amerigroup Mississippi, Inc., Virginia Beach, VA Magnolia Health, Jackson, MS MississippiTrue, Jackson, MS Molina Healthcare of Mississippi, Inc., Long Beach, CA Trusted Health Plan, Inc., Washington D.C. UnitedHealthcare of Mississippi, Inc., Ridgeland, MS WellCare of Mississippi, Inc., Tampa, FL The following Offerors have been awarded
- [Healthier MS Waiver Annual Post-Award Forum](https://medicaid.ms.gov/healthier-ms-waiver-post-award-forum/) - Pursuant to 42 C.F.R. Section 431.420(c), public notice is hereby given to the annual Post-Award Forum on the Division of Medicaid’s Healthier Mississippi Waiver. The annual Post-Award Forum provides stakeholders and the general public the opportunity to provide meaningful comment on the progress of the Healthier Mississippi Waiver. The Healthier Mississippi Waiver operates under the
- [Family Planning Waiver Annual Post-Award Forum](https://medicaid.ms.gov/family-planning-waiver-annual-post-award-forum/) - Pursuant to 42 C.F.R. Section 431.420(c), public notice is hereby given to the annual Post-Award Forum on the Division of Medicaid’s Family Planning Waiver. The annual Post-Award Forum provides stakeholders and the general public the opportunity to provide meaningful comment on the progress of the Family Planning Waiver. The Family Planning Waiver operates under the
- [Notice for 340B pharmacy providers](https://medicaid.ms.gov/notice-for-340b-pharmacy-providers/) - The Centers for Medicare and Medicaid Services (CMS) requires the Mississippi Division of Medicaid (DOM) to define its policies and oversight activities related to 340B purchased drugs as outlined in CMS state release No. 161, dated Oct. 26, 2012. In February 2017, letters were mailed to all Medicaid providers identified as 340B covered entities. These
- [Initial Approval Granted for the 1915(c) and 1915(i) Home and Community-Based (HCB) Setting Transition Plan](https://medicaid.ms.gov/initial-approval-granted-for-the-1915c-and-1915i-home-and-community-based-hcb-setting-transition-plan/) - The Centers for Medicare and Medicaid Services (CMS) granted the Division of Medicaid initial approval of its Statewide Transition Plan (STP) on May 25, 2017, to bring settings into compliance with the federal home and community­ based services (HCBS) regulations found at 42 C.F.R. §§441.30l(c)(4)(5) and Section 441.710(a)(l )(2). Initial approval was granted because DOM
- [Independent Living Waiver submitted to CMS](https://medicaid.ms.gov/independent-living-waiver-approved-by-cms/) - The Division of Medicaid submitted to the Centers for Medicare and Medicaid Services (CMS) the Independent Living Waiver Renewal and Application on May 19, 2017. Independent Living Waiver Renewal Application for Section 1915(b)(4)Waiver Fee-for-Service Selective Contracting Program
- [Elderly and Disabled Waiver submitted to CMS](https://medicaid.ms.gov/elderly-and-disabled-waiver-submitted-to-cms/) - The Division of Medicaid submitted to the Centers for Medicare and Medicaid Services (CMS) the Elderly and Disabled Waiver Renewal on May 17, 2017. Click here to view the submitted Elderly and Disabled Waiver renewal. Visit our Elderly and Disabled Waiver page for more information.
- [Public hearing scheduled for the Elderly and Disabled Waiver renewal](https://medicaid.ms.gov/public-hearing-scheduled-for-the-elderly-and-disabled-waiver-renewal/) - The Division of Medicaid will hold a Mississippi public hearing for the purpose of obtaining public input on the Division of Medicaid’s Elderly and Disabled (E&D) Waiver renewal submission. The public hearing will be held on May 3, 2017, at 10:00 am at the Woolfolk Building, Room 145 located at 501 N. West Street, Jackson, MS 39201. To
- [Public hearing scheduled for the Independent Living Waiver renewal](https://medicaid.ms.gov/public-hearing-scheduled-for-the-independent-living-waiver-renewal/) - The Division of Medicaid will hold a Mississippi public hearing for the purpose of obtaining public input on the Division of Medicaid’s Independent Living (IL) Waiver renewal submission. The public hearing will be held on May 3, 2017, at 2:00 pm at the Woolfolk Building Room 145 located at 501 N. West Street, Jackson, MS 39201.
- [Intellectual Disabilities/Developmental Disabilities (ID/DD) Waiver Amendment Approved](https://medicaid.ms.gov/intellectual-disabilitiesdevelopmental-disabilities-iddd-waiver-amendment-approved/) - The Centers for Medicare and Medicaid Services (CMS) has approved the Intellectual Disabilities/Developmental Disabilities (ID/DD) Waiver Amendment effective May 1, 2017. Approved ID/DD Waiver Amendment
- [Applying for Mississippi Medicaid Under the Affordable Care Act (ACA)](https://medicaid.ms.gov/this-is-a-medicaid-news-article-3/) - Insurance Affordability Programs Effective Jan.1, 2014, the Affordable Care Act (ACA) creates insurance affordability programs as a way to get health coverage at no cost or lower cost than purchasing coverage on your own. In Mississippi, these programs include Mississippi Health Benefits (Medicaid and CHIP) and health coverage through a federal marketplace. Federal Marketplace Individuals
- [Public Notice for the Elderly and Disabled (E&D) Waiver renewal](https://medicaid.ms.gov/public-notice-for-the-elderly-and-disabled-ed-waiver-renewal/) - Pursuant to 42 C.F.R. Section 441.304(e)-(f), public notice is hereby given to the submission of the Elderly and Disabled (E&D) Waiver renewal. The Division of Medicaid, in the Office of the Governor, will submit this proposed waiver renewal to the Centers for Medicare and Medicaid Services (CMS) for the E&D Waiver effective July 1, 2017.
- [Public Notice for the Independent Living (IL) Waiver renewal](https://medicaid.ms.gov/public-notice-for-the-independent-living-il-waiver-renewal/) - Pursuant to 42 C.F.R. Section 441.304(e)-(f), public notice is hereby given to the submission of the Independent Living (IL) Waiver renewal. The Division of Medicaid, in the Office of the Governor, will submit this proposed waiver renewal to the Centers for Medicare and Medicaid Services (CMS) for the IL Waiver effective July 1, 2017. Learn
- [DOM medical director helps to address provider concerns](https://medicaid.ms.gov/dom-medical-director-helps-to-address-provider-concerns/) - Communicating with Medicaid providers and fixing problems: Those are the key functions Dr. Tami Brooks performs on a weekly basis, one year into her role as medical director for the Mississippi Division of Medicaid (DOM). As an actively practicing pediatrician at the University of Mississippi Medical Center (UMMC), Brooks says she is ideally positioned to
- [Medicaid pharmacy announcements about reimbursement changes and 340B](https://medicaid.ms.gov/medicaid-pharmacy-announcements-about-reimbursement-changes-and-340b/) - Pharmacy Reimbursement changes will be implemented retrospectively upon CMS State Plan Amendment (SPA) approval On February 1, 2016, the Centers for Medicare and Medicaid Services (CMS) published 42 CFR, Part 447: Medicaid Program Covered Outpatient Drugs with final comments (CMS-2345-FC). This rule addresses regulations pertaining to reimbursement for covered outpatient drugs in the Medicaid program.
- [Mississippi Coordinated Access Network (MississippiCAN) RFP #20170203](https://medicaid.ms.gov/mississippi-coordinated-access-network-mississippican-rfp-20170203/) - The Mississippi Division of Medicaid (DOM) has released a Request for Proposals (RFP) #20170203 for the purpose of contracting with qualified contractors to provide services for the statewide administration of the Mississippi Coordinated Access Network (MississippiCAN), a coordinated care program for Mississippi Medicaid beneficiaries. DOM seeks competitive written proposals from qualified Offerors for a 3-year period
- [Free educational seminar about Civil Money Penalty grants](https://medicaid.ms.gov/free-educational-seminar-about-civil-money-penalty-grants/) - The Mississippi Division of Medicaid and Mississippi State Department of Health, Division of Licensure and Certification are hosting a free, one-day educational seminar for nursing home providers, and other individuals and organizations interested in applying for a Civil Money Penalty (CMP) grant. Several speakers with experience in the nursing home industry will share their expertise
- [Medicaid providers required to revalidate credentials](https://medicaid.ms.gov/medicaid-providers-required-to-revalidate-credentials/) - Mississippi Medicaid enrolled providers will be required to revalidate their credentials with the Mississippi Division of Medicaid (DOM), beginning this spring. Medicaid provider revalidation is a requirement stemming from 42 C.F.R. § 455.414 of the Affordable Care Act (ACA), which requires all state Medicaid agencies to revalidate the enrollment of all providers at least every
- [Public Notice for SPA 17-0002 Pharmacy Reimbursement](https://medicaid.ms.gov/public-notice-for-spa-17-0002-pharmacy-reimbursement/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA). The Division of Medicaid, in the Office of the Governor, is submitting SPA 17-0002 Pharmacy Reimbursement. Effective April 1, 2017, and contingent upon approval from the Centers for Medicare and Medicaid Services (CMS), the
- [Submitted MS Statewide Transition Plan](https://medicaid.ms.gov/submitted-ms-statewide-transition-plan/) - The Mississippi Statewide Transition Plan was submitted to CMS on February 6, 2017, for initial approval from the Centers for Medicare and Medicaid Services (CMS). This submission included the public comments and responses from the comment period November 28, 2016, through December 28, 2016. Learn more by reading the submitted pages for the Mississippi Statewide Transition
- [Agency holds pharmacy stakeholder meetings about reimbursement options](https://medicaid.ms.gov/agency-holds-pharmacy-stakeholder-meetings-about-reimbursement-options-2/) - On February 1, 2016, the Centers for Medicare and Medicaid Services (CMS) published 42 CFR, Part 447: Medicaid Program Covered Outpatient Drugs with final comments (CMS-2345-FC). This rule addresses regulations that pertain to reimbursement for covered outpatient drugs in the Medicaid program. The document is available online at http://federalregister.gov/a/2016-01274. On March 8, 2016, the Division of
- [Pharmacy instructions altered for tornado-affected areas](https://medicaid.ms.gov/pharmacy-instructions-altered-for-tornado-affected-areas/) - Following severe weather and tornadoes that hit Mississippi this past weekend, Gov. Phil Bryant has authorized a State of Emergency to provide resources to aid in recovery efforts. The Mississippi Emergency Management Agency (MEMA) has reported extensive damage caused by a tornado in Forrest County, in addition to other southern regions such as the cities
- [Division of Medicaid to issue RFP for coordinated care contractors](https://medicaid.ms.gov/division-of-medicaid-to-issue-rfp-for-coordinated-care-contractors/) - The Mississippi Division of Medicaid (DOM) launched its coordinated care program in January of 2011 and since then it has continuously changed. Currently, the Mississippi Coordinated Access Network (MississippiCAN) program has grown to include approximately 70 percent of Medicaid beneficiaries. Early this year, DOM will release a request for proposals (RFP) in an open, competitive
- [Public Notice for SPA 16-0020 Autism Spectrum Disorder (ASD) Services](https://medicaid.ms.gov/public-notice-for-public-notice-for-spa-16-0020-autism-spectrum-disorder-asd-services/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA). The Division of Medicaid, in the Office of the Governor, is submitting SPA 16-0020 Autism Spectrum Disorder (ASD) Services. Effective January 1, 2017, and contingent upon approval from the Centers for Medicare and Medicaid
- [Agency holds pharmacy stakeholder meetings about reimbursement options](https://medicaid.ms.gov/agency-holds-pharmacy-stakeholder-meetings-about-reimbursement-options/) - On February 1, 2016, the Centers for Medicare and Medicaid Services (CMS) published 42 CFR, Part 447: Medicaid Program Covered Outpatient Drugs with final comments (CMS-2345-FC). This rule addresses regulations that pertain to reimbursement for covered outpatient drugs in the Medicaid program. The document is available online at http://federalregister.gov/a/2016-01274. On March 8, 2016, the Division of
- [Extension of deadline to submit EPSDT Provider Agreement](https://medicaid.ms.gov/extension-of-deadline-to-submit-epsdt-provider-agreement-3/) - Effective Nov. 1, 2015, the Mississippi Division of Medicaid (DOM) received Centers for Medicare and Medicaid Services approval of State Plan Amendment (SPA) 15-017 Early and Periodic Screening, Diagnosis and Treatment (EPSDT). SPA 15-017 requires DOM EPDST providers to adhere to the American Academy of Pediatrics Bright Futures periodicity schedule for physical, mental, psychosocial and/or
- [Access Monitoring Review Plan submitted to the Centers for Medicare and Medicaid Services](https://medicaid.ms.gov/access-monitoring-review-plan-submitted-to-the-centers-for-medicare-and-medicaid-services/) - Federal regulation at 42 CFR § 447.203 requires states to develop an Access Monitoring Review Plan (AMRP) that includes an analysis of access to covered services under the Medicaid fee-for-service (FFS) delivery system. Mississippi developed an AMRP for the following service categories provided under a FFS arrangement: Primary care services Physician specialist services Behavioral health
- [Pharmacy prior authorization to transition to new vendor](https://medicaid.ms.gov/pharmacy-prior-authorization-to-transition-to-new-vendor/) - Effective Oct. 1, 2016, the Office of Pharmacy’s prior authorization unit for fee-for-service beneficiaries will transition from the University of Mississippi Medical Center Pharmacy to Change Healthcare Pharmacy Solutions (formerly Goold Health Systems). We do not anticipate a disruption in service during this transition. To submit a request for prior authorization, continue using the same
- [Extension of deadline to submit EPSDT Provider Agreement](https://medicaid.ms.gov/extension-of-deadline-to-submit-epsdt-provider-agreement-2/) - Effective November 1, 2015, Mississippi Division of Medicaid (DOM) received Centers for Medicare and Medicaid Services (CMS) approval of State Plan Amendment (SPA) 15-017 Early and Periodic Screening, Diagnosis and Treatment (EPSDT). SPA 15-017 requires DOM EPDST providers adhere to the American Academy of Pediatrics Bright Futures periodicity schedule for physical, mental, psychosocial and/or behavioral
- [Medicaid covers mosquito repellents to help prevent spread of Zika](https://medicaid.ms.gov/medicaid-covers-mosquito-repellents-to-help-prevent-spread-of-zika/) - As of early September, 20 cases of the Zika virus have been confirmed in Mississippi since the first case of an infected resident was verified in March. Although all of those cases are related to people who have traveled to countries where the mosquito-borne virus is widespread – mostly in Central and South America –
- [Bariatric surgery not currently covered by Medicaid](https://medicaid.ms.gov/bariatric-surgery-not-currently-covered-by-medicaid/) - Medicaid enrolled health-care providers should be advised that Mississippi Medicaid does not currently cover bariatric surgery. Any change to the status of the State Plan Amendment (SPA) will be posted on the Mississippi Division of Medicaid website at medicaid.ms.gov. Public notice for State Plan Amendment (SPA) 16-001 Bariatric Surgery
- [Public Notice for the Division of Medicaid's Access Monitoring Review Plan](https://medicaid.ms.gov/public-notice-for-the-division-of-medicaids-access-monitoring-review-plan/) - Pursuant to 42 C.F.R. Part 447, public notice is hereby given to the submission of the Division of Medicaid’s Access Monitoring Review Plan (AMRP). Learn more by reading the public notice and draft pages, Division of Medicaid's Access Monitoring Review Plan (AMRP).
- [Clarification of swing-bed hospital services reimbursement](https://medicaid.ms.gov/reimbursement-changes-for-swing-bed-services/) - In December of 2015 the Division of Medicaid (DOM) transitioned inpatient hospital services from regular fee-for-service to its managed care program, MississippiCAN. Despite originally being included in that transition, DOM has determined that swing-bed hospital services should be separate from inpatient services and not fall under managed care. As such, DOM maintains responsibility for the
- [Pharmacy billing procedures during officially declared states of emergency](https://medicaid.ms.gov/disaster-billing-directions-2/) - During states of officially declared emergencies, pharmacy providers should bill POS claims as follows: Enter a value of ’13-Payor Recognized Emergency’ in NCPDP Field ‘420-DK’ when it is necessary to override the following service limit edits: 2 Brand/5 Prescription Limit Early Refill Please note that when the declared emergency announcement is made, the fields noted
- [Medical service costs, enrollment drive DOM's budget](https://medicaid.ms.gov/medical-service-costs-enrollment-drive-doms-budget/) - The ink has dried on the Division of Medicaid’s (DOM) budget bill for fiscal year (FY) 2017. We asked the Legislature for $1.03 billion in our budget proposal and they approved $948 million, which is roughly $82 million below DOM’s FY 2017 request. Unfortunately, this comes as no surprise. At the same time, lawmakers passed
- [Public Notice for SPA 16-0019 Hospital Reimbursement of Long-Acting Reversible Contraceptives](https://medicaid.ms.gov/public-notice-for-spa-16-0019-hospital-reimbursement-of-long-acting-reversible-contraceptives/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA). The Division of Medicaid, in the Office of the Governor, is submitting SPA 16-0019 Hospital Reimbursement of Long-Acting Reversible Contraceptives (LARCs). Effective August 6, 2016, the Division of Medicaid will reimburse for LARCs and
- [Pharmacy Provider Information regarding the Zika Virus](https://medicaid.ms.gov/pharmacy-provider-information-regarding-the-zika-virus/) - Insect Repellents Covered Via Pharmacy POS Claims June 1, 2016 the Centers for Medicare and Medicaid Services (CMS) issued an Informational Bulletin informing Medicaid Agencies how Medicaid services can help states and territories prevent, detect, and respond to the Zika virus, including efforts to prevent the transmission and address health risks to beneficiaries. The Informational
- [All EPSDT screening providers must update their enrollment status](https://medicaid.ms.gov/all-epsdt-screening-providers-must-update-their-enrollment-status/) - Effective November 1, 2015, Mississippi Division of Medicaid (DOM) received Centers for Medicare and Medicaid Services (CMS) approval of State Plan Amendment (SPA) 15-017 Early and Periodic Screening, Diagnosis and Treatment (EPSDT). SPA 15-017 requires DOM EPDST providers adhere to the American Academy of Pediatrics Bright Futures periodicity schedule for physical, mental, psychosocial and/or behavioral
- [Public notice for State Plan Amendment (SPA) 16-001 Bariatric Surgery](https://medicaid.ms.gov/public-notice-for-state-plan-amendment-spa-16-001-bariatric-surgery/) - Under the provisions of Section 447.205, Title 42, Code of Federal Regulations, public notice is hereby given for the submission of a Mississippi Medicaid State Plan Amendment (SPA). If approved, the Mississippi Division of Medicaid, in the Office of the Governor, will provide coverage for inpatient hospital bariatric surgery and related services in accordance with
- [1915(c) Waivers and 1915(i) State Plan Transition Plans for Home and Community-Based Settings](https://medicaid.ms.gov/the-mississippi-division-of-medicaid-1915c-waivers-and-1915i-state-plan-transition-plans-for-home-and-community-based-settings/) - 1915(c) Waivers and 1915(i) State Plan Transition Plans for Home and Community-Based Settings 30 Day Comment Period: September 17 – October 17, 2014 Background On January 16, 2014, CMS issued a final rule, effective March 17, 2014, which amends the requirements for qualities of home and community-based (HCBS) settings. These requirements reflect CMS’s intent that
- [Public Notice for SPA 16-0006 Dental and Orthodontic Reimbursement](https://medicaid.ms.gov/public-notice-for-spa-16-0008-dental-and-orthodontic-reimbursement/) - This public notice for SPA 16-0006 Dental and Orthodontic Reimbursement supersedes the public notice that was published on February 29, 2016. Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA). Effective July 1, 2016, the Division of Medicaid, in the Office of the Governor, is
- [Public Notice for SPA 16-0017 Outpatient Prospective Payment System (OPPS) Update](https://medicaid.ms.gov/public-notice-for-spa-16-0017-outpatient-prospective-payment-system-opps-update/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA). The Division of Medicaid, in the Office of the Governor, is submitting SPA 16-0017 Outpatient Prospective Payment System (OPPS) Update. Effective July 1, 2016, the Division of Medicaid will make a revision to the
- [Public Notice for SPA 16-0008 Primary Care Physician (PCP) Payment for Obstetricians and Gynecologists (OB/GYNs)](https://medicaid.ms.gov/public-notice-for-spa-16-0008-primary-care-physician-pcp-payment-for-obstetricians-and-gynecologists-obgyns/) - Pursuant to 42 C.F.R. Section 447.205, public notice is herby given to the submission of a Medicaid Sate Plan Amendment (SPA). The Division of Medicaid, in the Office of the Governor, is submitting SPA 16-0008 Primary Care Physician (PCP) Payment for Obstetricians and Gynecologists (OB/GYNs) to reimburse certain eligible OB/GYNs for the provision of certain
- [Public Notice for the Post-Award Forum on Mississippi Section 1115(a) Family Planning Demonstration](https://medicaid.ms.gov/public-notice-for-the-post-award-forum-on-mississippi-section-1115a-family-planning-demonstration/) - Pursuant to 42 C.F.R. Section 431.420(c), public notice is hereby given to the annual Post-Award Forum on the Division of Medicaid’s Family Planning Waiver. The annual Post-Award Forum provides stakeholders the opportunity to provide meaningful comment on the progress of the Family Planning Waiver. The Family Planning Waiver operates under the authority of an 1115(a)
- [Public Notice for SPA 16-0010 All Patient Refined Diagnosis Related Groups (APR-DRG) Reimbursement](https://medicaid.ms.gov/public-notice-for-spa-16-0010-all-patient-refined-diagnosis-related-groups-apr-drg-reimbursement/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA). The Division of Medicaid, in the Office of the Governor, is submitting SPA 16-0010 All Patient Refined Diagnosis Related Groups (APR-DRG) Reimbursement to update the hospital inpatient payment methodology with an effective date of
- [UnitedHealthcare to exit Mississippi Federal Health Insurance Exchange](https://medicaid.ms.gov/unitedhealthcare-to-exit-mississippi-federal-health-insurance-exchange/) - UnitedHealthcare recently announced it will exit Mississippi’s Health Insurance Exchange, also known as the federally facilitated marketplace, on Jan. 1, 2017. Currently, UnitedHealthcare is one of three insurance companies offering individual policies in the state through the federal marketplace, and the only one that covers all 82 counties. UnitedHealthcare’s departure from the federal marketplace will
- [Guidance for providing concurrent services for both hospice and home and community-based waiver services](https://medicaid.ms.gov/guidance-for-providing-concurrent-services-for-both-hospice-and-home-and-community-based-waiver-services/) - Pursuant to Miss. Admin. Code Title 23, Part 205: Hospice Services, Chapter 1, Rule 1.1 and 1.4., effective June 1, 2016, a person may receive hospice and waiver services concurrently. As hospice and home and community-based services (HCBS) waiver providers may render similar services, it is imperative that these providers work collaboratively with the person
- [Public Notice for the Intellectual Disabilities/Developmental Disabilities (ID/DD) Waiver Amendment](https://medicaid.ms.gov/intellectual-disabilitiesdevelopmental-disabilities-iddd-waiver-amendment-2/) - The Division of Medicaid is re-posting the public notice for the Intellectual Disabilities/Developmental Disabilities (ID/DD) Waiver Amendment to correct a technical issue that occurred during the initial posting. The Division of Medicaid has not made substantive changes to the public notice regarding the ID/DD Waiver Amendment. Learn more by reading the public notice and draft
- [Public Notice for State Plan Amendment (SPA) 16-0014 Rural Health Center (RHC) Scope of Service](https://medicaid.ms.gov/public-notice-for-state-plan-amendment-spa-16-0014-rural-health-center-rhc-scope-of-service/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA). The Division of Medicaid, in the Office of the Governor, is submitting SPA 16-0014 Rural Health Clinics (RHC) Scope of Service to clarify the definition of a change in scope of service and the
- [Public Notice for State Plan Amendment (SPA) 16-0013 Federally Qualified Health Center (FQHC) Scope of Service](https://medicaid.ms.gov/public-notice-for-state-plan-amendment-spa-16-0013-federally-qualified-health-center-fqhc-scope-of-service/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA). The Division of Medicaid, in the Office of the Governor, is submitting SPA 16-0013 Federally Qualified Health Centers (FQHC) Scope of Service to clarify the definition of a change in scope of service and
- [Public Notice for the Intellectual Disabilities/Developmental Disabilities (ID/DD) Waiver Amendment](https://medicaid.ms.gov/public-notice-for-the-intellectual-disabilitiesdevelopmental-disabilities-iddd-waiver-amendment/) - Pursuant to 42 C.F.R. Section 441.304(e)-(f), public notice is hereby given to the submission of a Medicaid Intellectual Disabilities/Developmental Disabilities (ID/DD) Waiver Amendment. The Division of Medicaid, in the Office of the Governor, will submit this proposed amendment to the Centers for Medicare and Medicaid Services (CMS) for the ID/DD Waiver effective July 1, 2016.
- [Public Notice for State Plan Amendment (SPA) 16-0011 Long-Term Care (LTC) Reimbursement](https://medicaid.ms.gov/public-notice-for-state-plan-amendment-spa-16-0011-long-term-care-ltc-reimbursement/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA). Effective January 1, 2016, the Division of Medicaid, in the Office of the Governor, is adding clarification regarding property reimbursement calculations for Alzheimer’s Units, Nursing Facilities for the Severely Disabled (NFSDs), Intermediate Care Facilities
- [Public Notice for State Plan Amendment (SPA) 16-0006 Dental and Orthodontic Reimbursement](https://medicaid.ms.gov/public-notice-for-state-plan-amendment-spa-16-0006-dental-and-orthodontic-reimbursement/) - Pursuant to 42 C.F.R. Section 447.205, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA). Effective July 1, 2016, the Division of Medicaid, in the Office of the Governor, is revising the reimbursement methodology for Dental and Orthodontic Services, our Transmittal #16-0006. Learn more by reading the public notice
- [Public Notice for the Elderly and Disabled (E&D) Waiver Amendment](https://medicaid.ms.gov/public-notice-for-the-elderly-and-disabled-ed-waiver-amendment/) - Pursuant to 42 C.F.R. Section 441.304(f), public notice is hereby given to the submission of a Medicaid Elderly and Disabled Waiver (E&D) Amendment. The Division of Medicaid, in the Office of the Governor, will submit these proposed changes to the Centers for Medicare and Medicaid Services (CMS) for the E&D Waiver effective March 10, 2016.
- [State Plan Amendment Public Notice](https://medicaid.ms.gov/state-plan-amendment-public-notice/) - The Centers for Medicare & Medicaid Services (CMS) issued a final rule, effective January 4, 2016, amending 42 C.F.R. § 447.205, allowing the Division of Medicaid to publish public notices of proposed changes in Statewide methods and standards for setting payment rates for services on the agency’s web site. Accordingly, the Division of Medicaid will
- [Public notice for State Plan Amendment (SPA) 15-010 Mississippi Coordinated Access Network (MSCAN)](https://medicaid.ms.gov/public-notice-for-state-plan-amendment-spa-15-010-mississippi-coordinated-access-network-mscan/) - Under the provisions of Section 438.50(b)(4), Title 42, Code of Federal Regulations, public notice is hereby given to the submission of a Mississippi Medicaid State Plan Amendment (SPA). Effective December 1, 2015, the Mississippi Division of Medicaid, in the Office of the Governor, will implement changes to the Mississippi Coordinated Access Network (MSCAN) to comply
- [Public Notice for State Plan Amendment (SPA) 15-008 All Patient Refined Diagnosis Related Groups (APR-DRG)](https://medicaid.ms.gov/public-notice-for-state-plan-amendment-spa-15-008-all-patient-refined-diagnosis-related-groups-apr-drg/) - Under the provisions of Section 447.205, Title 42, Code of Federal Regulations, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA). Effective July 1, 2015, the Mississippi Division of Medicaid, in the Office of the Governor, will update the All Patient Refined Diagnosis Related Groups (APR-DRG) hospital inpatient payment
- [Public Notices for State Plan Amendment 15-012 Mississippi Hospital Access Program Transition Payment and Inpatient Hospital UPL Program Elimination](https://medicaid.ms.gov/public-notices-for-state-plan-amendment-15-012-mississippi-hospital-access-program-transition-payment-and-inpatient-hospital-upl-program-elimination/) - Under the provisions of Section 447.205, Title 42, Code of Federal Regulations, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA). For inpatient hospital services rendered after July 1, 2015, the Mississippi Division of Medicaid, in the Office of the Governor, may implement Mississippi Hospital Access Program (MHAP) Transition
- [Public Notice for State Plan Amendment (SPA) 15-011 Outpatient Prospective Payment System (OPPS) Phase II](https://medicaid.ms.gov/public-notice-for-state-plan-amendment-spa-15-011-outpatient-prospective-payment-system-opps-phase-ii/) - Under the provisions of Section 447.205, Title 42, Code of Federal Regulations, public notice is hereby given to the submission of a Medicaid State Plan Amendment (SPA). Effective July 1, 2015, the Mississippi Division of Medicaid, in the Office of the Governor, will implement the Outpatient Prospective Payment System (OPPS) Phase II, our Transmittal #
- [Physician visit limit lifted for dually-eligible beneficiaries](https://medicaid.ms.gov/physician-visit-limit-lifted-for-dually-eligible-beneficiaries/) - Effective May 1, 2016, the Medicaid-imposed 12 visit limit on physician visits is no longer applicable to individuals covered by both Medicare and Medicaid, who are eligible for Medicaid payment of crossover claims. These individuals are dually-eligible beneficiaries, who receive some type of health-care coverage from Medicare and Medicaid. This change means that Medicaid providers
- [Hospital and nursing facilities physician's signature notification](https://medicaid.ms.gov/hospital-and-nursing-facilities-physicians-signature-notification/) - Effective Jan. 1, 2016, Mississippi Division of Medicaid (DOM) will no longer require the physician’s certification, electronic or hardcopy signature to confirm clinical eligibility of a nursing facility resident. Applicable sections of Mississippi Administrative Code Title 23 are being revised to reflect these changes for Pre-Admission Screening and Resident Review (PASRR), formerly known as the Pre-Admission
- [Advanced imaging changes affect prior authorizations](https://medicaid.ms.gov/advanced-imaging-changes-affect-prior-authorizations/) - Effective March 1, 2016, eQHealth Solutions (eQHS) began performing prior authorization reviews for advanced imaging services, in accordance with Mississippi Administrative Code Title 23, Part 220 Radiology Services. Prior to March 1, 2016 advanced imaging services were prior authorized through MedSolutions (eviCore). The Mississippi Division of Medicaid (DOM) will honor MedSolutions (eviCore) treatment authorization numbers
- [Sign up to receive notifications for changes to the State Plan, Administrative Code, and Waivers](https://medicaid.ms.gov/sign-up-to-receive-notifications-for-changes-to-the-state-plan-administrative-code-and-waivers/) - The Division of Medicaid’s (DOM) Office of Policy sends out email notifications for submittals and approvals of State Plan Amendments, proposed and final revisions made to our Administrative Code Title 23, and to our Waiver renewal and amendments. Previously, these notifications were sent from three different email address. Effective Jan. 7, 2016, we have combined
- [Preferred Brand Drugs with federal upper limits](https://medicaid.ms.gov/preferred-brand-drugs-with-federal-upper-limits/) - The Mississippi Division of Medicaid has implemented a systematic fix for preferred brand drugs listed on the preferred drug list (PDL), which have been reimbursing with an ingredient cost based on the federal upper limits (FUL) price impacting fee-for-service Medicaid. Pharmacists may enter a DAW of '9' on claims to override the FUL price on preferred
- [Affordable Care Act (ACA) Changes to Move Segment of Children From CHIP to Medicaid](https://medicaid.ms.gov/this-is-a-medicaid-news-article-2/) - Under federal law, the Patient Protection and Affordable Care Act (PPACA) implements mandatory changes regarding eligibility guidelines for the Children’s Health Insurance Program (CHIP) and Medicaid. Effective Jan. 1, 2014, a new methodology based on Modified Adjusted Gross Income (MAGI) will be used for determining CHIP eligibility. As a result of a conversion to MAGI,
- [Electronic health records exchange win-win for UMMC, Medicaid patients](https://medicaid.ms.gov/electronic-health-records-exchange-win-win-for-ummc-medicaid-patients/) - The Mississippi Division of Medicaid has become the first agency of its kind in the nation to exchange patient medical data with a health system in real time, an accomplishment that lets caregivers at the University of Mississippi Medical Center quickly review a patient's medical history so they can make better-informed treatment decisions. Medicaid worked
- [Provider information for lead testing and treatment](https://medicaid.ms.gov/provider-information-for-lead-testing-and-treatment/) - Yesterday, the City of Jackson issued a press release regarding elevated levels of lead in some home water samples serviced by the city water system. (City of Jackson Meeting Additional Compliance Measures Related to Lead Exceedance) To better assist our providers who serve our beneficiaries, the Mississippi Division of Medicaid (DOM) has listed specific instructions about
- [Magnolia Health acute inpatient issues and behavioral health webinar scheduled](https://medicaid.ms.gov/magnolia-health-acute-inpatient-issues-and-behavioral-health-webinar-scheduled/) - Join Magnolia Health Plan Thursday, Feb. 11 for an educational webinar on acute inpatient issues and behavioral health. The participant registration information is listed below. Webinar: Magnolia Health acute inpatient issues and behavioral health Date: Thursday, Feb. 11 Time: 2 – 3 p.m. CDT Webinar participant information Conference number: 1-855-351-5537 Participant code: 5440205058 To join
- [Pharmacy permit renewal update](https://medicaid.ms.gov/pharmacy-permit-renewal-update-2/) - The Division of Medicaid (DOM) has been notified that the Board of Pharmacy is encountering delays processing bi-annual pharmacy permit renewals. Pharmacies enrolled in the Mississippi Medicaid program must be in good standing with their regulatory authority to be a Medicaid provider. Due to the delay with the permit renewal process at the Board of
- [ICD-10 preparation](https://medicaid.ms.gov/preparing-for-the-international-classification-of-diseases-10th-edition-icd-10/) - Effective October 1, 2015, entities covered under the Health Insurance Portability and Accountability Act (HIPAA) are required to use the International Classification of Diseases, 10th Edition (ICD-10) code sets in standard transactions adopted under HIPAA. All Mississippi Division of Medicaid enrolled providers must comply. Compliance dates are firm and not subject to change, other than
- [Inpatient hospital services claims submission instructions](https://medicaid.ms.gov/inpatient-hospital-services-claims-submission-instructions/) - Effective Dec. 1, 2015, inpatient hospital services have transitioned into our managed-care program, MississippiCAN. Providers and hospitals must check the eligibility status of each Mississippi Medicaid beneficiary on the date of admission and dates of service. This will help ensure that claims are submitted to the appropriate managed-care organization for timely reimbursement. On the day
- [Effective today, inpatient hospital services transitioned into managed care](https://medicaid.ms.gov/effective-today-inpatient-hospital-services-transitioned-into-managed-care/) - After months of preparation, planning, training and collaboration with related stakeholders, the Mississippi Division of Medicaid (DOM) has transitioned inpatient hospital services into our managed-care program, MississippiCAN. As planned, Mississippi Medicaid providers and hospitals should submit claims for beneficiary inpatient hospital services to the appropriate managed-care organization, Magnolia Health or UnitedHealthcare Community Plan, effective Dec.
- [Presentation information available from the webinar on newborns and the inpatient transition](https://medicaid.ms.gov/presentation-information-available-from-the-webinar-on-newborns-and-the-inpatient-transition/) - On Monday, No. 23, the Mississippi Division of Medicaid hosted a webinar on newborns and the inpatient transition for providers and hospitals. The transition of inpatient services into our managed care program, MississippiCAN, is effective Dec. 1, 2015. Representatives from Medicaid addressed changes affecting newborns and covered numerous topics, including: observation, concurrent review, notification, the newborn form, prior
- [Join us for a webinar on newborns and the inpatient transition](https://medicaid.ms.gov/join-us-for-a-webinar-on-newborns-and-the-inpatient-transition/) - The Mississippi Division of Medicaid (DOM) is preparing for the inclusion of inpatient services into our managed care program (MississippiCAN) and is collaborating with our partners to ensure a smooth transition. This transition will be effective Dec. 1, 2015. Join us Monday, Nov. 23 to learn about changes affecting newborns from representatives at DOM. During
- [Medicaid and MississippiCAN coordinated care organizations address inpatient behavioral health](https://medicaid.ms.gov/medicaid-and-mississippican-coordinated-care-organizations-address-inpatient-behavioral-health/) - In anticipation of the upcoming transition of inpatient services into managed care, the Mississippi Division of Medicaid hosted an inpatient behavioral health webinar on Nov. 17 for providers and hospitals. The transition of inpatient services into our managed care program, MississippiCAN, is set to be effective Dec. 1, 2015. Representatives from Medicaid and our MississippiCAN coordinated care
- [Join us for a webinar on behavioral health and the inpatient transition](https://medicaid.ms.gov/join-us-for-a-webinar-on-behavioral-health-and-the-inpatient-transition/) - The Mississippi Division of Medicaid (DOM) is preparing for the inclusion of inpatient services into our managed care program (MississippiCAN) and is collaborating with our partners to ensure a smooth transition. This transition will be effective Dec. 1, 2015. As part of the inpatient services transition, there will also be changes affecting inpatient behavioral health.
- [Medicaid and MississippiCAN coordinated care organizations give inpatient transition presentation](https://medicaid.ms.gov/medicaid-and-mississippican-coordinated-care-organizations-give-inpatient-transition-presentation/) - This morning, the Mississippi Division of Medicaid (DOM) held a webinar for hospital providers and facilities regarding the transition of inpatient services into our managed care program (MississippiCAN). This transition is set to be effective Dec. 1, 2015. Rolling inpatient services into managed care will change claims submission and other procedures. In collaboration with our MississippiCAN coordinated
- [Join us for a webinar on the inpatient transition](https://medicaid.ms.gov/join-us-for-a-webinar-on-the-inpatient-transition/) - The Mississippi Division of Medicaid (DOM) is preparing to roll inpatient services into our managed care program (MississippiCAN) and collaborating with our partners to ensure a smooth transition. This transition is set to be effective Dec. 1, 2015. Rolling inpatient services into managed care will change claims submission and other procedures. As a valued Medicaid
- [Medicaid presents fiscal year 2017 budget request to Legislative Budget Office](https://medicaid.ms.gov/medicaid-presents-fiscal-year-2017-budget-request-to-legislative-budget-office/) - The Mississippi Division of Medicaid (DOM) presented its budget request for fiscal year 2017 to the Legislative Budget Office on Sept. 21. The agency is seeking an appropriation of $1.036 billion in state funds. Fiscal Year 2017 Legislative Budget Hearing Presentation Fiscal year 2017 Medicaid budget request for the Legislative Budget Office
- [2015 Beneficiary workshops for MississippiCAN and CHIP scheduled](https://medicaid.ms.gov/2015-beneficiary-workshops-for-mississippican-and-chip-scheduled/) - 2015 Beneficiary workshops for MississippiCAN and CHIP scheduled The Mississippi Division of Medicaid, Office of Coordinated Care is conducting beneficiary workshops for our managed care program, MississippiCAN, scheduled for August 17- September 17 at locations throughout the state. There will be door prizes, refreshments and loads of information about MississippiCAN and Children's Health Insurance Program (CHIP)
- [Statewide Medicaid Provider Conference survey](https://medicaid.ms.gov/statewide-medicaid-conference-survey/) - The Division of Medicaid (DOM) is in the beginning stages of planning a statewide Medicaid Provider Conference and we need your input! This conference will be designed to offer interactive discussion sessions as well as classes targeted to the Medical professional and their supporting administrative and billing office staff. We need your input to ensure
- [Providers should note pharmacy changes for children transitioning from Medicaid to MississippiCAN ](https://medicaid.ms.gov/providers-should-note-pharmacy-changes-for-chlidren-transitioning-from-medicaid-to-mississippican/) - From May 1, 2015 through July 31, 2015, all children up to the age of 19, will be transitioned from traditional Medicaid to MississippiCAN. The transition will occur incrementally in months May, June, and July. Exceptions are those beneficiaries who are dually eligible (Medicaid/Medicare), enrolled in a waiver, living in a long term care (LTC)
- [Back to school health fairs](https://medicaid.ms.gov/back-to-school-health-fairs/) - The Mississippi Division of Medicaid (DOM) along with Magnolia Health Plan and UnitedHealthcare are partnering with Medicaid providers to conduct Back to School Health Fairs. During these health fairs, Medicaid beneficiaries will have the opportunity to receive their annual physical examinations and/or required immunizations. Magnolia Health Plan and UnitedHealthcare will be offering incentives (music cards,
- [Anthem data breach may affect CHIP beneficiaries enrolled during 1998-2009](https://medicaid.ms.gov/anthem-data-breach-may-affect-chip-beneficiaries-enrolled-during-1998-2009/) - Anthem data breach may affect CHIP beneficiaries enrolled during 1998-2009 Anthem, a health insurer, notified the Mississippi Division of Medicaid on Feb. 25, 2015 that they were the target of a cyber-attack. This security breach compromised personal information for 1,042 Mississippi CHIP beneficiaries enrolled during 1998-2009. Anthem will mail affected beneficiaries a notification letter. At
- [Medicaid to transition children into MississippiCAN managed care program](https://medicaid.ms.gov/medicaid-to-transition-children-into-mississippican-managed-care-program/) - Medicaid to transition children into MississippiCAN managed care program Mississippi routinely ranks as one of the poorest and unhealthiest states in the country. The state has a population of almost three million people, and more than a quarter of them are currently enrolled in Medicaid or the Children’s Health Insurance Program (CHIP). Of those, the
- [The Centers for Medicare and Medicaid Services conducts successful Medicare fee-for-service ICD-10 end-to-end testing week](https://medicaid.ms.gov/the-centers-for-medicare-and-medicaid-services-conducts-successful-medicare-fee-for-service-icd-10-end-to-end-testing-week/) - From Jan. 26 through Feb. 3, 2015, Medicare fee-for-service (FFS) health care providers, clearinghouses, and billing agencies participated in the first successful ICD-10 end-to-end testing week with all Medicare Administrative Contractors (MACs) and the Durable Medical Equipment (DME) MAC Common Electronic Data Interchange (CEDI) contractor. The Centers for Medicare and Medicaid Services (CMS) was able
- [MississippiCAN changes include transition of children from regular Medicaid](https://medicaid.ms.gov/mississippican-changes-include-transition-of-children-from-regular-medicaid/) - MississippiCAN changes include transition of children from regular Medicaid The following information applies to the transition of children from regular Medicaid to MississippiCAN. Children ages 1 to 19 will be transitioned from Mississippi Medicaid Fee-for-Service (FFS) to MississippiCAN, except those excluded as members on Medicare, on waivers or in institutions. Effective dates - May 1,
- [Pharmacy billing instructions during a disaster or emergency](https://medicaid.ms.gov/pharmacy-billing-instructions-during-a-disaster-or-emergency/) - Effective Jan. 1, 2015, during states of officially declared emergencies please use the following pharmacy emergency supply procedures, for fee-for-service (FFS) Medicaid, MississippiCAN, and the Children's Health Insurance Program (CHIP). Payer - MS Medicaid: Pharmacy fee for service claims only. 72 hour supply is to be used any time a PA is not available and
- [Children's Health Insurance Program now has two provider options](https://medicaid.ms.gov/childrens-health-insurance-program-now-has-two-provider-options/) - Beginning Jan. 1, Mississippi children who are enrolled in the Children’s Health Insurance Program (CHIP) now have the option of choosing one of two health insurance providers. Previously UnitedHealthcare was the only provider; now families have the option to choose Magnolia Health Plan. Families with children enrolled in CHIP are given 30 days to choose
- [Medicaid presents budget request to House Appropriations Committee](https://medicaid.ms.gov/medicaid-presents-budget-request-to-house-appropriations-committee/) - Medicaid presents budget request to House Appropriations Committee The Mississippi Division of Medicaid (DOM) presented its budget request for fiscal year 2016 to the House Appropriations Committee on Jan. 13. The agency is seeking an appropriation of $989,759,038 for the year, a revision of the $1,015,308,843 request made to the Legislative Budget Committee last October. That
- [Medicaid beneficiary renewal process changes due to the Affordable Care Act](https://medicaid.ms.gov/medicaid-beneficiary-renewal-process-changes-due-to-the-affordable-care-act/) - Medicaid beneficiary renewal process changes due to the Affordable Care Act The Affordable Care Act (ACA) includes changes to the process for renewing a person’s Medicaid benefits, which take effect Jan. 1, 2015. Here are some important facts to know: Beneficiaries no longer are required to visit a regional office or outstation in Mississippi in
- [Billing notice regarding newborn babies of mother in MississippiCAN](https://medicaid.ms.gov/billing-notice-regarding-newborn-babies-of-mother-in-mississippican/) - It has come to the attention of the Division of Medicaid that prescription billing issues exist for newborn babies of mothers enrolled in MississippiCAN plans. The process is as follows: Pharmacy bills regular Medicaid using the mother’s Medicaid identification number followed by the letter K (otherwise known as K baby). Use the baby’s name and baby’s date of
- [Reimbursement and cost report changes: training for long term care providers](https://medicaid.ms.gov/reimbursement-and-cost-report-changes-training-for-long-term-care-providers/) - Pursuant to 2012 Legislation House Bill 421, Section 5, the Division of Medicaid (DOM) requested legislative approval to implement changes to the current reimbursement methodology for nursing facilities (NF), psychiatric residential treatment facilities (PRTF), and intermediate care facilities for individuals with intellectual disabilities (ICF/IID), effective Jan. 1, 2015, pending approval from the Centers for Medicare
- [Public notice for TBI/SCI Waiver transition plan](https://medicaid.ms.gov/public-notice-for-tbisci-waiver-transition-plan/) - Under the provisions of Title 42, Section 431.408, Code of Federal Regulations, public notice is hereby given to the submission of the Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) Waiver transition plan for Home and Community Settings, effective July 1, 2014 through June 30, 2019. Based upon the State’s assessment of the HCBS settings in the
- [Medicaid presents budget request for fiscal year 2016](https://medicaid.ms.gov/medicaid-presents-budget-request-for-fiscal-year-2016/) - Medicaid presents budget request for fiscal year 2016 This morning the Mississippi Division of Medicaid (DOM) had it's annual presentation to the Joint Legislative Budget Committee and requested more than $1 billion for the first time, for fiscal year 2016. To be specific, this year the agency is asking the Legislature for an appropriation of $1,015,308,843. Despite
- [Beneficiary access issues regarding Doxycycline](https://medicaid.ms.gov/beneficiary-access-issues-regarding-doxycycline/) - It has come to our attention that beneficiaries are experiencing difficulties getting prescriptions for doxycycline filled. Drug shortages and availability issues have created significant price increases for the hyclate formulation. Reimbursement of doxycycline hyclate is based upon the federal upper limits (FUL) which cannot be overridden. However, doxycycline monohydrate is a readily available formulation without
- [Provider Reminder: All prescribers must be enrolled with Medicaid](https://medicaid.ms.gov/provider-reminder-all-prescribers-must-be-enrolled-with-medicaid/) - Effective January 1, 2014, in accordance with Federal Regulations at 42 CFR Subpart E, the Division of Medicaid (DOM) requires that all ordering and referring physicians or other professionals providing services under the State plan or under a waiver of the Plan be enrolled as participating providers. Prescribers who write prescriptions for Medicaid beneficiaries must
- [Mississippi Division of Medicaid Case Mix RUG-IV and Time-Weighted training and updates](https://medicaid.ms.gov/mississippi-division-of-medicaid-case-mix-rug-iv-and-time-weighted-training-and-updates/) - This seminar is being provided by Myers and Stauffer LC in cooperation with the Division of Medicaid to Mississippi nursing facilities. Locations and Dates Jackson - October 27 Hilton 1001 East County Line Rd. Jackson, MS 39211 Phone: 601-957-2800 Tupelo - October 30 BancorpSouth Conference Center 387 East Main Street Tupelo, MS 38804 Phone: 662-718-5555 Hattiesburg
- [Hospital inpatient and outpatient alerts](https://medicaid.ms.gov/hospital-inpatient-and-outpatient-alerts/) - Hospital Inpatient Update The Mississippi Division of Medicaid will adopt V.31 of the 3M Health Information System APRDRG Grouper and V.31 of the Health Care Acquired Conditions (HCAC) utility for payment of hospital inpatient claims for discharges on or after July 1, 2014. APR-DRG parameters may also change effective for hospital inpatient discharges on or after July 1,
- [Proposed Family Planning Waiver demonstration extension](https://medicaid.ms.gov/proposed-family-planning-waiver-demostration-extension/) - The Family Planning Waiver demonstration extension request full public notice and comment period runs from April 14-May 14, 2014. Under the provisions of Title 42, Section 431.408, Code of Federal Regulations, public notice is hereby given to the submission of a Medicaid proposed demonstration extension request of the Family Planning Waiver (FPW), effective July 1, 2014 through
- [Hospital OPPS chemotherapy claims reprocessed](https://medicaid.ms.gov/hospital-opps-chemotherapy-claims-reprocessed/) - The Division of Medicaid has reprocessed hospital OPPS chemotherapy claims for dates of service Jan. 1, 2013 through June 30, 2013 to pay chemotherapy drug codes at ASP+6%. These adjusted claims are shown on Provider Remittance Advices dated March 17, 2014. Please direct questions and inquiries to Xerox Provider and Beneficiary Services by calling toll-free at 800-884-3222. No
- [Oral proceeding on Miss. Admin. Code Part 203, Rule 1.11:  Global Package](https://medicaid.ms.gov/oral-proceeding-on-miss-admin-code-part-203-rule-1-11-global-package/) - An Oral Proceeding on the MS Division of Medicaid’s Administrative Code proposed filing on the Global Package payment system will be held on Wednesday, July 23 at 1:30 p.m. at the War Memorial, 120 North State Street, Jackson, MS. This filing is to comply with the Affordable Care Act and the National Correct Coding Initiative
- [MississippiCAN beneficiary workshops](https://medicaid.ms.gov/mississippican-beneficiary-workshops/) - Attention all Medicaid beneficiaries, 2014 MississippiCAN Beneficiary Workshops are coming your way Aug. 12-Sept. 3, 2014 at locations throughout the state. There will be door prizes, refreshments and information about services available through MississippiCAN. RSVP Please call toll-free 800-884-3222 to let us know you will be attending. Beneficiary Workshop Resources 2014 MississippiCAN Beneficiary Workshop flyer MississippiCAN
- [Pharmacy provider notice](https://medicaid.ms.gov/pharmacy-provider-notice/) - Medicaid Fee for Service (FFS) claims: Beginning Aug. 21, 2014 at 12:01 a.m., pharmacy point of sale (POS) fee for service (FFS) claims will be reimbursed at the previous payment rate used prior to July 1, 2014. Be advised that the Aug. 25, 2014 Remittance Advice (RA) may reflect payments with two reimbursement methodologies. Please continue
- [Universal preferred drug List delay notice](https://medicaid.ms.gov/universal-preferred-drug-list-delay-notice/) - The Mississippi Division of Medicaid fee-for-service and MississippiCAN managed care providers, Magnolia Health Plan and UnitedHealthcare, universal preferred drug list projected start date of Oct. 1, 2014 has been postponed. At this time, we anticipate the new universal preferred drug list effective date to be Jan. 1, 2015. Please continue to check the Mississippi Division
- [Fall 2013 Provider Program Notice](https://medicaid.ms.gov/fall-2013-provider-program-notice/) - Pharmacy Permit Renewal - Expiration Dec. 31, 2013 MS Medicaid requires that providers be in good standing with their regulatory authorities. Pharmacists are required to update their provider information with license renewal information with Division of Medicaid’s (DOM) fiscal agent or Xerox. Most MS pharmacy permits expire on Dec.31, 2013. Fax the following to Xerox's Provider
- [Medicaid and Xerox Change Four Medical Review Forms](https://medicaid.ms.gov/medicaid-and-xerox-change-four-medical-review-forms/) - The Division of Medicaid, along with Xerox State Healthcare, LLC has made changes to four of its forms used by Medical Review. The forms are as follows: RTP (Return to Provider) Letters, Denial Letters, Consent EOB Codes, and Claims Reconsideration Form. The RTP letter, Denial Letter, and EOB Consent Codes will be used for correspondence with providers only
- [Advanced Imaging Claims Reprocessed for Specific Time Frame](https://medicaid.ms.gov/advanced-imaging-claims-reprocessed-for-specific-time-frame/) - Due to a delay in implementation of system requirements for the radiology management program, the Division of Medicaid will reprocess advanced imaging claims for dates of service July 1, 2013 through Jan. 27, 2014. Specifically, claims billed separately for Professional and Technical components will be affected. Any claim previously submitted for Professional component only must be resubmitted to include
- [Tamper Resistant Prescription Pads/Paper Mandate](https://medicaid.ms.gov/tamper-resistant-prescription-padspaper-mandate/) - Beginning April 1, 2008, all written prescriptions for outpatient drugs prescribed to a Medicaid beneficiary must be on paper with at least one tamper-resistant feature as outlined by CMS. Beginning Oct. 1, 2008 these same prescriptions must be on paper that meets all three baseline characteristics of tamper-resistant pads. CMS has recently issued new documents
- [ICD-10 International Classification of Diseases, 10th Edition implementation ](https://medicaid.ms.gov/icd-10-international-classification-of-diseases-10th-edition-implementation/) - For dates of service on and after Oct. 1, 2015, entities covered under the Health Insurance Portability and Accountability act (HIPAA) are required to use the International Classification of Diseases, 10th Edition (ICD-10) code sets in standard transactions adopted under HIPAA. All providers covered by HIPAA must make the transition. This is a directive of
- [FDA dose reduction of acetaminophen in prescription drugs, Jan. 1, 2014 ](https://medicaid.ms.gov/fda-dose-reduction-of-acetaminophen-in-prescription-drugs-jan-1-2014/) - For several years, the FDA has been actively involved regarding drug safety for both legend and over the counter drugs. Now, the FDA is taking steps to reduce the maximum dosage unit strength of acetaminophen in prescription drug products. This change will provide an increased margin of safety to help prevent liver damage due to
- [Beneficiary Access issues: Doxycycline ](https://medicaid.ms.gov/beneficiary-access-issues-doxycycline/) - Beneficiary Access issues: Doxycycline It has come to our attention that beneficiaries are experiencing difficulties getting prescriptions for doxycycline filled. Drug shortages and availability issues have created significant price increases for the hyclate formulation. Reimbursement of doxycycline hyclate is based upon the federal upper limits (FUL) which cannot be overridden. However, doxycycline monohydrate is a
- [Provider Notice: Zoster Vaccine coverage in POS ](https://medicaid.ms.gov/provider-notice-zoster-vaccine-coverage-in-pos/) - Effective Dec. 1, 2013: Addition of Zoster vaccine administered in the Pharmacy Venue to Medicaid fee for service (FFS) beneficiaries Effective Dec. 1, 2013, in the MS Medicaid Pharmacy program zoster immunizations are covered services for Medicaid beneficiaries ages 60 and older. As with other pharmacy services, a hard copy prescription must be on file. Immunizations
- [Pharmacy Permit Renewal Update](https://medicaid.ms.gov/pharmacy-permit-renewal-update/) - The Division of Medicaid (DOM) has been notified that the Board of Pharmacy is encountering delays processing bi-annual pharmacy permit renewals. Pharmacies enrolled in the MS Medicaid program must be in good standing with their regulatory authority to be a Medicaid provider. Due to the delay with the permit renewal process at the Board of
- [Two Orthodontic Services Codes Opened](https://medicaid.ms.gov/two-orthodontic-services-codes-opened/) - Effective March 15, 2014 Mississippi Division of Medicaid (DOM) opened two Orthodontic service codes to streamline Phase I Prior Authorization (PA) requests. Phase I Orthodontic PA requests will no longer be approved in a lump sum. D8050 – Phase I Interceptive Orthodontic treatment of the primary detention D8060 – Phase I Interceptive Orthodontic treatment of the transitional
- [HOR Phase II Implements](https://medicaid.ms.gov/hor-phase-ii-implements/) - The Division of Medicaid, along with Xerox State Healthcare, LLC have incorporated HOR Phase II of the new HIPAA operating rules. As a result, some previous codes are no longer supported. For more information concerning these changes, please visit the Mississippi Medicaid web portal. If you have any additional questions, please contact Xerox Provider and Beneficiary Services toll-free at
- [ICD 10 Testing](https://medicaid.ms.gov/icd-10-testing/) - On Sept. 5, 2012, the U.S. Department of Health and Human Services (HHS) released the final rule delaying the ICD-10 compliance date mandating that everyone covered by the Health Insurance Portability and Accountability Act (HIPAA) must implement ICD-10 for medical coding to Oct. 1, 2014. On Oct. 1, 2014, medical coding in U.S. health care

## Pages

- [Home](https://medicaid.ms.gov/) - The Mississippi Division of Medicaid responsibly provides access to quality health coverage for vulnerable Mississippians.
- [Medicaid and Human Services Transparency and Fraud Prevention Act](https://medicaid.ms.gov/resources/legislative-resources/hope-act/) - The Medicaid and Human Services Transparency and Fraud Prevention Act, which was passed during the 2017 legislative session, directed the Division of Medicaid to partner with the Department of Human Services to conduct enhanced identity and asset verification for all applications for benefits and to share information between agencies. The legislation also revised various provisions
- [MississippiCAN and CHIP Companion Guides](https://medicaid.ms.gov/mississippican-and-chip-companion-guides/) - Companion guides are the normal tool for communicating to EDI submitters how medical and pharmacy claims information is expected to be received. These documents are often very lengthy. Under DOM’s new fiscal agent, Gainwell Technologies, FFS, MississippiCAN and MississippiCHIP companion guides were combined. Items which specifically affect the CCOs are noted within each guide. The
- [High-Risk Maternal and Infant Case Management](https://medicaid.ms.gov/high-risk-maternal-and-infant-case-management/) - Case management services are available for certain Medicaid-eligible pregnant/postpartum women and infants to support healthy pregnancies, improve birth outcomes, and reduce infant mortality. The maternal and infant risk screening forms located on this page must be completed and submitted to the appropriate managed care organization, or to Telligen, which oversees services provided to Fee‑for‑Service members.
- [Procurement](https://medicaid.ms.gov/resources/procurement/) - The Mississippi Division of Medicaid endeavors to ensure the fair and equitable treatment of all persons and offerors in regards to the procurement process. The procurement process provides for the evaluation of proposals and selection of the winning proposal in accordance with federal and state law and regulations. Current and previous procurements along with other
- [Resources](https://medicaid.ms.gov/resources/) - Eligibility Enrollment Reports The reports listed below include enrollment numbers for the following populations: children (foster care, DHS and k-babies), aged, blind & disabled, adults (parents, pregnant women and adult refugees), family planning waiver, Children's Health Insurance Program (CHIP) and the total for all populations. The Medicaid enrollment report reflects the population counts when the
- [Provider Terminations](https://medicaid.ms.gov/providers/provider-terminations/) - The Mississippi Division of Medicaid maintains a list of providers whose Medicaid provider agreement has been terminated. Refer to the Miss. Code Ann. §43-13-121 and the Code of Federal Regulations (CFR) §455.416 for the reasons a provider’s enrollment may be denied or revoked. The following list contains individuals or entities whose participation in the Medicaid
- [Completed Procurements](https://medicaid.ms.gov/resources/procurement/completed-procurements/) - The procurements listed below are for informational purposes only. These procurements have been previously completed. 2026 School Based Administrative Claiming Consultation Services - QR #20260227 - 2/27/2026 QR #20260227 Attachment A - Quote Form Release Attachment C - Subcontractor Attachment D - Drug Free Workplace Attachment E - Debarment Attachment F - Amendment Acknowledgment
- [Fee Schedules and Rates](https://medicaid.ms.gov/providers/fee-schedules-and-rates/) - Click here to download the Comprehensive Fee Schedule. Click here to go to the Interactive Fee Schedule on the Provider Portal. Below are the fee schedules and rates listed by codes for particular provider or facility types. Paper Claims Billing Manual Administered Drug Services Dental Professional Services Hearing and
- [Contract Award Analysis Reports](https://medicaid.ms.gov/resources/procurement/contract-award-analysis-reports/) - Contract Award Analysis Reports The contract award analysis reports are for informational purposes only. The contract is available on the Mississippi Transparency website at: www.transparency.ms.gov, and the contract is available for public inspection in the Office of Procurement. Please contact procurement@medicaid.ms.gov for more information. School Based Administrative Claiming Services Certified Public Accountant Program Coordinator MSCAN/CHIP
- [Pharmacy Resources](https://medicaid.ms.gov/pharmacy/pharmacy-resources/) - Below are resources and links for pharmacy services. Pharmacy Forms *Main Forms webpage DOM Lists 90-Day Maintenance List - disease state format effective April 1, 2019 90-Day Maintenance List - effective April 1, 2019 Clinician Administered Drugs and Implantable Drug System Devices (CADD) Covered Over-The-Counter (OTC) Drug List Covered Over-The-Counter (OTC) NDC List Family Planning Waiver
- [Drug Prior Authorization (PA)](https://medicaid.ms.gov/pharmacy-prior-authorization/) - Pharmacy Point-of-Sale (POS) Pharmacy PA (applies to prescription drugs typically dispensed by outpatient pharmacies - (click here for instructions) Gainwell Technologies handles PA requests for drugs billed through the POS venue. If you are a Mississippi Medicaid prescriber, please submit your PA requests through the Gainwell provider web portal (preferred route) or fax completed PA
- [Universal Preferred Drug List](https://medicaid.ms.gov/preferred-drug-list/) - The Office of Pharmacy does not routinely meet with pharmaceutical manufacturers to review drug presentations. Instead, we ask that industry present pertinent clinical drug information to Medimpact. Medimpact is responsible for Pharmacy and Therapeutics Committee drug and drug class reviews, administration of the supplemental rebate program and management of the Universal Preferred Drug List (PDL).
- [Administrative Code](https://medicaid.ms.gov/providers/administrative-code/) - Title 23 of the Mississippi Administrative Code The Mississippi Administrative Code (Admin. Code) Title 23 Division of Medicaid is a set of rules that dictate how the Medicaid agency is administered. The Code is divided into parts, chapters and rules which outlines policy and procedures. Changes to the Admin. Code must be filed with the
- [Preferred Drug List Archive](https://medicaid.ms.gov/preferred-drug-list-archive/) - Preferred Drug List Archive Preferred Drug List Provider Notice Archive Preferred/Non-Preferred Drug List Archive Brand Preferred Over Generic Archive
- [Medicaid Advisory Committee](https://medicaid.ms.gov/medicaid-advisory-committee/) - Medicaid Advisory Committee On May 10, 2024, the Centers for Medicare & Medicaid Services (CMS) published the Ensuring Access to Medicaid Services Final Rule, 89 FR 40542 (hereafter called the 2024 Access Final Rule). A key provision in the 2024 Access Final Rule establishes requirements for states to operate Medicaid Advisory Committee (MACs) and Beneficiary
- [MESA Portal for Providers](https://medicaid.ms.gov/mesa-portal-for-providers/) - MESA Portal for Providers The Mississippi Division of Medicaid's transition to a new Fiscal Agent, effective Oct. 3, 2022, includes a new Medicaid Management Information System (MMIS) and provider portal known as MESA: Medicaid Enterprise System Assistance. The goal of MESA is to enhance connections between health services systems and improve access to health information
- [Late Breaking News](https://medicaid.ms.gov/late-breaking-news/) - The latest updates and information Mississippi Medicaid providers need to know is posted in Late Breaking News 7/28/2026 New Training Resources Available Related to Certain Claim Denials The Mississippi Division of Medicaid (DOM) and Gainwell are pleased to announce the development of new training resources to assist providers with understanding and resolving certain
- [Measuring Managed Care Performance](https://medicaid.ms.gov/programs/managed-care/measuring-managed-care-performance/) - National Committee for Quality Assurance Health Plan Ratings Follow the link below to view the most recent ratings of MississippiCAN's coordinated care organizations (CCOs) published by the National Committee for Quality Assurance. NCQA Health Insurance Plan Ratings 2022 Child and Adult Core Sets Measure Trend Snapshot The Child and Adult Core Sets consist of a
- [HCBS Waiver Providers](https://medicaid.ms.gov/hcbs-waiver-providers/) - Administrative Code, Part 208, Chapter 1 Updates Effective June 1, 2025 Medicaid Administrative Code, Part 208, Chapter 1 Home and Community-Based Services (HCBS) Elderly and Disabled (E&D) Waiver has been updated. The new regulations go into effect Sunday June 1, 2025. The Office of Long Term Services & Supports is creating service specific training for
- [Contact](https://medicaid.ms.gov/contact/) - Contact the Mississippi Division of Medicaid The Mississippi Division of Medicaid (DOM) is committed to providing access for members, providers, and partners to get the help and information they need. Whether you have a question, need to submit a request, or aren’t sure who to contact, we’re here to guide you. You’ll find our general
- [Employee Benefits](https://medicaid.ms.gov/employee-benefits/) - Division of Medicaid Benefit Information Health and Life Benefits State Employee's Health State Employee's Life Voluntary Supplemental Benefits 2026 Division of Medicaid Benefit Guide Voluntary Insurance Products Dental Insurance – Dental Guard network Vision Insurance – VSP Network Short-Term Disability Long-Term Disability Critical Illness Accident Cancer Hospital Indemnity Employee Assistance Identify & Fraud
- [Managed Care](https://medicaid.ms.gov/programs/managed-care/) - The Mississippi Division of Medicaid (DOM) has implemented a managed care program called Mississippi Coordinated Access Network (MississippiCAN). MississippiCAN is designed to get a better return on Mississippi’s health care investment by improving the health and well-being of Medicaid beneficiaries. MississippiCAN is a statewide coordinated care program designed to meet the following goals: improve beneficiary access to
- [Public Records Requests](https://medicaid.ms.gov/public-records-requests/) - The General Counsel of Mississippi Division of Medicaid has oversight of the Public Records Office. Mississippi Division of Medicaid is committed to the accurate sharing of non-exempt public records, in accordance with agency policies. All records and portions of records, not exempt from disclosure, will be made available in accordance with the procedures outlined in
- [Inpatient and Outpatient Hospital UPL Payment Programs](https://medicaid.ms.gov/inpatient-and-outpatient-hospital-upl-payment-programs/) - Inpatient and Outpatient Hospital UPL Payment Programs The State Plan Amendment (SPA) 23-0029 for Hospital Upper Payment Limit (UPL) payments has been approved by the Centers for Medicare & Medicaid Services (CMS). This SPA allows the Division of Medicaid (DOM) to establish a hospital UPL program effective October 1, 2023 for inpatient and outpatient hospital
- [Pharmacy and Therapeutics Committee](https://medicaid.ms.gov/pharmacy-and-therapeutics-committee/) - The Office of Pharmacy does not routinely meet with pharmaceutical manufacturers to review drug presentations. Instead, we ask that industry present pertinent clinical drug information to Medimpact. Medimpact is responsible for Pharmacy and Therapeutics Committee drug and drug class reviews, administration of the supplemental rebate program and management of the Universal Preferred Drug List (PDL).
- [Provider Resources](https://medicaid.ms.gov/providers/provider-resources/) - Below are links for provider resources. Medical Services Early Periodic Screening, Diagnosis, and Treatment (EPSDT) Periodicity examination schedule Telligen- the utilization management and quality improvement organization responsible for certain advanced imaging procedures. Dental Periodicity Schedule Durable Medical Equipment Wheelchair Code Resource Document Long Term Care Nursing Facility Case Mix Civil Money Penalty (CMP) Grant Awards
- [Beneficiary Advisory Council](https://medicaid.ms.gov/beneficiary-advisory-council-2/) - On May 10, 2024, the Centers for Medicare & Medicaid Services (CMS) published the Ensuring Access to Medicaid Services Final Rule, 89 FR 40542. In accordance with Code of Federal Regulations (CFR) Title 42 §431.12(e) the Mississippi Division of Medicaid has established a Beneficiary Advisory Council. The state must form and support a BAC, which
- [Transforming Maternal Health Model](https://medicaid.ms.gov/transforming-maternal-health-model/) - The Mississippi Division of Medicaid was awarded funding under the CMS TMaH (Transforming Maternal Health) Model beginning January 2025. The grant is for $17 million and will run for 10 years (2025-2034). The TMaH model supports participating state Medicaid agencies in the development of a whole-person approach to pregnancy, childbirth, and postpartum care. By
- [Healthier Mississippi Waiver](https://medicaid.ms.gov/medicaid-coverage/who-qualifies-for-coverage/healthier-mississippi-waiver/) - The Healthier Mississippi Waiver enrollment started Jan. 1, 2006, and is for individuals age 65-years-old or older, or disabled with no Medicare. Effective July 24, 2015, the maximum number of individuals who can be enrolled in this waiver may not be more than 6,000 at any given time. If enrollment reaches 6,000, the waiver is closed to enrollment
- [Family Planning](https://medicaid.ms.gov/medicaid-coverage/who-qualifies-for-coverage/family-planning/) - The Mississippi Family Planning Waiver Demonstration program is for women and men who receive Medicaid benefits limited to family planning services and family planning related services. This includes one annual visit and subsequent visits related to their birth control methods and family planning services. Beneficiaries cannot exceed a total of four visits per calendar year
- [Pharmacy](https://medicaid.ms.gov/pharmacy/) - Latest Pharmacy News and Notices The latest pharmacy provider billing updates and news notices will be posted here. Please check daily for updates. Pharmacy News and Notices Archive Pharmacy Drug Coverage Inquiry Drug Presentations The Office of Pharmacy does not routinely meet with pharmaceutical manufacturers to review drug presentations. Instead, we ask that industry
- [Proposed Administrative Code Filings](https://medicaid.ms.gov/providers/administrative-code/proposed-administrative-code-filings/) - 2026 2025 Agency: DIVISION OF MEDICAID Compilation: No Proposed Date: 1/3/2025 Final Date: Effective Date: Withdrawal Date: Rule: Title 23: Medicaid, Part 205: Hospice Services, Chapter 1: Program Overview, Rule 1.8: Reimbursement Summary: This Administrative Code is being revised to allow the Division of Medicaid (DOM) to reimburse the hospice provider for services rendered
- [Final Administrative Code Filings](https://medicaid.ms.gov/providers/administrative-code/final-administrative-code-filings/) - Final Administrative Code Filings The Administrative Code filings below have been final filed with Secretary of State’s office and are listed by year. 2019 | 2018 | 2017 | 2016 | 2015 | 2014 | 2013 | 2012 2026 Agency: DIVISION OF MEDICAID Compilation: No Proposed Date: 6/5/2026 Final Date: 7/1/2026 Effective Date: 8/1/2026 Withdrawal Date:
- [Drug Utilization Review Board](https://medicaid.ms.gov/drug-utilization-review-dur-board/) - Drug Utilization Review Board members (from left) Dena Jackson, MD; Joshua Pierce, PharmD; Joshua Trull, DO; Terrence Brown, PharmD; Greg Browning, MD; Rachel Burt, PharmD; Chrysanthia Davis, PharmD; Gaylen Sanders, MD; Steven Clark, MD. Not pictured are Amy Catherine Baggett, PharmD; Jessica Lavender, MD; Holly Moore, PharmD. DUR Board Overview The Mississippi Division of Medicaid’s
- [Proposed State Plan Amendments submitted to CMS](https://medicaid.ms.gov/about/state-plan/state-plan-amendments/) - Proposed State Plan Amendments The State Plan Amendments below have been submitted to Centers for Medicare and Medicaid Services (CMS) for approval. 2026 MS SPA 26-0002 Federally Qualified Health Center (FQHC) Submitted to CMS State Plan Amendment (SPA) 26-0002 is being submitted to allow Federally Qualified Health Center (FQHC) mobile units to operate under the
- [Children's Health Insurance Program (CHIP) State Plan](https://medicaid.ms.gov/childrens-health-insurance-program-chip-state-plan/) - Current CHIP State Plan CHIP State Plan CHIP Dental Coverage Proposed CHIP State Plan Amendments MS SPA 26-0020-CHIP submitted to CMS State Plan Amendment (SPA) 26-0020-CHIP is being submitted to update the CHIP State Plan to align with the most recent CHIP contract, effective July 1, 2025. MS SPA 25-0018-CHIP Incarcerated Youth submitted to CMS
- [Cell and Gene Therapy (CGT) Access Model](https://medicaid.ms.gov/cell-and-gene-therapy-cgt-access-model/) - Centers for Medicare and Medicaid Services (CMS) Cell and Gene Therapy (CGT) Access Model Overview The Cell and Gene Therapy (CGT) Access Model is a multi-year model for states and manufacturers to test whether a CMS-led approach to developing and administering outcomes-based agreements for CGTs increases Medicaid members’ access to innovative treatments, improves their health
- [Eligibility Policy and Procedures Manual](https://medicaid.ms.gov/eligibility-policy-and-procedures-manual/) - Eligibility Policy and Procedures Manual
- [Services](https://medicaid.ms.gov/programs/) - Services For individuals who can get full Medicaid benefits, the following services available through a variety of programs may be covered if medically necessary: Children Mississippi Health Benefits for Children Health benefits for children from birth to age 19 are provided through Medicaid. Some children may be eligible for Medicaid. Other children whose families make too
- [MississippiCAN Enrollment](https://medicaid.ms.gov/mississippican-enrollment/) - How does MississippiCAN Enrollment Work? All Medicaid beneficiaries who are in the categories of eligibility will receive an enrollment packet in the mail that will explain the program in more detail. The beneficiaries that are optional will have the choice to choose one of the coordinated care organizations (CCOs), choose not to participate or “opt-out”.
- [MississippiCAN Resources](https://medicaid.ms.gov/mississippican-resources/) - Coordinated Care Contracts Mississippi contracts with three Coordinated Care Organizations (CCOs) to administer the managed care program that includes Medicaid and Children’s Health Insurance Program (CHIP) benefits. The previous contract ended June 30, 2025 with the following CCOs: Magnolia Health Plan, Molina Healthcare and UnitedHealthcare. The current contract that commenced August 12, 2024 and began
- [MississippiCAN, CHIP Contracts](https://medicaid.ms.gov/programs/managed-care/11081-2/) - Coordinated Care Contracts August 12, 2024 – August 11, 2028 Coordinated Care Contract Documents Magnolia Health Plan, Inc. August 12, 2024 – August 11, 2028 Contract (pending CMS approval) Magnolia Health Plan, Inc. August 12, 2024 – August 11, 2028 Contract Amendment No. 1 (pending CMS approval) Magnolia Health Plan, Inc. August 12, 2024 –
- [Medicaid Vital Signs Archive](https://medicaid.ms.gov/medicaid-vital-signs-3/) - The Medicaid Vital Signs dashboard displays key Mississippi Medicaid metrics in one easy-to-reference visual package. This report allows anyone to quickly check specific Medicaid statistics and follow recent program trends. Most of the information presented in Medicaid Vital Signs will be updated on a monthly basis.
- [EDI Technical Documents](https://medicaid.ms.gov/edi-technical-documents/) - Electronic Data Interchange (EDI) Technical Documents The Mississippi Division of Medicaid (DOM) is in the process of implementing a new Medicaid Management Information System (MMIS), named MESA: Medicaid Enterprise System Assistance, in collaboration with Gainwell Technologies. In preparation for go-live, each DOM trading partner must undergo Electronic Data Interchange (EDI) testing to ensure the integrity
- [Subrogation](https://medicaid.ms.gov/contact/subrogation/) - The Mississippi Division of Medicaid (DOM)’s Office of Third Party Recovery is charged with the task of identifying and recovering funds by means of collections from third persons by either assignment or subrogation. DOM has contracted with Health Management Systems (HMS) to act as its collection vendor to facilitate and enforce the agency’s statutory right to
- [Public Notices](https://medicaid.ms.gov/news-and-notices/public-notices/) - Pursuant to federal regulations, the Division of Medicaid posts public notices for significant proposed changes in methods and standards for setting reimbursement rates, significant proposed changes in services and/or operations of home and community-based service waivers, any application or extension of demonstration projects, any changes to premiums or cost-sharing for beneficiaries, any applicable changes to
- [Covered Services](https://medicaid.ms.gov/medicaid-coverage/covered-services/) - Mississippi Medicaid Health Benefits Overview For individuals who can get full Mississippi Medicaid health benefits, the following are covered services: office visits family planning services inpatient hospital care outpatient hospital care prescription drugs eyeglasses long term care services inpatient psychiatric care For more details regarding limits and maximum services available, please refer to the
- [2023-2024 Procurements](https://medicaid.ms.gov/2023-2024-procurements/) - 2024 DOM Coordinated Care RFQ – RFQ No. 20211210 Request for Applications — Certified Public Accountant — RFX #3150005351 – 12/8/2023 Attachment A – References Attachment B – Reference Survey State of MS Application Business Associate Agreement Template Amendment #1 – Clarifications (12/8/2023) No Questions Received (12/20/23) Non-Emergency Transportation (NET) Brokerage Services IFB #20230113, RFX
- [Paper Claims Billing Manual](https://medicaid.ms.gov/providers/billing-manual/) - The Paper Claims Billing Manual, produced by Gainwell Technologies, is designed to offer guidance and assistance to providers submitting claims for reimbursement to the Mississippi Division of Medicaid (DOM). The Paper Claims Billing Manual includes detailed information specific to the submission of paper claims which includes Centers for Medicare and Medicaid (CMS)-1500, Dental, and UB-04
- [Legislative Updates](https://medicaid.ms.gov/legislative-updates/) - Listed below are the updates and summaries of legislative bill enacted during the previous legislative session that revise the powers and duties of the Mississippi Division of Medicaid. 2026 Legislative Session Updates and Summary HB 3 (CON; revise certain provisions of) Removes Medicaid bed limitation for PRTF in Desoto County Revised statutory language to limit
- [Prior Authorization](https://medicaid.ms.gov/prior-authorization/) - Notice Section The Mississippi Division of Medicaid (DOM) provides notice of Prior Authorization changes on its Late Breaking News webpage. You can find past Late Breaking News updates or sign up to receive Late Breaking News email alerts at this link: https://medicaid.ms.gov/late-breaking-news/. Lists of Services Requiring a Prior Authorization • Pharmacy PA: Pharmacy Prior
- [Appeals](https://medicaid.ms.gov/appeals/) - The Mississippi Division of Medicaid has created a SharePoint based portal for appeals brought pursuant to 23 Mississippi Administrative Code, Part 300, Chapter 3, Rule 3.1. Provider Appeals Portal You must be granted access to use the portal. If you would like to request access, you may email Medicaid.Appeals@medicaid.ms.gov.
- [Who Qualifies for Coverage?](https://medicaid.ms.gov/medicaid-coverage/who-qualifies-for-coverage/) - Depending on a number of factors an individual may qualify for full Mississippi Medicaid health benefits, reduced coverage or limited benefits (full coverage with some service limits) in a covered group briefly described below. Full Medicaid Benefits The following covered groups of people qualify for full Mississippi Medicaid health benefits if eligible under the appropriate
- [Regional Office Chart](https://medicaid.ms.gov/regional-office-chart/)
- [Office Locations](https://medicaid.ms.gov/about/office-locations/) - The Mississippi Division of Medicaid operates from one central office in Jackson and 30 regional offices across the state. Although it is not required, it is always best to check with the regional office which serves the county in which you reside to obtain information about applying for Medicaid. Office Locations Central Office Walter Sillers
- [Income Limits for Medicaid and CHIP Programs](https://medicaid.ms.gov/medicaid-coverage/who-qualifies-for-coverage/income-limits-for-medicaid-and-chip-programs/) - Income Limits for Medicaid and CHIP Programs Internal Revenue Service (IRS) rules for Modified Adjusted Gross Income (MAGI) are used to determine countable income and, in some instances, household size. Household gross income is then compared to the limits shown below based on household size for the applicable program. A 5% disregard based on the
- [Reimbursement](https://medicaid.ms.gov/providers/reimbursement/) - Inpatient Hospital Payment Method for Mississippi Medicaid ***There are no APR-DRG updates for July 1, 2025. The following July 1, 2023 APR-DRG parameters below are currently in effect. The Mississippi Division of Medicaid (DOM) maintains the hospital inpatient APR-DRG payment methodology effective for the payment of hospital inpatient claims for discharges on and after July
- [Interoperability and Patient Access](https://medicaid.ms.gov/interoperability-and-patient-access/) - Interoperability and Patient Access In 2021, a new federal rule made it easier for our members to manage their digital medical records. The Interoperability and Patient Access rule (CMS-9115-F) focuses on interoperability and patient access, making it easier for members to get their health records when they need it most in a way they can
- [Mississippi Medicaid State Plan](https://medicaid.ms.gov/about/state-plan/) - Mississippi Medicaid State Plan The Mississippi Medicaid State Plan (State Plan) is a detailed agreement between the State of Mississippi and the Federal Government that describes the nature and scope of Mississippi’s Medicaid Program. The State Plan is based on the federal requirements and regulations found in Title XIX of the Social Security Act.
- [Approved State Plan Amendments](https://medicaid.ms.gov/about/state-plan/approved-state-plan-amendments/) - Approved State Plan Amendments The State Plan Amendments below have been previously approved and are listed by year. 2019 | 2018 | 2017 | 2016 | 2015 | 2014 | 2013 | 2012 | 2011 | 2010 | 2009 | 2008 | 2007 | 2006 | 2005 2026 MS SPA 25-0002 Automatic Enrollment approved by
- [Legislative Resources](https://medicaid.ms.gov/resources/legislative-resources/) - Throughout each legislative session, the Mississippi Division of Medicaid will be assembling a collection of materials and fast facts for the public to utilize. These materials cover a variety of different subjects such as agency overviews, coordinated care, enrollment numbers, annual reports and budget presentations. This page will be updated as necessary with more information as the session progresses.
- [Provider Enrollment Application Fee](https://medicaid.ms.gov/provider-enrollment-application-fee/) - Provider Enrollment Application Fee Increased for 2026 The enrollment application fee for institutional providers for the 2026 calendar year has increased from $730 to $750. See the following announcement: Federal Register. • Initial enrollment, reactivation, revalidation or reenrollment of providers in Medicaid and the Children’s Health Insurance Program (CHIP) • Addition of New Owners
- [Providers](https://medicaid.ms.gov/providers/) - The Mississippi Division of Medicaid values all types of health care providers enrolled in the Medicaid program. Medicaid is a federal and state program created to provide medical assistance to eligible, low income populations. This service is in place to provide access to quality health care coverage for vulnerable Mississippians. Request for Coverage (RFC) – Mississippi
- [Civil Money Penalty Grant Awards Program](https://medicaid.ms.gov/programs/civil-money-penalty-cmp-grant-awards-program/) - The goal of the Civil Money Penalty (CMP) Grant awards program is to facilitate the use of Federally Imposed Civil Money Penalty Funds to support activities that support, protect and benefit residents living in nursing facilities. Only CMP fund applications that meet the statutory intent of the regulations, federal law and policy will be considered.
- [Beneficiary Advisory Council](https://medicaid.ms.gov/beneficiary-advisory-council/) - The Mississippi Medicaid Beneficiary Advisory Council The purpose of the Mississippi Medicaid Beneficiary Advisory Council (MBAC) is to advise the Mississippi Division of Medicaid (DOM) Executive Director with recommendations that will enhance the experience of Medicaid members and facilitate access to high quality medical care delivered in a cost-effective manner. The goal is to obtain
- [Forms](https://medicaid.ms.gov/resources/forms/) - The best way to contact the Mississippi Division of Medicaid (DOM) is through our secure online forms, available on this website. These forms are designed to efficiently and securely route your request to the appropriate recipient. You may also reach us by phone, postal mail, or fax using the contact details below. Toll-free: 800-421-2408 or
- [Third Party Liability and Recoveries](https://medicaid.ms.gov/providers/third-party-liability-and-recoveries/) - The Office of Recovery performs third party functions in two ways: by avoiding Medicaid payments when other commercial or public health insurance carriers should pay for a service; and by recovering Medicaid payments made prior to the identification of a legally-obligated third-party source. Third party liability (TPL) refers to the legal obligation of health care
- [Report Third Party Insurance](https://medicaid.ms.gov/contact/report-third-party-insurance/) - Report Third Party Insurance The Mississippi Division of Medicaid (DOM) by law is intended to be the “payer of last resort”; that is, all other available third-party sources must meet their legal obligation to pay claims before the Mississippi Medicaid program pays for the care of an individual eligible for Medicaid or CHIP. Mississippi Medicaid
- [Open Enrollment 2025](https://medicaid.ms.gov/open-enrollment-2025/) - Want to make changes to your current healthcare coverage? This is your annual opportunity to change your health plan. Changes will be effective Jan. 1, 2026. You can only switch once - you can chose to: Stay with the MississippiCAN or CHIP health plan you have now. Switch to another health plan. If you like
- [Moments with Medicaid](https://medicaid.ms.gov/moments-with-medicaid/) - Welcome to Moments with Medicaid! Most Recent Moments Open Enrollment 2025 - Posted Oct. 7, 2025 How to Complete a Change Form - Posted Oct. 7, 2025 Previous Moments What is MississippiCAN? - Posted Feb. 21, 2025 What is Eligible for MississippiCAN? - Posted Feb. 21, 2025
- [MississippiCAN Feedback](https://medicaid.ms.gov/mississippican-feedback/) - We want and appreciate feedback about the MississippiCAN program from our members, providers and related entities. Read the information below on how to give feedback, submit an inquiry or complaint. How do I submit a managed care issue? How long will it take before I hear something about my issue? What if
- [Katie Beckett Program (DCLH)](https://medicaid.ms.gov/medicaid-coverage/who-qualifies-for-coverage/disabled-child-living-at-home/) - The Katie Beckett Program - formerly known as Disabled Child Living at Home (DCLH) - is a special eligibility category that allows certain disabled children who are residents of Mississippi with long-term disabilities or complex medical needs, living at home with their families, to obtain Mississippi Medicaid eligibility. General Information Qualification is not based on
- [Emergency Administrative Code Filings](https://medicaid.ms.gov/providers/administrative-code/emergency-administrative-code-filings/) - 2025 Agency: DIVISION OF MEDICAID Compilation: No Proposed Date: 9/10/2025 Final Date: 9/10/2025 Effective Date: 9/10/202 Withdrawal Date: Rule: Title 23: Medicaid, Part 207: Institutional Long-Term Care, Chapter 4: Psychiatric Residential Treatment Facility, Rule 4.2: Provider Enrollment Summary: This administrative code is being emergency filed to revise the provider enrollment requirements for a PRTF to
- [Preferred Drug List](https://medicaid.ms.gov/preferred-drug-list-2/)
- [Rural Health Transformation Program](https://medicaid.ms.gov/rural-health-transformation-program/) - Summary On July 3, Congress passed via the FY 2025 budget reconciliation process H.R.1, the One Big Beautiful Bill Act (OBBBA), and on July 4, the President signed it into law. Section 71401 of the Bill modifies Section 2105 of the Social Security Act and establishes a $50 billion grant program ($10 billion per fiscal
- [After You Apply](https://medicaid.ms.gov/medicaid-coverage/after-you-apply/) - Application Processing and Case Overview Case Review After you submit an application for Mississippi Medicaid health benefits, the regional office that serves your county of residence will be in contact with you by phone or you may get a letter regarding your eligibility determination. If something is incorrect, missing or needs clarification a regional office
- [How to Apply](https://medicaid.ms.gov/how-to-apply-2/) - How to Apply for Mississippi Medicaid Health Benefits There are multiple ways you can apply for Mississippi Medicaid Health Benefits: * Account Required Applications: MAGI Application Form (Click here for Spanish version of Application): Use this application to apply for children, pregnant women, low-income parents of children under age 18 and anyone in your
- [Institutional Long Term Care Providers](https://medicaid.ms.gov/institutional-long-term-care-providers/) - Institutional Long Term Care Providers The Offices of Long Term Care and Mental Health are responsible for administering activities related to Medicaid long term services and supports rendered in institutional settings including nursing facilities (NFs), intermediate care facilities for individuals with intellectual/developmental disabilities (ICF/IDDs) and psychiatric residential treatment facilities (PRTFs). Provider Education Upcoming Trainings/Events
- [Who Qualifies for MississippiCAN](https://medicaid.ms.gov/who-qualifies-for-mississippican/) - Who Qualifies for MississippiCAN? Beneficiaries eligible to be a part of this program are those that receive Medicaid through: Supplemental Security Income (SSI) Department of Human Services foster care children Disabled child living at home Working disabled Breast/cervical cancer Pregnant women and infants Family/children on the Temporary Assistance for Needy Families (TANF) All newborns Mandatory
- [Medical Care Advisory Committee](https://medicaid.ms.gov/resources/legislative-resources/medical-care-advisory-committee/) - The Mississippi Medical Care Advisory Committee, also referred to as the Medicaid Advisory Committee, is an advisory committee required by federal regulation to advise the Division of Medicaid about health and medical care services in accordance with 43-13-107(3) and 42 CFR 431.12. The Advisory Committee currently is comprised of not less than eleven members appointed
- [MississippiCAN Prior Authorization Information](https://medicaid.ms.gov/mississippican-prior-authorization-information/) - MississippiCAN Pharmacy Prior Authorization Contact Information Keep in mind that MSCAN claims and PA requests must be submitted to the respective PBM. Submitting claims and/or prior authorization requests to MS Medicaid rather than to the respective plan delays the process for Medicaid, providers and beneficiaries. MississippiCAN Pharmacy Prior Authorization Contact Information Non-Mental Health Service Click
- [Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID)](https://medicaid.ms.gov/programs/intermediate-care-facilities-for-individuals-with-intellectual-disabilities-icfiid/) - The Division of Medicaid (DOM), Office of Mental Health is responsible for monitoring Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) surveys from the Mississippi State Department of Health Licensure and Certification Branch (L&C). DOM enforces penalty recommendations from L&C on ICF/IIDs enrolled as Medicaid providers that are out of compliance with the state and federal
- [Children's Health Insurance Program (CHIP)](https://medicaid.ms.gov/programs/childrens-health-insurance-program-chip/) - Through Mississippi Health Benefits there are two health insurance options that cover children, the Children's Health Insurance Program (CHIP) and Medicaid. The income limits are based on Modified Adjusted Gross Income or MAGI limits. The limits are referred to as MAGI because the programs using MAGI limits are based primarily on IRS rules for counting
- [MississippiCAN CHIP Information](https://medicaid.ms.gov/mississippican-chip-information/) - Below is Children's Health Insurance Program (CHIP) information in regards to MississippiCAN. Who is Eligible? CHIP provides health coverage for uninsured children up to age 19 years old. To be eligible for CHIP, a child cannot be eligible for Medicaid. At the time of application, children with health insurance are not eligible for CHIP. It is
- [Managed Care Contacts](https://medicaid.ms.gov/mississippican-contacts/) - DOM has contracted with three coordinated care organizations (CCOs), Magnolia Health, TrueCare and Molina Healthcare who are responsible for providing services to beneficiaries who participate in MississippiCAN and Children's Health Insurance Program (CHIP). Below is the contact information for each CCO. MississippiCAN Contacts Gainwell: for MississippiCAN enrollment Toll-free: 800-884-3222 Website: https://portal.ms-medicaid-mesa.com/ Magnolia Health Toll-free: (877)
- [MississippiCAN Health Plans](https://medicaid.ms.gov/mississippican-health-plans/) - The Mississippi Division of Medicaid has contracts with three Coordinated Care Organizations, who are responsible for providing services to the Mississippi Medicaid beneficiaries who participate in the MississippiCAN program. All plans offer the same services Medicaid offers. Each plan will offer extra benefits such as vision and physician visits benefits. The three plans must adhere to
- [Early and Periodic Screening, Diagnosis, and Treatment](https://medicaid.ms.gov/programs/early-and-periodic-screening-diagnosis-and-treatment-epsdt/) - Early and Periodic Screening, Diagnosis, and Treatment The Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program is a federally mandated service which provides preventive and comprehensive health services for children from birth up to age 21 who are eligible for Medicaid. It provides critical services to improve the health of infants, children and adolescents. It provides
- [American Rescue Plan Act HCBS Enhancement Opportunities](https://medicaid.ms.gov/american-rescue-plan-act-hcbs-enhancement-opportunities/) - Summary The American Rescue Plan Act (ARPA) of 2021 was signed into law on March 11, 2021. Section 9817 of ARPA provides states with a temporary ten (10) percentage point increase to the federal medical assistance percentage (FMAP) for Medicaid Home and Community-Based Services (HCBS). HCBS is defined broadly in the statute and guidance to
- [Transforming Reimbursement for Emergency Ambulance Transportation (TREAT)](https://medicaid.ms.gov/transforming-reimbursement-for-emergency-ambulance-transportation-treat/) - Program Overview The Transforming Reimbursement for Emergency Ambulance Transportation (TREAT) program began effective July 1, 2022. In the 2022 regular legislative session, House Bill 657 authorized the additional payments program for emergency ambulance services to be funded with a health care provider fee. The TREAT upper payment limit program provides reimbursement for emergency ambulance
- [Withdrawn State Plan Amendments](https://medicaid.ms.gov/about/state-plan/withdrawn-state-plan-amendments/) - Withdrawn or Terminated State Plan Amendments The proposed State Plan Amendments below have been withdrawn or terminated, and are listed by year. 2018 | 2014 | 2013 | 2010 | 2009 | 2008 | 2007 | 2005 2024 MS SPA 23-0023 Rural Health Clinics (RHC) State Plan Amendment (SPA) 23-0023 was submitted to add
- [Provider Bulletins](https://medicaid.ms.gov/providers/provider-resources/provider-bulletins/) - The Mississippi Division of Medicaid publishes a quarterly Provider Bulletin for our enrolled Medicaid providers. This publication aims to inform providers of Medicaid news, policy changes, a way to connect with our executive director and provides contact information for provider field representatives listed by county, and more. The Provider Bulletin is published four times per year or as needed
- [Elderly and Disabled Waiver](https://medicaid.ms.gov/programs/elderly-and-disabled-waiver/) - The Elderly and Disabled Waiver program is administered and operated by the Office of Long Term Care. Case Management services are provided by the Planning and Development Districts. The case management team is composed of a registered nurse and a licensed social worker who are responsible for identifying, screening and completing an assessment on individuals in
- [Dual Special Needs Plans (DSNPs)](https://medicaid.ms.gov/programs/dual-special-needs-plans-dsnps/) - Dual Eligible Special Needs Plans (DSNPs) serve members who are eligible for both Medicaid and Medicare, known as "dual eligibles." DSNPs offer care coordination and provide supplemental benefits to their members to improve coordination of services and enhance quality of care. Dual eligible individuals have the option to enroll in a DSNP during the following
- [Pharmacy Resources Archive](https://medicaid.ms.gov/pharmacy-resources-archive/) - Listed below is an archive of resources and links for pharmacy services from previous years. DOM Lists Cough and cold quick list - Sept. 2015 DESI Drug list 2010 OTC drug list - effective Feb. 1, 2020 - July 27, 2020 OTC drug list - effective October 1, 2013 - Jan. 31, 2019 OTC drug list -
- [Breast and Cervical Cancer Program (BCC)](https://medicaid.ms.gov/breast-and-cervical-cancer-program-bcc/) - The Mississippi Division of Medicaid (DOM) covers treatment for women who have been screened and diagnosed with breast and/or cervical cancer or pre-cancerous condition through the Mississippi State Department of Health's Breast and Cervical Cancer (BCC) program. Eligibility continues throughout the course of active treatment for cancer. Women receive full Medicaid coverage while enrolled in
- [340B](https://medicaid.ms.gov/340b/) - 340B Program The 340B program is a Drug Pricing Program established by the Veterans Health Care Act of 1992, which is Section 340B of the Public Health Service Act (PHSA). Section 340B limits the cost of covered outpatient drugs to certain federal grantees, federally-qualified health center look-alikes, and qualified hospitals. These providers purchase, dispense and/or
- [Leadership](https://medicaid.ms.gov/about/leadership/) - Executive Director Cindy Bradshaw is Executive Director of the Mississippi Division of Medicaid (DOM). She was appointed by Governor Tate Reeves in October 2024. As Executive Director, Bradshaw manages a team of more than 900 employees and is focused on ensuring long-term sustainability for the Division of Medicaid, as well as enhancing operational excellence and
- [New Coverage Requirements for Eligible Incarcerated Youth](https://medicaid.ms.gov/new-coverage-requirements-for-eligible-incarcerated-youth/) - New requirements under Section 5121 of the Consolidated Appropriations Act (CAA), 2023 Beginning January 1, 2025, the Division of Medicaid is required to cover specific screening, diagnostic, and targeted case management services for eligible juveniles who are being held post adjudication as inmates of a public institution. These services are required to be covered in
- [Pharmacy Reimbursement](https://medicaid.ms.gov/pharmacy/pharmacy-reimbursement/) - A new pharmacy reimbursement methodology for the Mississippi Division of Medicaid (DOM) impacts both fee-for-service and MississippiCAN pharmacy claims. This page covers the current pharmacy reimbursement timeline in addition to providing specific information regarding stakeholder meetings, pharmacy reimbursement methodology as found in the State Plan Amendment (SPA), specialty drug list, and the 340B program. Reimbursement
- [Waivers](https://medicaid.ms.gov/providers/waivers/) - 1115(a) | 1915(c) | 1915(b)(4) 1115(a) summary: 42 C.F.R. § 431.400 Section 1115 of the Social Security Act allows the Secretary of the Department of Health and Human Services (HHS) to waive certain federal requirements and gives the Centers for Medicare and Medicaid Services (CMS) the authority to approve experimental, pilot, or demonstration projects. The
- [Notice of Privacy Practices](https://medicaid.ms.gov/notice-of-privacy-practices/) - THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW THE NOTICE BELOW CAREFULLY. Health Insurance Portability and Accountability Act (HIPAA) Notice of Privacy Practices View or print this information as a document: Notice of Privacy Practices The Mississippi Division of
- [MESA Portal for Providers - New](https://medicaid.ms.gov/mesa-portal-for-providers-new/) - MESA Portal for Providers The Mississippi Division of Medicaid's transition to a new Fiscal Agent, effective Oct. 3, 2022, includes a new Medicaid Management Information System (MMIS) and provider portal known as MESA: Medicaid Enterprise System Assistance. The goal of MESA is to enhance connections between health services systems and improve access to health information
- [Bridge to Independence](https://medicaid.ms.gov/programs/bridge-to-independence/) - Attention: Long Term Care Providers The Mississippi Division of Medicaid's (DOM) Bridge to Independence (B2I) program, funded by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS), completed it's final year as a demonstration project. Effective January 2019, the Medicaid Extender's Act of 2019 provided for an extension of
- [Pharmacy and Therapeutics Committee Archive](https://medicaid.ms.gov/pharmacy-and-therapeutics-committee-archive/) - Listed below is an archive of Pharmacy and Therapeutics (P&T) Committee meeting minutes and agendas from previous years.
- [Acronyms and Glossary](https://medicaid.ms.gov/resources/acronyms-and-glossary/) - A | B | C | D | E | F | G | H | I | J | L | M | N | O | P | Q | R | S | T | U | V | W | Y A ACA (or PPACA) - Patient Protection and Affordable Care
- [EVV Schedule of Events](https://medicaid.ms.gov/evv-schedule-of-events/) - Upcoming EVV Events EVV System Training Opportunities EVV system training will be provided by the vendor in partnership with DOM during a later phase in the implementation. The schedule will be updated accordingly. HHAX In-Person Supplemental Training Notice DOM along with their partners, HHAeXchange and FEI Systems, Inc., are hosting three (3) in-person supplemental
- [About](https://medicaid.ms.gov/about/) - The Mississippi Division of Medicaid is a state and federal program created by the Social Security Amendments of 1965 (PL 89-97), authorized by Title XIX of the Social Security Act to provide health coverage for eligible, low income populations. All 50 states, five territories of the United States and District of Columbia participate in this voluntary
- [Mississippi Medicaid Health Benefits](https://medicaid.ms.gov/medicaid-coverage/who-qualifies-for-coverage/mississippi-medicaid-health-benefits/) - Mississippi provides health coverage through Medicaid programs and the Children’s Health Insurance Program (CHIP). Individuals who may qualify are: Infants and children up to age 19 Low-income parents/caretakers of children under age 18 Pregnant women The following groups of people qualify for full Mississippi Medicaid health benefits under the appropriate income limits and other qualifications. Infants and
- [EVV for Home Health Care Services](https://medicaid.ms.gov/evv-for-home-health-care-services/) - What is considered Home Health Care Services (HHCS)? The 21st Century Cures Act defines home health care services requiring EVV as any services requiring an in-home visit as described in section 1905(a)(7) of the SSA and provided under the state plan or under a waiver of the state plan (such as a Section 1915(c) waiver
- [EVV for Personal Care Service Providers](https://medicaid.ms.gov/evv-for-personal-care-service-providers/) - What is considered Personal Care Services (PCS)? The 21st Century Cures Act defines personal care services requiring EVV as any services requiring an in-home visit that support activities of daily living (ADL) such as movement, bathing, toileting, transferring, and personal hygiene or offers support for instrumental activities of daily living (IADL) such as meal preparation, money management,
- [Mississippi Electronic Visit Verification (EVV)](https://medicaid.ms.gov/mississippi-electronic-visit-verification-evv/) - Mississippi Electronic Visit Verification (EVV) Electronic Visit Verification (EVV) is a process that uses technology to verify provider visits for personal or home health care services. EVV gives providers, case managers, and DOM access to service delivery information in real-time to ensure there are no gaps in care throughout the entire course of the service
- [CHIP Enrollment](https://medicaid.ms.gov/chip-enrollment/) - How does Children's Health Insurance Program (CHIP) enrollment work? All Medicaid beneficiaries who are in the categories of eligibility will receive an enrollment packet in the mail that will explain the program in more detail. Beneficiaries may join the coordinated care organizations (CCOs) of their choice, either UnitedHealthcare Community Plan or Magnolia Health. If Medicaid does
- [MS Division of Medicaid Job Openings](https://medicaid.ms.gov/ms-division-of-medicaid-job-openings/) - Current Job Openings If you have questions regarding these positions, you may contact: MS State Personnel Board: 601-359-1406 MS Division of Medicaid's Human Resources Department: 601-359-6059 The hiring process is under the MS State Personnel Board (MSPB). To apply, follow the links below associated with the position of interest. Job postings may take 3-5 business
- [National Correct Coding Initiative](https://medicaid.ms.gov/providers/national-correct-coding-initiative/) - The Centers for Medicare and Medicaid Services (CMS) developed the National Correct Coding Initiative (NCCI) to promote national correct coding methodologies and to eliminate improper coding. The Affordable Care Act of 2010 required state Medicaid programs to incorporate compatible NCCI methodologies in their systems for processing Medicaid claims. NCCI associated modifiers may be appended when
- [Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) Waiver](https://medicaid.ms.gov/programs/traumatic-brain-injuryspinal-cord-injury-tbisci-waiver/) - The TBI/SCI Waiver is a home and community-based waiver that provides services to beneficiaries who, but for the provision of such services would require the level of care found in a nursing facility. This statewide waiver is administered jointly by the Division of Medicaid and the Department of Rehabilitation Services. Emergency Preparedness and Response the
- [Independent Living Waiver](https://medicaid.ms.gov/programs/independent-living-waiver/) - The Independent Living Waiver is a home and community-based waiver that provides services to beneficiaries who, but for the provision of such services would require the level of care found in a nursing facility. This statewide waiver is administered jointly by the Division of Medicaid and the Department of Rehabilitation Services. Emergency Preparedness and Response
- [Intellectual Disabilities/Developmental Disabilities Waiver](https://medicaid.ms.gov/programs/intellectual-disabilitiesdevelopmental-disabilities-waiver/) - The ID/DD Waiver provides services to individuals who, but for the provision of home and community-based services, would require placement in an Intermediate Care Facility for Individuals with Intellectual Disabilities. The ID/DD waiver is administered by the Department of Mental Health, Bureau of Intellectual and Developmental Disabilities. Emergency Preparedness and Response the COVID-19 The Centers
- [Assisted Living Waiver](https://medicaid.ms.gov/programs/assisted-living-waiver/) - The Assisted Living Waiver is a home and community-based waiver that provides services to beneficiaries who, but for the provision of such services, would require the level of care provided in a nursing facility. Qualified beneficiaries are allowed to reside in a Personal Care Home-Assisted Living (PCH-AL) facility that is licensed as a PCH-AL Facility
- [Reimbursement Archive](https://medicaid.ms.gov/providers/reimbursement/finance-archive/) - Below is an archive of hospital inpatient and outpatient notifications. Hospital Inpatient Information Updates July 1, 2021: Updates Hospital Reimbursement Policy Updates for July 1, 2021 SFY 2022 Inpatient Update for July 1, 2021 APR-DRG Quick Tips APR-DRG 3M Grouper Settings APR-DRG Pricing Calculator V38 - Excel APR-DRG Pricing Calculator V38 - PDF APR-DRG Frequently
- [Drug Utilization Review Board Archive](https://medicaid.ms.gov/drug-utilization-review-board-archive/) - Listed below is an archive of Drug Utilization Review Board packets and meeting minutes from previous years. DUR Meeting Addendum - Nov. 17, 2011 DUR Meeting Addendum - Feb. 17, 2011 DUR Meeting Addendum - May 16, 2013
- [MESA Portal for Members](https://medicaid.ms.gov/mesa-portal-for-members/) - MESA Portal for Members This member portal contains all of the information you need to know about your Mississippi Medicaid benefits. Through this easy, safe internet portal, members can learn more about their services, sign up to receive news, update their personal information and more. In addition to this, the various links included provide a wide
- [Member Services](https://medicaid.ms.gov/medicaid-coverage/member-services/) - Serving Mississippians in Need The Mississippi Division of Medicaid (DOM) serves a variety of Mississippi populations through three main coverage groups: Regular fee-for-service Medicaid, Medicaid’s coordinated care program MississippiCAN, and the Children’s Health Insurance Program (CHIP). DOM serves roughly one in four Mississippians who receive health benefits through Medicaid or CHIP. For individuals who
- [Helpful Links](https://medicaid.ms.gov/resources/helpful-links/) - Fiscal Agent MESA Portal for Providers Provider Bulletins Late Breaking News Medical Services Alliant Health Solutions - the utilization management and quality improvement organization responsible for certain prior authorizations including, but not limited to, acute and ancillary services, behavioral health services, dental/orthodontia services and advanced imaging procedures. Medical Transportation Management (MTM) - contact for Non-Emergency Transportation
- [Mental Health Services](https://medicaid.ms.gov/programs/mental-health/mental-health-services/) - The Mental Health Services division oversees the following programs: Acute Freestanding Psychiatric Facilities Community/Private Mental Health Centers (CMHC/PMHC) Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC) Outpatient Mental Health Hospital Services Psychiatric Residential Treatment Facilities (PRTF) Psychiatric Units at General Hospitals Psychiatric Services by Physicians or Nurse Practitioners Therapeutic and Evaluative (T&E) Mental Health
- [EVV for Members/Caregivers](https://medicaid.ms.gov/evv-for-members-caregivers/) - What does EVV mean for program members and/or their families? There will be no significant disruption in services to members. Members will be able to keep current providers and caregivers if they comply with the EVV requirements. An EVV system does NOT change the services provided, the provider selection, constrain individual’s choice of provider/personal care
- [Nursing Facilities and Case Mix Reimbursement](https://medicaid.ms.gov/programs/nursing-facility-case-mix/) - Nursing Facilities The Division of Medicaid (DOM) Office of Long Term Care is responsible for monitoring an interagency agreement with the Mississippi State Department of Health, Bureau of Health Facilities Licensure and Certification (HFLC). As part of the agreement, HFLC surveys nursing facilities. DOM has the discretion to impose civil monetary penalties and other recommendations made by HFLC on nursing
- [Reimbursement Stakeholder Meetings](https://medicaid.ms.gov/reimbursement-options/) - On February 1, 2016, the Centers for Medicare and Medicaid Services (CMS) published 42 CFR, Part 447: Medicaid Program Covered Outpatient Drugs with final comments (CMS-2345-FC). This rule addresses regulations that pertain to reimbursement for covered outpatient drugs in the Medicaid program. The document is available online at http://federalregister.gov/a/2016-01274. On March 8, 2016, the Division of
- [Pharmacy Medicare and Medicaid Relationship](https://medicaid.ms.gov/pharmacy-medicare-and-medicaid-relationship/) - The Medicare prescription drug benefit provides drug coverage for Medicare beneficiaries, including those who also receive coverage from Medicaid. In addition, individuals eligible for both Medicare and Medicaid also receive the low-income subsidy for both the Medicare drug plan premium and assistance with cost sharing for prescriptions. Medicaid will no longer provide drug benefits for
- [Specialty Drug List Archive](https://medicaid.ms.gov/specialty-drug-list-archive/) - Specialty Drug List Archive Please utilize the drop-down menus below to search historical Specialty Drug Lists sorted by year and month.
- [Transition to Community Referral](https://medicaid.ms.gov/programs/transition-to-community-referral-tcr/) - Transition to Community Referrals (TCR) are submitted by nursing facility staff based on information obtained from resident assessments. Nursing facility residents or their representatives can also notify nursing facility staff of the need to complete a TCR for residents desiring to return to the community. Effective April 5, 2021, the Mississippi Access to Care (MAC)
- [Electronic Data Interchange (EDI) Enrollment and Testing](https://medicaid.ms.gov/electronic-data-interchange-edi-testing/) - EDI Enrollment and Testing The Mississippi Division of Medicaid (DOM) is in the process of implementing a new Medicaid Management Information System (MMIS) – which will include a new Provider Portal – known as MESA: Medicaid Enterprise System Assistance. The new system, going live at the beginning of October, is being developed by Gainwell Technologies. EDI
- [Coronavirus Updates](https://medicaid.ms.gov/corona-virus-updates/) - As the state continues to respond to the unfolding coronavirus (COVID-19) outbreak, the Mississippi Division of Medicaid will provide relevant updates, resources and links at this location. Preparing for the COVID-19 Public Health Emergency Unwinding News Pharmacy providers billing directions for COVID-19 vaccines - Updated Jan. 8, 2021; Originally Published Dec. 29, 2020 COVID-19 Vaccine
- [The Mississippi Medicaid MMIS Replacement Project](https://medicaid.ms.gov/the-mississippi-medicaid-mmis-replacement-project/) - The Mississippi Medicaid MMIS Replacement Project The Mississippi Division of Medicaid (DOM) is working with a vendor to develop a new Medicaid Management Information System (MMIS) to replace the aging Envision system, which has been in use for many years. The new provider-enrollment and claims-processing solution is called MESA: Medicaid Enterprise System Assistance, and the
- [Coordinated Care Procurement](https://medicaid.ms.gov/coordinated-care-procurement/) - The Mississippi Medicaid Coordinated Care Procurement This year marks ten years since the inception of the Mississippi Division of Medicaid’s (DOM) coordinated care program, MississippiCAN. The program began in 2011 with only about 54,500 members enrolled. With additional categories of eligibility rolled into MississippiCAN over the years, the program currently covers more than 480,000
- [MMIS Replacement Project FAQs](https://medicaid.ms.gov/the-mississippi-medicaid-mmis-replacement-project/mmis-replacement-project-faqs/) - (FAQs Updated August 31, 2022) What if important emails from Gainwell go to my spam folder? Read the linked Tip Sheet for completing Safe Sender email setup to prevent emails from getting flagged as spam. Why can’t I use my old provider ID? The MESA system does not have the ability to process claims with
- [Trading Partner FAQs](https://medicaid.ms.gov/trading-partner-faqs/) - Trading Partner: Frequently Asked Questions If I already have a Trading Partner number, do I need a new one? Yes, the old Trading Partner (TP) ID issued by Conduent will not transfer over to the new system called MESA: Medicaid Enterprise System Assistance. Will my Trading Partner ID work for the provider portal? No,
- [MMIS Replacement Project FAQs](https://medicaid.ms.gov/about/mmis-replacement-project-faqs/) - (FAQs Updated July 27, 2022) Why can’t I use my old provider ID? The MESA system does not have the ability to process claims with the old provider ID (which is 8 characters in length). Why do I now have more than one provider ID when I only used to have one before? The new
- [Statewide Transition Plan](https://medicaid.ms.gov/providers/1915c-and-1915i-home-and-community-based-hcb-setting-transition-plan/) - 1915(c) and 1915(i) Home and Community-Based (HCB) Setting Transition Plan On Jan. 16, 2014, the Centers for Medicare and Medicaid Services (CMS) issued a final rule, effective March 17, 2014, which amends the requirements for qualities of home and community-based (HCB) settings. These requirements reflect CMS’s intent that individuals receive services and supports in settings
- [Preparing for MESA certification](https://medicaid.ms.gov/preparing-for-mesa-certification/) - Operational Readiness Review Through our MMIS Replacement Project (MRP), we are transitioning from our current Envision MMIS to our new system, MESA: Medicaid Enterprise System Assistance. Under the Streamlined Modular Certification (SMC) approach, there are two milestone reviews required by the Centers for Medicare and Medicaid Services (CMS). DOM is approaching the first milestone known
- [Recovery Audit Contractor (RAC) Program](https://medicaid.ms.gov/providers/recovery-auditor-contractors/) - Background Section 6411(a) of the Affordable Care Act amended section 1902(a) (42) of the Social Security Act to require that States and territories establish Medicaid RAC programs. States that have not received an exemption from the Centers for Medicare and Medicaid Services (CMS) are required by statute to contract with one or more RACs to
- [Eligibility Hearings](https://medicaid.ms.gov/medicaid-coverage/after-you-apply/eligibility-hearings/) - What are my rights before, during and after a hearing? You, or the person you choose to represent you, have the following rights: You have the right to read everything in your case record which is kept on file at your Medicaid regional office. The case record has all the documents which relate to your Medicaid
- [Hospice](https://medicaid.ms.gov/programs/hospice/) - Hospice Benefit is a State Plan service for terminally ill individuals at the end of their life cycle and having certification from a physician with a life expectancy of six (6) months or less. Hospice provides palliative treatment such as nursing care, medical social services, physician services, counseling short term patient care, medical appliances and
- [Aged, Blind or Disabled Residing in Nursing Facilities or Participating in Home and Community Based Waiver Programs](https://medicaid.ms.gov/medicaid-coverage/who-qualifies-for-coverage/aged-blind-or-disabled-living-in-nursing-homes/) - Who is eligible? Someone may qualify in a nursing home or Home and Community Based Services (HCBS) waiver program is the person is in need of long term care. “Long-term” care means that the patient individual will remain in a nursing home or hospital for 31 consecutive days or longer. For HCBS waiver participants, long
- [Provider Billing Handbook](https://medicaid.ms.gov/provider-billing-handbook-2/) - Information for All Providers (Billing Manual) Policy Guidelines (Administrative Code) Billing Guidelines General Billing Hospital Services Billing UB-04 Billing
- [Care Management Services for Medicaid Beneficiaries with Specific Conditions](https://medicaid.ms.gov/programs/care-management-services-for-medicaid-beneficiaries-with-specific-conditions/) - Care Management Services for Medicaid Beneficiaries with Specific Conditions Care management services are available to Mississippi Medicaid fee-for-service beneficiaries not enrolled in MississippiCAN (MSCAN) who meet one of the five specific conditions below. Hepatitis-C, Hemophilia, HIV/AIDS, Women 60 days postpartum after delivery, and Disabled Children Living at Home (DCLH). If you qualify, a care management
- [CCO Procurement FAQs](https://medicaid.ms.gov/procurement-faqs/) - How is this version of coordinated care going to be different and better than before? The coordinated care system began in Mississippi in 2011. Now, with a decade of experience, the Division of Medicaid (“DOM”) has had the opportunity to analyze data, consult with experts and stakeholders, and learn from previous experiences to develop
- [Other Programs](https://medicaid.ms.gov/programs/other-programs/) - Other Programs Family Planning Waiver The Family Planning Waiver program is for women and men who receive Medicaid benefits limited solely to family planning services. This includes one annual visit and subsequent visits related to their birth control methods. These women will not be eligible to receive any other Medicaid benefits. Hospice Hospice Benefit is a
- [Long Term Care](https://medicaid.ms.gov/programs/long-term-care-2/) - Institutional Long Term Care Civil Money Penalty (CMP) Grant Awards Program The goal of the Mississippi Division of Medicaid Civil Money Penalty Grant program is to facilitate the use of Federally Imposed Civil Money Penalty Funds to support activities that support, protect and benefit residents living in nursing facilities. Only CMP fund applications that meet
- [Frequently Asked Questions](https://medicaid.ms.gov/providers/administrative-code/frequently-asked-questions/) - Frequently Asked Questions for Providers Check back here as additional FAQ resources are developed and posted. Outpatient Hospital Dental Services Frequently Asked Questions - Updated Dec. 14, 2020 Outpatient Hospital Dental Policy FAQ - All Payers - 12.14.2020v2
- [Long Term Care Cost Report Forms](https://medicaid.ms.gov/providers/finance/long-term-care-cost-report-forms/) - Long Term Care Cost Report Forms Long Term Care Facility Cost Report Forms - Integrated
- [Notice of Non-Discrimination](https://medicaid.ms.gov/notice-of-non-discrimination/) - The Mississippi Division of Medicaid (DOM) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. DOM does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. The Mississippi Division of Medicaid: Provides free
- [Expanded Mississippi Early and Periodic Screening, Diagnosis, and Treatment](https://medicaid.ms.gov/programs/early-and-periodic-screening-diagnosis-and-treatment-epsdt/expanded-mississippi-early-and-periodic-screening-diagnosis-and-treatment/) - Mississippi Administrative Code, Title 23, Part 213, Rule 3.11 provides “[t]he Division of Medicaid pays for all medically necessary services for EPSDT-eligible beneficiaries in accordance with Part 223 of Title 23, without regard to service limitations and with prior authorization.” Mississippi Administrative Code, Title 23, Part 223, Rule 1.7 (Diagnostic and Treatment Program Services) provides
- [Report Fraud and Abuse](https://medicaid.ms.gov/contact/report-fraud-and-abuse/) - Program Integrity investigates activities relating to the prevention, detection and investigation of alleged provider and beneficiary fraud and/or abuse in the Medicaid program. Every dollar lost to the misuse of Medicaid benefits, is one less dollar available to fund programs providing essential medical services for vulnerable Mississippians. If we don't work together to help stop
- [Mental Health Programs](https://medicaid.ms.gov/programs/mental-health/) - The Mental Health Programs division oversees the following programs: Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) The Mental Health Programs division is responsible for oversight of intermediate care facilities for individuals with intellectual disabilities approved by the Mississippi Division of Medicaid (DOM) and federal certification requirements established by the Centers
- [Mental Health](https://medicaid.ms.gov/office-of-mental-health-programs/) - Office of Mental Health The Office of Mental Health provides a way for people to get the mental health treatment they need in a variety of settings, depending on age and conditions. However, several of our programs are limited to children under age 21. Some services are not covered, while others may require a specific diagnosis
- [340B Program](https://medicaid.ms.gov/pharmacy/340b-program/) - The 340B program is a Drug Pricing Program established by the Veterans Health Care Act of 1992, which is Section 340B of the Public Health Service Act (PHSA). Section 340B limits the cost of covered outpatient drugs to certain federal grantees, federally-qualified health center look-alikes, and qualified hospitals. These providers purchase, dispense and/or administer pharmaceuticals
- [Special Mental Health Initiatives](https://medicaid.ms.gov/programs/mental-health/special-mental-health-initiatives/) - The Special Mental Health Initiatives division oversees the following programs: Autism Spectrum Disorder (ASD) Services Community Support Program 1915(i) Intellectual Disabilities/Developmental Disabilities (ID/DD) Waiver Mississippi Youth Programs Around the Clock (MYPAC) Substance Use Disorder (SUD) Services Autism Spectrum Disorder Services Services are covered for Early, Periodic Screening, Diagnosis and Treatment (EPSDT)-eligible beneficiaries with an Autism Spectrum
- [Medicaid Vital Signs](https://medicaid.ms.gov/medicaid-vital-signs/)
- [Office of Client Relations](https://medicaid.ms.gov/contact/office-of-provider-beneficiary-relations/) - The Office of Client Relations is split into three main divisions; Beneficiary Relations Division, Provider Relations Division and the Central Communications Center. Beneficiary Relations Division This division has the responsibility of working in the DOM Call Center as customer service specialist to handle calls (related to Medicaid programs, covered services, Medicaid eligibility, application processing, how to find
- [Mississippi Medicaid State Level Registry for Provider Incentive Payments](https://medicaid.ms.gov/providers/mississippi-medicaid-state-level-registry-for-provider-incentive-payments/) - Welcome to the Mississippi Division of Medicaid State Level Registry for Provider Incentive Payments. Eligible professionals and hospitals can attest for Electronic Health Records (EHR) Incentive Payments through the MS State Level Registry (MS SLR) and learn more information about this program. As the healthcare landscape continues to modernize, recent legislation was passed to encourage the
- [Legislative Updates Archive](https://medicaid.ms.gov/legislative-updates-archive/) - Listed below are the updates and summaries of legislative bill enacted during past legislative sessions that revise the powers and duties of the Mississippi Division of Medicaid. 2017 Legislative Session Updates and Summary Senate Bill 2138 | SB 2138 legislation Directs DOM to partner with the Department of Human Services (DHS) to conduct enhanced identity and asset
- [Mississippi Access to Care (MAC) 2.0](https://medicaid.ms.gov/mississippi-access-to-care-mac-2-0/) - Mississippi Access to Care 2.0 is a continuation of Mississippi’s earlier efforts in long term care reform. Its purpose and that of the stakeholder groups is to bring together any and all projects that support home and community based services and community living for seniors and individuals with disabilities. As such, MAC 2.0 and this
- [Privacy and Security](https://medicaid.ms.gov/privacy-and-security/) - Thank you for visiting the Mississippi Division of Medicaid's website and reviewing the Privacy and Security Notice, Disclaimer and Terms of Use. We remind you that if you link to a site outside of the Division of Medicaid, you are subject to the policies of the new site. Privacy Information Collected and Stored Automatically If
- [Payment Error Rate Measurement](https://medicaid.ms.gov/providers/payment-error-rate-measurement-perm/) - Payment Error Rate Measurement (PERM) was developed by the Centers for Medicare and Medicaid Services (CMS) to measure improper payments in the Medicaid program and the Children’s Health Insurance (CHIP). PERM reviews will be conducted in three areas: Beneficiary Eligibility for both the Medicaid and CHIP programs, Managed Care payments, and Fee-for-service claims payments. The fee-for-service claims
- [Finance](https://medicaid.ms.gov/providers/finance/) - The Office of Finance is responsible for effective fiscal management of the agency. These offices perform financial and performance reviews related to providers and contractors, monitors the expenses paid and incurred by the managed care contractors, and maximize third party recovery efforts. Additionally, the Chief Financial Officer assists with responsibility for three offices covering the accounting
- [Early Intervention/Targeted Case Management](https://medicaid.ms.gov/programs/early-interventiontargeted-case-management/) - Early Intervention/Targeted Case Management (EI/TCM) is an active, ongoing process that involves activities carried out by a case manager to assist and enable a child (0 to 3 years of age) enrolled and participating in the Mississippi Early Intervention Program gain access to needed medical, social, educational and other services. EI/TCM activities include but are not
- [Mississippi Medicaid Workforce Training Initiative](https://medicaid.ms.gov/mississippi-medicaid-workforce-training-initiative/) - This proposed MS Medicaid Workforce Training Initiative 1115 Waiver Demonstration will allow the Division of Medicaid to identify individuals eligible for workforce training opportunities and assist them with accessing workforce training, and garner enhanced federal matching funds to assist with workforce training programs for individuals covered under this waiver. MS Medicaid Workforce Training Initiative
- [Provider Incentive Payments Registration and Accounts](https://medicaid.ms.gov/providers/mississippi-medicaid-state-level-registry-for-provider-incentive-payments/provider-incentive-payments-registration-and-accounts/) - Registration with the Centers for Medicare and Medicaid Services (CMS) CMS Registration and Attestation System Eligible Professionals When you visit this site you will need your personal NPI, your Social Security Number. You will designate the recipient of your EHR Incentive Payment. You may either pay yourself OR you may designate your payment to go
- [Program Information for Eligible Professionals](https://medicaid.ms.gov/providers/mississippi-medicaid-state-level-registry-for-provider-incentive-payments/program-information-for-eligible-professionals/) - Program Year 1 For Eligible Professionals (EPs): Adopt / Implement / Upgrade Visit the Mississippi State Level Registry (MS SLR) website to begin your EHR Attestation for Year 1. Establishing Medicaid Patient Volume Eligibility: Determine if you as an EP will use Medicaid patient volume taken from your individual patient volume statistics or if your
- [Provider Incentive Payments Resources](https://medicaid.ms.gov/providers/mississippi-medicaid-state-level-registry-for-provider-incentive-payments/provider-incentive-payments-resources/) - Program Calculators The calculators below were revised January 2013. Use the calculators as worksheets to help complete your state level registry attestations. All of the calculator documents must be attached in the State Level Registry - step two. Download the EHR incentive calculators in Microsoft Excel format, by clicking the links below. Patient volume calculator -
- [Working Disabled](https://medicaid.ms.gov/medicaid-coverage/who-qualifies-for-coverage/working-disabled/) - In July 1999, the Division of Medicaid began a new program to offer Medicaid coverage for disabled individuals who are: working but have no health insurance or not enough insurance, or want to return to work and need health insurance. This group is sometimes referred to as a “Buy-In” program because workers who earn over a
- [Eligibility Reporting Requirements](https://medicaid.ms.gov/contact/eligibility-reporting-requirements/) - Eligibility Reporting Requirements Someone who is eligible for Medicaid or CHIP must report changes that could affect eligibility. Changes to report include: Income: A change in the amount of income the beneficiary’s household receives. This can be an increase or decrease in income from wages, self-employment or any type of income received such as retirement benefits,
- [Medicaid Coverage](https://medicaid.ms.gov/medicaid-coverage/) - Medicaid is a federal and state program created to provide medical assistance to eligible, low income populations. This service is in place to provide access to quality health care coverage for vulnerable Mississippians. Mississippi Medicaid health benefits are available for many populations including children, low income families, aged, blind or disabled, and pregnant women. Individuals must
- [General Inquiry Form](https://medicaid.ms.gov/general-inquiry-form/) - You can contact the Mississippi Division of Medicaid (DOM) multiple ways as listed below, including by phone, postal mail, and fax. If you choose to contact DOM in writing, you are advised to submit information by postal mail or fax to protect the confidentiality of your protected health information or personally identifiable information. General Inquiry Form
- [Inpatient Transition Information](https://medicaid.ms.gov/inpatient-transition-information/) - The Mississippi Division of Medicaid (DOM) is preparing to roll inpatient services into our managed care program, MississippiCAN. We are working closely with our MississippiCAN coordinated care organizations, Magnolia Health and UnitedHealthcare Community Plan, to clarify changes impacting providers and hospitals, and ensure the transition goes as smoothly as possible. This transition is set to be
- [Access Monitoring Review Plan](https://medicaid.ms.gov/about/state-plan/access-monitoring-review-plan/) - Federal regulation at 42 CFR § 447.203 requires states to develop an Access Monitoring Review Plan (AMRP) that includes an analysis of access to covered services under the Medicaid fee-for-service (FFS) delivery system. Mississippi developed an AMRP for the following service categories provided under a FFS arrangement: Primary care services Physician specialist services Behavioral health
- [Fraud and Abuse Complaint Form](https://medicaid.ms.gov/contact/report-fraud-and-abuse/fraud-and-abuse-complaint-form/) - Fill out my Wufoo form!
- [Medicare Cost-Sharing](https://medicaid.ms.gov/medicaid-coverage/who-qualifies-for-coverage/medicare-cost-sharing/) - Individuals with Medicare Part A and/or Part B, who have limited income may get help paying for their out-of pocket medical expenses from the Medicaid Program. Allow four to six weeks before the Medicare premium is added back to your Social Security check. Social Security will refund any premiums withheld from your check beginning with the
- [Aged, Blind or Disabled Former Supplemental Security Income (SSI) Recipients](https://medicaid.ms.gov/medicaid-coverage/who-qualifies-for-coverage/aged-blind-or-disabled-former-supplemental-security-income-ssi-recipients/) - SSI Eligibility and Eligibility for Certain Former SSI Recipients You may qualify for SSI (Supplemental Security Income)/Medicaid, or you may be able to remain eligible for Medicaid after your SSI payments stop if you meet certain eligibility guidelines. SSI Eligibility If you qualify for Supplemental Security Income (SSI), you automatically receive Medicaid. SSI makes monthly payments
- [News and Notices](https://medicaid.ms.gov/news-and-notices/)
- [ICD-10 information](https://medicaid.ms.gov/providers/icd-10-information/) - Effective October 1, 2015, entities covered under the Health Insurance Portability and Accountability Act (HIPAA) are required to use the International Classification of Diseases, 10th Edition (ICD-10) code sets in standard transactions adopted under HIPAA. All Mississippi Division of Medicaid (DOM) enrolled providers must comply. Compliance dates are firm and not subject to change, other
- [Estate Recovery](https://medicaid.ms.gov/medicaid-coverage/member-services/estate-recovery/) - Effective July 1, 1994, Medicaid will seek recovery from the estate of deceased Medicaid recipients who are age 55 or older and in a nursing facility, or enrolled in a Home and Community Based Services Waiver Program at the time of death. Recovery will be made from any real or personal property in the estate
- [Women](https://medicaid.ms.gov/programs/women/) - Women Perinatal High Risk Management/Infant Services System (PHRM/ISS) Perinatal High Risk Management/Infant Services System is a multidisciplinary case management program established to help improve access to health care and to provide enhanced services to certain Medicaid eligible pregnant/postpartum women and infants. The enhanced services for this target population include case management, psychosocial and nutritional counseling/assessments, home
- [MississippiCAN Provider Information](https://medicaid.ms.gov/programs/mississippican/mississippican-provider-information/) - Prior Authorization Medicaid and MississippiCAN Pharmacy Prior Authorization Contacts Keep in mind that MississippiCAN claims and PA requests must be submitted to the respective PBM. Submitting claims and/or prior authorization requests to Medicaid rather than to the respective plan delays the process for Medicaid, providers and beneficiaries. Prior Authorization Forms Magnolia Prior Authorization form for
- [Children](https://medicaid.ms.gov/programs/children/) - Children Mississippi Health Benefits for Children Health benefits for children from birth to age 19 are provided through Medicaid. Some children may be eligible for Medicaid. Other children whose families make too much money to qualify for Medicaid may be eligible for UnitedHealthcare insurance, otherwise known as the Children's Health Insurance Program (CHIP). Children's Health Insurance
- [Disclaimer and Terms of Service](https://medicaid.ms.gov/disclaimer/) - Acceptance of Terms You have accessed the Mississippi Division of Medicaid (DOM) computer network or website. Use of this network, authorized or unauthorized, may be monitored including activity or communication and retrieval for the Division of Medicaid purposes. Unauthorized use of or access to the system or the information contained therein is strictly prohibited and
- [MississippiCAN Opt-Out Change Form](https://medicaid.ms.gov/programs/mississippican/mississippican-opt-out-change-form/)
- [MississippiCAN Change Form](https://medicaid.ms.gov/programs/mississippican/mississippican-change-form/)
- [EHR Provider Incentive Program Basic Requirements](https://medicaid.ms.gov/providers/mississippi-medicaid-state-level-registry-for-provider-incentive-payments/ehr-provider-incentive-program-basic-requirements/) - Eligibility for Professionals Mississippi allows the following provider types to participate the MS Medicaid EHR Provider Incentive Program: Physicians Dentists Nurse Practitioners Certified Nurse Mid Wives Physicians Assistant (serving under the supervision of a Physician in a Federally Qualified Health Clinic – FQHC or a Rural Health Clinic – RHC) Optometrists Mississippi requires Eligible Professionals
- [Immigrants](https://medicaid.ms.gov/medicaid-coverage/who-qualifies-for-coverage/immigrants/) - A Medicaid application will ask for your Social Security Number and immigration status of everyone living in your household who is applying for Medicaid. This notice tells you when you must give us this information and what will happen if you cannot give us this required information. Citizenship Anyone who wants to receive Medicaid
- [Transplant Information](https://medicaid.ms.gov/providers/transplant-information/) - Organ transplants that do not require prior approval are: cornea kidney bone marrow peripheral hematopoietic stem cells (autologous, syngeneic or allogeneic) For organs that need prior approval, providers must submit clinical documentation to the Division of Medicaid’s Utilization Management/Quality Improvement Organization (UM/QIO) for medical necessity. Toll-free: 1-888-204-0502 Fax: 1-888-204-0504 Detailed information regarding organ transplant can be
- [School Health Related Services ](https://medicaid.ms.gov/programs/school-health-related-services/) - The School Health Related Services Program was designed to identify children who have a learning problem because of a medical problem which requires special services. Once the child is identified an IEP (Individual Education Plan) listing services they need is then completed by the school. The schools have employed people with special training to assist
- [Reporting Requirements](https://medicaid.ms.gov/medicaid-coverage/member-services/reporting-requirements/) - Eligibility Reporting Requirements When a person accepts a Medicaid card, that person (or his or her representative) must report all changes in either income or resources that could affect his or her eligibility. These changes should be reported to the Medicaid regional office that serves his or her home county. These changes may be made

## Portfolio

- [2013 Fiscal Year Annual Report](https://medicaid.ms.gov/?portfolio=2013-fiscal-year-annual-report) - 2013 Fiscal Year Annual Report 2013FY_annual_report

## Testimonials

- [PRN Updates for Pharmacy Providers](https://medicaid.ms.gov/?testimonials=2018-legislative-session) - LATE BREAKING NEWS Click here for the latest news and sign up to receive email alerts every time Late Breaking News is updated

## Categories

- [Uncategorized](https://medicaid.ms.gov/category/uncategorized/)
- [News and Notices](https://medicaid.ms.gov/category/news-and-notices/)
- [Pharmacy](https://medicaid.ms.gov/category/providers/pharmacy/)
- [Electronic Health Records](https://medicaid.ms.gov/category/electronic-health-records/)
- [sticky](https://medicaid.ms.gov/category/sticky/)
- [Providers](https://medicaid.ms.gov/category/providers/)
- [Procurement](https://medicaid.ms.gov/category/procurement/)
- [MississippiCAN](https://medicaid.ms.gov/category/mississippican/)
- [Children's Health Insurance Program](https://medicaid.ms.gov/category/childrens-health-insurance-program/)
- [Public Notices](https://medicaid.ms.gov/category/public-notices/)
- [News Room](https://medicaid.ms.gov/category/news-room/)
- [Medicaid Vital Signs](https://medicaid.ms.gov/category/medicaid-vital-signs/)

## Tags

- [active](https://medicaid.ms.gov/tag/active/)
- [ICD-10](https://medicaid.ms.gov/tag/icd-10/)
- [HIPAA](https://medicaid.ms.gov/tag/hipaa/)

## Media Categories

- [Annual Report](https://medicaid.ms.gov/media-category/annual-report/) - Annual Report
- [Form](https://medicaid.ms.gov/media-category/form/)
- [Home and Community Based Services](https://medicaid.ms.gov/media-category/home-and-community-based-services/)
- [State Plan](https://medicaid.ms.gov/media-category/state-plan/)
- [Administrative Code](https://medicaid.ms.gov/media-category/administrative-code/)
- [State Plan Amendments](https://medicaid.ms.gov/media-category/state-plan-amendments/)
- [Proposed](https://medicaid.ms.gov/media-category/proposed/)
- [Approved](https://medicaid.ms.gov/media-category/approved/)
- [Withdrawn](https://medicaid.ms.gov/media-category/withdrawn/)
- [Provider Billing Handbook](https://medicaid.ms.gov/media-category/provider-billing-handbook/)
- [Fee Schedules](https://medicaid.ms.gov/media-category/fee-schedules/)
- [Procurement](https://medicaid.ms.gov/media-category/procurement/)
- [Active](https://medicaid.ms.gov/media-category/active-procurement/)
- [Rates](https://medicaid.ms.gov/media-category/rates/)
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- [Long Term Care](https://medicaid.ms.gov/media-category/long-term-care/)
- [Publications](https://medicaid.ms.gov/media-category/publications/)
- [Mental Health](https://medicaid.ms.gov/media-category/mental-health/)
- [Eligibility](https://medicaid.ms.gov/media-category/eligibility/)
- [Reimbursement](https://medicaid.ms.gov/media-category/reimbursement/)
- [MississippiCAN](https://medicaid.ms.gov/media-category/mississippican/)
- [Eligibility Policy and Procedures Manual](https://medicaid.ms.gov/media-category/eligibility-policy-and-procedures-manual/)
- [Closed](https://medicaid.ms.gov/media-category/closed/)
- [P&T Committee Agenda](https://medicaid.ms.gov/media-category/pt-committee-agenda/)
- [P&T Committee Minutes](https://medicaid.ms.gov/media-category/pt-committee-minutes/)
- [Preferred Drug List](https://medicaid.ms.gov/media-category/preferred-drug-list/)
- [DUR Board Packets](https://medicaid.ms.gov/media-category/dur-board-packets/)
- [DUR Board Minutes](https://medicaid.ms.gov/media-category/dur-board-minutes/)
- [Payment Error Rate Measurement](https://medicaid.ms.gov/media-category/payment-error-rate-measurement/)
- [Recovery Audit Contractors](https://medicaid.ms.gov/media-category/recovery-audit-contractors/)
- [MississippiCAN Form](https://medicaid.ms.gov/media-category/mississippican-form/)
- [Pharmacy Form](https://medicaid.ms.gov/media-category/pharmacy-form/)
- [Provider Form](https://medicaid.ms.gov/media-category/provider-form/)
- [Mississippi Access to Care](https://medicaid.ms.gov/media-category/mississippi-access-to-care/)
- [Long Term Care Cost Report Form](https://medicaid.ms.gov/media-category/long-term-care-cost-report-form/)
- [Finance](https://medicaid.ms.gov/media-category/finance/)
- [Proposed](https://medicaid.ms.gov/media-category/proposed-administrative-code/)
- [Eligibility Form](https://medicaid.ms.gov/media-category/eligibility-form/)
- [Children's Health Insurance Program](https://medicaid.ms.gov/media-category/childrens-health-insurance-program/)
- [Public Notice](https://medicaid.ms.gov/media-category/public-notice/)
- [Pharmacy](https://medicaid.ms.gov/media-category/pharmacy/)
- [News and Notices](https://medicaid.ms.gov/media-category/news-and-notices/)
- [Contract Workers](https://medicaid.ms.gov/media-category/contract-workers/)
- [Medical Care Advisory Committee](https://medicaid.ms.gov/media-category/medical-care-advisory-committee/)
- [Government Relations](https://medicaid.ms.gov/media-category/government-relations/)
- [Provider Bulletin](https://medicaid.ms.gov/media-category/provider-bulletin/)
- [Community Transition Services (CTS) Forms](https://medicaid.ms.gov/media-category/community-transition-services-forms/)
- [Waivers](https://medicaid.ms.gov/media-category/waivers/)
- [News Room](https://medicaid.ms.gov/media-category/news-room/)
- [Assisted Living](https://medicaid.ms.gov/media-category/assisted-living/)
- [Family Planning](https://medicaid.ms.gov/media-category/family-planning/)
- [ID/DD](https://medicaid.ms.gov/media-category/id-dd/)
- [HMW](https://medicaid.ms.gov/media-category/hmw/)
- [Resources](https://medicaid.ms.gov/media-category/resources/)
- [CEMMC](https://medicaid.ms.gov/media-category/cemmc/)
- [Medicaid Vital Signs](https://medicaid.ms.gov/media-category/medicaid-vital-signs/)
- [Long Term Care](https://medicaid.ms.gov/media-category/long-term-care-2/)
- [PA Criteria](https://medicaid.ms.gov/media-category/pa-criteria/)
- [E&D](https://medicaid.ms.gov/media-category/ed/)