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 Centers for Medicare and Medicaid Services (CMS) regarding State Plan Amendment 21-0018, which was submitted last year to freeze reimbursement for outpatient drugs in compliance with Senate Bill 2799 as passed during the 2021 Legislative Session. While CMS has not yet taken official action, DOM anticipates CMS will disapprove SPA 21-0018. Once this disapproval is received from CMS, DOM will reprocess fee-for-service claims for prescription drugs with dates of service between July 1, 2021 and June 30, 2022.

Published June 24, 2022