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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


2024

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/3/2024   Final Date: 10/01/2024
Effective Date: 11/01/2024   Withdrawal Date:
Rule: Title 23: Medicaid, Part 215: Home Health Services, Chapter 1: Home Health Services, Rule 1.3: Covered Services
Summary: This Administrative Code is being filed to correspond with MS SPA 24-0006 Home Health LPN that allowed 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 System Number: 27702
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/27/2024   Final Date: 9/23/2024
Effective Date: 11/01/2024   Withdrawal Date:
Rule: Title 23: Medicaid, Part 219: Laboratory Services, Chapter 1: General, Rule 1.7: Qualitative Drug Screening
Summary: This Administrative Code is being filed to revise and clarify the language regarding non-covered “medicolegal” drug screenings
System Number: 27693
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/25/2024   Final Date: 7/23/2024
Effective Date: 9/1/2024   Withdrawal Date:
Rule: Title 23: Medicaid, Part 202: Hospital Services, Chapter 1: Inpatient Services, Rule 1.3: Prior Authorization of Inpatient Hospital Services, Rule 1.13: Out-of-State Facilities, Rule 1.14: Inpatient Hospital Payments. Chapter 2: Outpatient Services, Rule 2.3: Emergency Department Outpatient Visits, Rule 2.8: Outpatient Hospital Rates. Chapter 3: Swing Beds, Rule 3.4: Reimbursement. Chapter 4: Organ Transplants, Rule 4.4: Reimbursement
Summary: This administrative code is being revised to clarify the length of stay for obstetrical deliveries and removes rate freeze language from Part 202 to correspond with SPA 23-0016 All Patient Refined Diagnosis Related Groups (APR-DRG) Reimbursement (effective July 1, 2023)
System Number: 27613
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/4/2024   Final Date: 7/1/2024
Effective Date: 8/1/2024   Withdrawal Date:
Rule: Title 23: Medicaid, Part 204: Dental Services, Chapter 1: General, Rule 1.17: Early and Periodic Screening, Diagnosis, and Treatment (EPSDT)
Summary: This administrative code is being filed to correspond with SPA 23-0030 to allow the Division of Medicaid (DOM) to increase reimbursement rates for orthodontic services by ten percent (10%), effective October 1, 2023
System Number: 27577
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/2/2024   Final Date: 5/29/2024
Effective Date: 7/1/2024   Withdrawal Date:
Rule: Title 23: Medicaid, Part 222: Perinatal High-Risk Management and Infant Services (PHRM-ISS), Chapter 2: Perinatal High-Risk Management and Infant Services, Rule 2.1: Provider Participation, Rule 2.2: Covered Services, Rule 2.3: Documentation Requirements, Rule 2.4: Freedom of Choice, Rule 2.5: Reimbursement, Rule 2.6: Early and Periodic Screening Diagnosis and Treatment
Summary: This administrative code is being filed to update and revise Perinatal High-Risk Management and Infant Services (PHRM/ISS) to align with the current Mississippi State Depart of Health (MSDH) interagency agreement and MS SPA 21-0014
System Number: 27514
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 4/3/2024   Final Date: 5/1/2024
Effective Date: 6/1/2024   Withdrawal Date:
Rule: Title 23: Medicaid, Part 225: Telemedicine, Chapter 1: Telehealth Services, Rule 1.4: Non-Covered Services
Summary: This administrative code is being filed to remove the restriction on Level IV and V telehealth visits
System Number: 27469
Notice Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 4/3/2024   Final Date: 5/3/2024
Effective Date: 6/1/2024   Withdrawal Date:
Rule: Title 23: Medicaid, Part 103, Chapter 5: Trust Provisions, Rule 5.16: Special Needs Trust (SNT) and Pooled Trust Guidelines and Restrictions
Summary: This Administrative Code is being filed to revise the guidelines and restrictions for special needs trusts
System Number: 27470
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 4/5/2024   Final Date: 5/1/2024
Effective Date: 6/1/2024   Withdrawal Date:
Rule: Title 23: Medicaid, Part 207: Institutional Long Term Care, Chapter 2: Nursing Facility, Rule 2.15: Ventilator Dependent Care
Summary: This administrative code is being filed to allow a Respiratory Therapist to be assigned primary responsibility to residents in need of Ventilator Dependent Care services
System Number: 27471
Notice  |  Full Text

 

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 1/31/2024   Final Date: 2/27/2024
Effective Date: 4/1/2024   Withdrawal Date:
Rule: Title 23: Medicaid, Part 222: Maternity Services, Chapter 1: General, Rule 1.1: Maternity Service
Summary: This Administrative Code is being submitted to extend postpartum coverage for pregnant women from sixty (60) days to twelve (12) months to correspond with SPA 23-0015 Postpartum Coverage (effective 04/01/2023)
System Number: 27392
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 1/31/2024   Final Date: 2/27/2024
Effective Date: 4/1/2024  Withdrawal Date:
Rule: Title 23: Medicaid, Part 221: Family Planning and Family Planning Related Services, Chapter 2: 1115(a) Family Planning and Family Planning Related Waiver Services, Rule 2.2: Eligibility
Summary: This Administrative Code is being submitted to extend postpartum coverage for pregnant women from sixty (60) days to twelve (12) months to correspond with SPA 23-0015 Postpartum Coverage (effective 04/01/2023)
System Number: 27391
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 1/26/2024   Final Date: 2/27/2024
Effective Date: 4/1/2024   Withdrawal Date:
Rule: Title 23: Medicaid, Part 101: Coverage Groups and Processing Applications and Reviews Redetermination Processes, Chapter 1: Coverage of the Categorically Needy in Mississippi, Rule 1.5: Mandatory Coverage of Pregnant Women
Summary: This Administrative Code is being submitted to extend postpartum coverage for pregnant women from sixty (60) days to twelve (12) months to correspond with SPA 23-0015 Postpartum Coverage (effective 04/01/2023)
System Number: 27390
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 1/7/2022   Final Date: 1/26/2024
Effective Date: 3/1/2024   Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 223: EPSDT, Chapter 6: Expanded Rehabilitative Services, Rules 6.1-6.6
Summary: This administrative code is being submitted to add coverage and reimbursement requirements for Mississippi Youth Programs Around the Clock (MYPAC) Therapeutic Services. This Administrative Code is being submitted to add coverage and reimbursement requirements for Mississippi Youth Programs Around the Clock (MYPAC) Therapeutic Services. This Administrative code filing is being submitted to correspond with MS SPA 21-0028 EPSDT Extended Services effective July 1, 2021, and MS SPA 23-0025 MYPAC effective November 1, 2023.
System Number: 27339
Notice  |  Full Text

2023

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 12/1/2023   Final Date: 12/28/2023
Effective Date: 2/1/2024   Withdrawal Date:
Rule: Title 23: Medicaid, Part 225: Telemedicine, Chapter 1: Telehealth Services, Rule 1.3: Covered Services, Rule 1.4: Non-Covered Services
Summary: This administrative code is being filed to add provider types to Rule 1.3 and make a technical correction to Rule 1.4
System Number: 27310
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 11/29/2023   Final Date: 12/28/2023
Effective Date: 2/1/2024   Withdrawal Date:
Rule: Title 23; Division of Medicaid, Part 201, Transportation Services, Chapter 1: Emergency Transportation Services, Rules 1.1, 1.2, and 1.3
Summary: This Administrative Code filing is being submitted to update definitions and staffing requirements to be consistent with the requirements of the Bureau of Emergency Medical Services (BEMS)
System Number: 27311
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/26/2023   Final Date: 11/27/2023
Effective Date: 1/1/2024   Withdrawal Date:
Rule: Title 23: Medicaid, Part 200: General Provider Information, Chapter 5: General, Rule(s) 5.4
Summary: This Administrative Code is to being filed to correspond with MS SPA 23-0024 that allows the Division of Medicaid (DOM) to add coverage for up to twelve (12) tobacco cessation counseling sessions per year.
System Number: 27263
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/26/2023   Final Date: 10/23/2023
Effective Date: 12/01/2023   Withdrawal Date:
Rule: Title 23: Medicaid, Part 223: Early and Periodic Screening, Diagnosis, and Treatment (EPSDT), Chapter 4: Private Duty Nursing, Rule 4.8: Reimbursement.
Summary: This Administrative Code is being filed to correspond with MS SPA 23-0010 to maintain the PDN rates put into effect during the PHE.
System Number: 27217
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/26/2023   Final Date: 10/23/2023
Effective Date: 12/1/2023   Withdrawal Date:
Rule: Title 23: Medicaid, Part 214: Pharmacy; Chapter 1: General Pharmacy; Rule(s) 1.3: Drugs Subject to Exclusion or Otherwise Restricted
Summary: This Administrative Code is being filed to correspond with MS SPA 23-0013 (effective July 1, 2023) which adds coverage for selected drugs that treat obesity.
System Number: 27215
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 08/03/2023   Final Date: 08/29/2023
Effective Date: 10/01/2023   Withdrawal Date:
Rule: Title 23; Division of Medicaid, Part 225, Telemedicine, Chapter 4: Continuous Glucose Monitoring Services, Rules 4.3 and 4.6
Summary: This Administrative Code is being filed to update language regarding coverage and reimbursement of FDA-approved Continuous Glucose Monitoring devices, effective October 1, 2023.
System Number: 27121
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 08/03/2023   Final Date: 08/29/2023
Effective Date: 10/01/2023   Withdrawal Date:
Rule: Title 23; Division of Medicaid, Part 209, Durable Medical Equipment, Chapter 1: Durable Medical Equipment and Medical Supplies, Rule 1.26
Summary: This Administrative Code is being filed to update language regarding coverage and reimbursement of FDA-approved Continuous Glucose Monitoring devices, effective October 1, 2023.
System Number: 27120
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 7/21/2023   Final Date: 8/18/2023
Effective Date: 10/01/2023   Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 201: Transportation Services, Chapter 1: Emergency Transportation Services, Rule 1.2: Definitions, Rule 1.3: Covered Services
Summary: This Administrative Code is being submitted to allow the Division of Medicaid (DOM) to clarify the categories of emergency ground ambulance services and to correspond with MS SPA 23-0012 (effective January 1, 2023), effective October 1, 2023.
System Number: 27114
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/30/2023   Final Date: 7/27/2023
Effective Date: 9/1/2023   Withdrawal Date:
Rule: Title 23: Medicaid, Part 214: Pharmacy Services, Chapter 1: General Pharmacy, Rule 1.16: Clinician Administered Drugs and Implantable Drug System Devices (CADDs)
Summary: This administrative code is being submitted to remove copays from Medicaid services to correspond with SPA 23-0011 Copay (effective May 1, 2023), effective September 1, 2023. System Number: 27073
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/30/2023   Final Date: 7/27/2023
Effective Date: 9/1/2023   Withdrawal Date:
Rule: Title 23: Medicaid, Part 209: Durable Medical Equipment, Medical Appliances and Medical Supplies, Chapter 1: Durable Medical Equipment and Medical Appliances, Rule 1.5: DME Co-payments
Summary: This administrative code is being submitted to remove copays from Medicaid services to correspond with SPA 23-0011 Copay (effective May 1, 2023), effective September 1, 2023.
System Number: 27072
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/30/2023   Final Date: 7/27/2023
Effective Date: 9/1/2023   Withdrawal Date:
Rule: Title 23: Medicaid, Part 306: Third Party Recovery, Rule 1.2 Provider Requirements
Summary: This administrative code is being submitted to remove copays from Medicaid services to correspond with SPA 23-0011 Copay (effective May 1, 2023), effective September 1, 2023.
System Number: 27074
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/30/2023   Final Date: 7/27/2023
Effective Date: 9/1/2023   Withdrawal Date:
Rule: Title 23: Medicaid, Part 208, Rule 1.6: Covered Services, Rule 2.9: Beneficiary Cost Sharing, Rule 3.9: Beneficiary Cost Sharing, Rule 4.8: Beneficiary Cost Sharing, Rule 5.11: Beneficiary Cost Sharing
Summary: This administrative code is being submitted to remove copays from Medicaid services to correspond with SPA 23-0011 Copay (effective May 1, 2023), effective September 1, 2023.
System Number: 27070
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/30/2023   Final Date: 7/26/2023
Effective Date: 9/1/2023   Withdrawal Date:
Rule: Title 23: Medicaid, Part 222: Maternity Services, Chapter 1: General, Rule 1.9: Alpha Hydroxyprogesterone
Summary: This admin code is being submitted to remove coverage of Alpha-Hydroxyprogesterone. The U.S. Food and Drug Administration (FDA) has withdrawn approval of the drug.
System Number: 27068
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/27/2023   Final Date: 7/26/2023
Effective Date: 9/1/2023   Withdrawal Date:
Rule: Title 23: Medicaid, Part 200: General Provider Information, Chapter 3: Beneficiary Information, Rule 3.7: Beneficiary Cost Sharing; Chapter 5: General, Rule 5.3: Wellness Program
Summary: This administrative code is being submitted to remove copays from Medicaid services to correspond with SPA 23-0011 Copay (effective May 1, 2023), effective September 1, 2023.
System Number: 27067
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 3/3/2023   Final Date: 3/30/2023
Effective Date: 5/1/2023   Withdrawal Date:
Rule: Title 23 Part 215: Home Health Reimbursement, Chapter 1: Home Health Services, Rule 1.5 Reimbursement
Summary: This administrative code is being filed to remove rate freeze language for home health services.
System Number: 26831
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 3/3/2023   Final Date: 3/30/2023
Effective Date: 5/1/2023   Withdrawal Date:
Rule: Title 23: Medicaid, Part 201: Transportation Services, Chapter 1: Emergency Transportation Services, Rule 1.3: Covered Services, Rule 1.5: Reimbursement, Rule 1.6: Documentation Summary: This admin code is being submitted to add reimbursement for emergency ambulances for the initial twenty-five (25) miles correspond with MS State Plan Amendment (SPA) 23-0004 Ambulance Mileage.
System Number: 26830
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 12/29/2022   Final Date: 1/26/2023
Effective Date: 3/1/2023   Withdrawal Date:
Rule: Title 23: Medicaid, Part 300: Appeals, Chapters 1 – 4, Rules 1.1, 1.2, 2.1- 2.22, 3.1-3.8 (NEW), 4.1, 4.2 (NEW)
Summary: This Administrative Code is being filed to update and reformat Part 300 Appeals. Final file changes made to add standard of review language for provider appeals, revise the timely filing requirement for appeals, and minor technical corrections.
System Number: 26740
Notice  |  Full Text  |  Comments

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 12/29/2022   Final Date: 1/26/2023
Effective Date: 3/1/2023   Withdrawal Date: Rule: Title 23 Division of Medicaid, Part 305 Program Integrity, Chapter 1: Program Integrity, Rules 1.1 and 1.4
Summary: This Administrative Code is being filed to move and update language regarding the provider peer review protocols, effective March 1, 2023.
System Number: 26741
Notice  |  Full Text  |  Comments

2022

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 11/3/2022   Final Date: 11/29/2022
Effective Date: 1/1/2023   Withdrawal Date:
Rule: Title 23: Medicaid, Part 210: Ambulatory Surgical Centers, Chapter 1: General, Rule 1.6: Reimbursement
Summary: This Administrative Code is being filed to correspond with MS SPA 22-0026, effective October 1, 2022, 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 January 1, 2023. Specific legal authority authorizing the promulgation of rule: 42 C.F.R. Part 416; Miss. Code § 43-13-117
System Number: 26672
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 11/23/2022   Final Date: 11/29/2022
Effective Date: 1/1/2023   Withdrawal Date:
Rule: Title 23: Medicaid, Part 209: Durable Medical Equipment, Medical Appliances and Medical Supplies, Chapter 1 and 2, Rules 1.4 and 2.2.
Summary: This Administrative Code is being filed to correspond with MS SPA 22-0027, effective October 1, 2022, to update the rates for 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, in compliance with Miss. Code § 43-13-117, as amended by MS House Bill 657.
System Number: 26671
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/3/2022   Final Date: 5/31/2022
Effective Date: 07/01/2022   Withdrawal Date:
Rule: Title 23: Medicaid, Part 207: Institutional Long Term Care Services, Chapter 2: Nursing Facility, Chapter 3: Intermediate Care Facility for Individuals with Intellectual Disabilities, and Chapter 4: Psychiatric Residential Treatment Facility, Rule(s) 2.5, 2.10, 2.15 – 2.17, 3.6 and 4.6.
Summary: This Administrative Code is being filed to correspond with MS SPA 22-0006, effective May 1, 2022, to remove the language that set the fees for institutional long term care services the same as those effective as of July 1, 2021 in compliance with Miss. Code § 43-13-117, as amended by MS House Bill 657.
System Number: 26379
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 05/03/2022   Final Date: 5/31/2022
Effective Date: 07/01/2022   Withdrawal Date:
Rule: Title 23: Medicaid, Part 206: Mental Health Services, Chapter 1: Community Mental Health Services, Rule 1.5
Summary: This Administrative Code is being filed to remove the language that set the fees for mental health services the same as those effective in State Fiscal Year (SFY) 2021 in compliance with Miss. Code § 43-13-117, as amended by MS House Bill 657.
System Number: 26378
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/3/2022   Final Date: 5/31/2022
Effective Date: 07/01/2022   Withdrawal Date:
Rule: Title 23: Medicaid, Part 224: Immunizations, Chapter 1: General, Rule(s) 1.5: Reimbursement
Summary: This Administrative Code is being filed to remove the language that set the fees for immunizations the same as those effective for State Fiscal Year (SFY) 2021, in compliance with Miss. Code § 43-13-117, as amended by MS House Bill 657.
System Number: 26377
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/3/2022   Final Date: 5/31/2022
Effective Date: 07/01/2022   Withdrawal Date:
Rule: Title 23: Medicaid, Part 221: Family Planning and Family Planning Related Services, Chapter 1: Family Planning and Family Planning Related State Plan Services, Chapter 2: 1115(a) Family Planning and Family Planning Related Waiver Services, Rule(s) 1.8 and 2.10
Summary: This Administrative Code is being filed to remove the language that set the fees for family planning services the same as those effective for State Fiscal Year (SFY) 2021 in compliance with Miss. Code § 43-13-117, as amended by MS House Bill 657.
System Number: 26376
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/3/2022   Final Date: 5/31/2022
Effective Date: 7/1/2022   Withdrawal Date:
Rule: Title 23: Medicaid, Part 203: Physician Services, Chapter 1: General; Rules 1.2: Physician Fees
Summary: This Administrative Code is being filed to remove the language that set the fees for physician services the same as those effective as of July 1, 2021 in compliance with Miss. Code § 43-13-117, as amended by MS House Bill 657.
System Number: 26375
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 04/01/2022   Final Date: 4/28/2022
Effective Date: 06/01/2022   Withdrawal Date:
Rule: Title 23: Medicaid, Part 306: Third Party Recovery, Chapter 1: Third Party Recovery, Rule 1.3: Billing
Summary: This Administrative Code filing makes a technical correction. No substantive changes were made.
System Number: 26299
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 04/01/2022   Final Date: 04/28/2022
Effective Date: 06/01/2022   Withdrawal Date:
Rule: Title 23: Medicaid, Part 200: General Provider Information, Chapter 1: General Administrative Rules for Providers, Rule 1.10: Electronic Signatures
Summary: This Administrative Code is being submitted to add language clarifying the electronic signature technologies that can be utilized by providers.
System Number: 26300
Notice Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 3/4/2022   Final Date: 3/31/2022
Effective Date: 5/1/2022   Withdrawal Date:
Rule: Title 23: Medicaid, Part 202: Hospital Services, Chapter 2: Outpatient Services, Rule 2.6: Mental Health Services
Summary: This Administrative Code is being filed to require prior authorization for all outpatient hospital mental health services as previously required prior to May 1, 2021.
System Number: 26227
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 2/22/2022   Final Date: 3/29/2022
Effective Date: 5/1/2022   Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 201: Transportation, Chapter 2: Non-Emergency Transportation (NET) Broker Program, Rule 2.3: Non-Emergency Transportation (NET) Services
Summary: This Administrative Code filing is being submitted to include an exception to the three (3) day request requirement for NET services when the beneficiary would not be able to meet the requirement.
System Number: 26225
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 2/22/2022   Final Date: 3/29/2022
Effective Date: 5/1/2022   Withdrawal Date:
Rule: Title 23, Part 207, Chapters 2, 3 and 4, Rules 2.5, 2.6, 2.9, 2.11, 3.5, 3.7, 3.8, and 4.6
Summary: This administrative code filing is being submitted to update language regarding transportation of long-term care residents, resident fund requirements, and add language regarding timing and content of Minimum Data Set (MDS) assessments. Rules 2.8 and 3.6 were removed from the final file because there were no substantive changes made in those rules.
System Number: 26224
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 2/22/2022   Final Date: 3/29/2022
Effective Date: 5/1/2022   Withdrawal Date:
Rule: Title 23: Medicaid, Part 207: Institutional Long-Term Care, Chapter 4: Psychiatric Residential Treatment Facilities, Rule 4.9: Treatment Planning.
Summary: This Administrative Code is being filed to make minor corrections, including corrections to correspond with the MS Department of Health Minimum Standards. Changes made in the final file in response to public comments received.
System Number: 26223
Notice  |  Full Text  |  Public Comments

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 2/3/2022   Final Date: 3/1/2022
Effective Date: 4/1/2022   Withdrawal Date:
Rule: Title 23: Medicaid, Part 203: Physician Services, Chapter 1: General, Rule 1.4: Physician Office Visits
Summary: This Administrative Code filing is being submitted to add language clarifying how the Division of Medicaid is covering Medication Assisted Treatment (MAT) services provided by office based opioid treatment providers.
System Number: 26167
Notice  |  Full Text

2021

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/13/2020   Final Date: 12/28/2021
Effective Date:   Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 206: Mental Health Services, Chapter 1: Community Mental Health Services, Rules 1.1 and 1.3
Summary: This Administrative Code filing is being 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, to correspond with MS SPA 20-0023 effective October 1, 2020.
System Number: 26046
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 11/2/2021   Final Date: 11/29/2021
Effective Date: 1/1/2022   Withdrawal Date:
Rule: Title 23: Medicaid, Part 105: Budgeting and Eligibility Requirements, Chapters 1 – 8, Rule(s) 1.1 – 1.5, 2.1 – 2.2, 3.1 – 3.7, 4.1 – 4.6, 5.1, 6.1- 6.3, 7.1 – 7.6, and 8.1 – 8.3.
Summary: This Administrative Code filing adds budgeting for Aged, Blind and Disabled (ABD) and revises MAGI and institutional information, including information on budgeting and eligibility for all categories of eligibility (COEs).
System Number: 25999
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/29/2021   Final Date: 11/24/2021
Effective Date: 01/01/2022   Withdrawal Date:
Rule: Title 23: Medicaid, Part 205: Hospice Services, Chapter 1: Program Overview, Rule(s) 1.4, 1.8 and 1.10
Summary: This Administrative Code is being filed to 1) add language clarifying the prior authorization and notice of election requirements, 2) add language that late documentation will result in the hospice effective date beginning on the date the completed documentation is received, and 3) add exceptions to the timely submission of documentation requirement, effective January 1, 2022.
System Number: 25991
Notice  |  Full Text  |  Public Comments

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 09/02/2021   Final Date: 9/29/2021
Effective Date: 11/01/2021   Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 200: General Provider Information, Chapter 4: Provider Enrollment, Rule 4.2: Conditions of Participation
Summary: This Administrative Code is being filed to require providers to provide a thirty (30) day written notice to beneficiaries and the Division of Medicaid prior to the discontinuation of services. If a provider fails to provide the notice, the provider will not be reimbursed for the thirty (30) day period the beneficiary and Division of Medicaid should have been notified. This rule will not apply if the failure to provide notice was due to circumstances outside of the provider’s control.
System Number: 25887
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/3/2021   Final Date: 9/29/2021
Effective Date: 11/01/2021   Withdrawal Date:
Rule: Title 23: Medicaid, Part 213: Therapy Services, Chapters 1-3, Rules 1.6, 2.5, and 3.5.
Summary: This Administrative Code is being filed to allow the Division of Medicaid to cover the initial therapy evaluation on the same day as the first therapy session.
System Number: 25886
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/6/2021   Final Date: 9/1/2021
Effective Date: 10/1/2021   Withdrawal Date:
Rule: Title 23: Medicaid, Part 209: Durable Medical Equipment, Medical Appliances and Medical Supplies, Chapter 2: Medical Supplies, Rule(s) 2.2.
Summary: This Administrative Code is being filed to 1) remove the prior authorization requirement for up to six (6) incontinence garments per day, and 2) add a dates of service requirement to the delivery documentation.
System Number: 25854
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 05/05/2021   Final Date: 06/01/2021
Effective Date: 06/30/2021   Withdrawal Date: 6/30/2021
Rule: Title 23: Medicaid, Part 205: Hospice Services, Chapter 1: Program Overview, Rule 1.8: Reimbursement
Summary: This Administrative Code is being withdrawn as final filed on 6/1/2021 APA 25641.
System Number: 25641
Notice

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 05/05/2021   Final Date: 06/22/2021
Effective Date: 08/01/2021   Withdrawal Date:
Rule: Title 23: Medicaid, Part 223: EPSDT Services, Chapters 1, 2 and 6, Rules 1.3, 1.5, 1.8, 2.5, and 6.1-6.6
Summary: This final filing includes clarifications and corrections regarding replacing Mississippi Youth Programs Around the Clock (MYPAC) coverage and reimbursement with coverage and reimbursement for wraparound services. All medically necessary mental health services will be reimbursed individually and covered without regard to limitations for EPSDT-eligible beneficiaries.
System Number: 25682
Notice  |  Full Text  | Public Comments

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 05/05/2021   Final Date: 06/01/2021
Effective Date: 07/01/2021   Withdrawal Date:
Rule: Title 23: Medicaid, Part 225: Telemedicine, Chapter 1: Telemedicine, Rule(s) 1.3 – 1.5
Summary: This Administrative Code is being filed to (1) add language allowing FQHCs and RHCs to act as a originating and distant site and (2) and for FQHCs, RHCs, and CMHCs to receive both the distant site and originating site fees when such services are appropriately provided by the same organization, in compliance with Miss. Code § 43-13-117, as amended by MS Senate Bill 2799. This final file includes additional originating and distant providers and revises the requirement of a telepresenter as determined by the Division of Medicaid.
System Number: 25640
Notice  |  Full Text  |  Public Comments

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 05/05/2021   Final Date: 06/01/2021
Effective Date: 07/01/2021   Withdrawal Date:
Rule: Title 23: Medicaid, Part 224: Immunizations, Chapter 1: General, Rule(s) 1.5: Reimbursement
Summary: This Administrative Code is being filed to set the fees for immunizations the same as those effective for State Fiscal Year (SFY) 2021, except for 340B drugs, in compliance with Miss. Code § 43-13-117, as amended by MS Senate Bill 2799.
System Number: 25639
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 05/05/2021   Final Date: 06/01/2021
Effective Date: 07/01/2021   Withdrawal Date:
Rule: Title 23: Medicaid, Part 221: Family Planning and Family Planning Related Services, Chapter 1: Family Planning and Family Planning Related State Plan Services, Chapter 2: 1115(a) Family Planning and Family Planning Related Waiver Services, Rule(s) 1.8 and 2.10.
Summary: This Administrative Code is being filed to set the fees for family planning services the same as those effective for State Fiscal Year (SFY) 2021 in compliance with Miss. Code § 43-13-117, as amended by MS Senate Bill 2799. Specific legal authority authorizing the promulgation of rule: Miss. Code §§ 43-13-117, 43-13-121. List all rules repealed, amended, or suspended by the proposed rule: 1.8 and 2.10
System Number: 25638
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 05/05/2021   Final Date: 06/01/2021
Effective Date: 07/01/2021   Withdrawal Date:
Rule: Title 23: Medicaid, Part 217: Vision Services, Chapter 1: General, Rule(s) 1.3 and 1.5
Summary: This Administrative Code is being filed to 1) increase the number of physician office visits from twelve (12) to sixteen (16), and 2) set the fees for vision services the same as those effective for State Fiscal Year (SFY) 2021 in compliance with Miss. Code § 43-13-117, as amended by MS Senate Bill 2799.
System Number: 25637
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 05/05/2021   Final Date: 06/01/2021
Effective Date: 07/01/2021   Withdrawal Date:
Rule: Title 23: Medicaid, Part 216: Dialysis Services, Chapter 1: Dialysis Services, Rule(s) 1.3
Summary: This Administrative Code is being filed to set the fees for dialysis services the same as those effective as of January 1, 2021 in compliance with Miss. Code § 43-13-117, as amended by MS Senate Bill 2799.
System Number: 25636
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 05/05/2021   Final Date: 06/01/2021
Effective Date: 07/01/2021   Withdrawal Date:
Rule: Title 23: Medicaid, Part 215: Home Health Services, Chapter 1: Home Health Services, Rule(s) 1.1, 1.3 – 1.6
Summary: This Administrative Code is being filed to 1) add language allowing non-physician practitioners to prescribe or order home health services and plans of care, sign home health plans of care, certify and recertify eligibility for home health services and conduct the required initial face-to-face visit with the recipient of the services, and 2) to set the fees and or rates for home health services the same as those effective as of July 1, 2021 in compliance with Miss. Code § 43-13-117, as amended by MS Senate Bill 2799.
System Number: 25635
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 05/05/2021   Final Date: 06/01/2021
Effective Date: 07/01/2021   Withdrawal Date:
Rule: Title 23: Medicaid, Part 212: Rural Health Centers, Chapter 1: General, Rule(s) 1.1 – 1.7
Summary: This Administrative Code is being filed to add language allowing DOM to cover a Rural Health Center (RHC) as a distant site provider and to be in compliance with Miss. Code § 43-13-117, as amended by MS Senate Bill 2799.
System Number: 25643
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 05/05/2021   Final Date: 06/01/2021
Effective Date: 07/01/2021   Withdrawal Date:
Rule: Title 23: Medicaid, Part 211: Federally Qualified Health Centers, Chapter 1: General, Rule(s) 1.1 – 1.6
Summary: This Administrative Code is being filed to add language allowing DOM to cover a Federally Qualified Health Center (FQHC) as a distant site provider to be in compliance with Miss. Code § 43-13-117, as amended by MS Senate Bill 2799.
System Number: 25644
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 05/05/2021   Final Date: 06/01/2021
Effective Date: 07/01/2021   Withdrawal Date:
Rule: Title 23: Medicaid, Part 210: Ambulatory Surgical Centers, Chapter 1: General, Rule(s) 1.6: Reimbursement
Summary: This Administrative Code is being filed to set the fees for Ambulatory Surgical Centers the same as those effective for October 1, 2020, in compliance with Miss. Code § 43-13-117, as amended by MS Senate Bill 2799.
System Number: 25634
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 05/05/2021   Final Date: 06/01/2021
Effective Date: 07/01/2021   Withdrawal Date:
Rule: Title 23: Medicaid, Part 209: Durable Medical Equipment, Medical Appliances and Medical Supplies, Chapter 1: Durable Medical Equipment and Medical Appliances and Chapter 2: Medical Supplies, Rule(s) 1.4: Reimbursement, 2.2: Covered Medical Supplies
Summary: This Administrative Code is being filed to set the fees for Durable Medical Equipment and Medical Supplies the same as those in effect for State Fiscal Year (SFY) 2021, in compliance with Miss. Code § 43-13-117, as amended by MS Senate Bill 2799.
System Number: 25633
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 05/05/2021   Final Date: 06/01/2021
Effective Date: 07/01/2021   Withdrawal Date:
Rule: Title 23: Medicaid, Part 207: Institutional Long Term Care Services, Chapter 2: Nursing Facility, Chapter 3: Intermediate Care Facility for Individuals with Intellectual Disabilities, and Chapter 4: Psychiatric Residential Treatment Facility, Rule(s) 2.5, 2.10, 2.15 – 2.17, 3.6 and 4.6.
Summary: This Administrative Code is being filed to set the fees for institutional long term care services the same as those effective as of July 1, 2021 in compliance with Miss. Code § 43-13-117, as amended by MS Senate Bill 2799.
System Number: 25632
Notice  |  Full Text Public Comments

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 05/05/2021   Final Date: 06/01/2021
Effective Date: 07/01/2021   Withdrawal Date:
Rule: Title 23: Medicaid, Part 206: Mental Health Services, Chapter 1: Community Mental Health Services, Rule 1.1-1.6
Summary: This Administrative Code is being filed to 1) include revisions from MS SPA 20-0022 and 2) set the fees for mental health services the same as those effective in State Fiscal Year (SFY) 2021 in compliance with Miss. Code § 43-13-117, as amended by MS Senate Bill 2799. This final filing contains minor edits and corrections.
System Number: 25630
Notice  |  Full Text  | Public Comments

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 05/05/2021   Final Date: 06/01/2021
Effective Date: 07/01/2021   Withdrawal Date:
Rule: Title 23: Medicaid, Part 205: Hospice Services, Chapter 1: Program Overview, Rule 1.8: Reimbursement
Summary: This Administrative Code is being filed to set the fees for hospice services the same as those effective as of July 1, 2021 in compliance with Miss. Code § 43-13-117, as amended by MS Senate Bill 2799.
System Number: 25641
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 05/05/2021   Final Date: 06/01/2021
Effective Date: 07/01/2021   Withdrawal Date:
Rule: Title 23: Medicaid, Part 202: Hospital Services, Chapter 1 – Chapter 4, Rules 1.13 – 1.16, 2.3- 2.4, 2.8, 3.4 and 4.4
Summary: This Administrative Code is being filed to 1) add language requiring electronic submission of reports, 2) increased outpatient observation from twenty-three hours to seventy-two hours, 3) and set the fees for hospital services the same as those effective as of July 1, 2021 in compliance with Miss. Code § 43-13-117, as amended by MS Senate Bill 2799. Final Filing adds additional clarification to Rule 2.4.
System Number: 25631
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 05/05/2021   Final Date: 06/01/2021
Effective Date: 07/01/2021   Withdrawal Date:
Rule: Title 23: Medicaid, Part 203: Physician Services, Chapter 1: General and Chapter 9: Psychiatric Services, Rules 1.2: Physician Fees and Rule 9.5: Services Limits.
Summary: This Administrative Code is being filed to set the fees for physician services the same as those effective as of July 1, 2021 in compliance with Miss. Code § 43-13-117, as amended by MS Senate Bill 2799.
System Number: 25629
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 05/05/2021   Final Date: 06/01/2021
Effective Date: 07/01/2021   Withdrawal Date:
Rule: Title 23: Medicaid, Part 201: Transportation Services, Chapter 1: Emergency Transportation Services, Rule 1.5
Summary: This Administrative Code is being filed to set the fees for emergency ground transportation services the same as those effective as of July 1, 2021 in compliance with Miss. Code § 43-13-117, amended by MS Senate Bill 2799.
System Number: 25628
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 05/05/2021   Final Date: 06/01/2021
Effective Date: 07/01/2021   Withdrawal Date:
Rule: Title 23, Part 200, Chapter 1, 3 – 4, Rules 1.8, 3.7, and 4.10
Summary: This Administrative Code filing (1) revises the timeframe from 30 to 90 days that providers may request an Administrative Review in Rule 1.8, (2) revises Rule 3.7 to be in compliance with U.S.C § 1396a and 42 C.F.R. § 447.50 et seq.– 447.59, and (3) revises Rule 4.10 to be incompliance with Miss. Code Ann. 43-13-117 as amended by MS Senate Bill 2799.
System Number: 25627
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 05/05/2021   Final Date: 06/01/2021
Effective Date: 07/01/2021   Withdrawal Date:
Rule: Title 23, Part 225, Rules 2.3, 4.3, 4.4, 4.6
Summary: This Administrative Code filing (1) removes the two (2) or more hospitalizations from the coverage requirements of remote patient monitoring, (2) adds the required information for prior authorization, if it’s required, (3) adds diabetes type II as a covered diagnosis for continuous glucose monitoring (CGM), and (4) revises the coverage requirement for CGM which corresponds with Medicare coverage.
System Number: 25626
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 05/05/2021   Final Date: 06/01/2021
Effective Date: 07/01/2021   Withdrawal Date:
Rule: Title 23, Part 209, Rules 1.26, 2.2
Summary: This Administrative Code filing: (1) adds diabetes type II as a covered diagnosis for continuous glucose monitoring (CGM) and (2) adds the rental up to the purchase price of an Federal Drug Administration (FDA) class III medical device for home use for CGM for those beneficiaries with diabetes type II with long-term insulin usage who meet the requirements in Miss. Admin. Code Part 225.
System Number: 25625
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 03/31/2021   Final Date: 05/05/2021
Effective Date: 07/01/2021   Withdrawal Date:
Rule: Title 23: Medicaid, Part 223: Early and Periodic Screening, Diagnosis and Treatment (EPSDT), Chapter 4: Private Duty Nursing and Chapter 5: Personal Care Services, Rule(s) 4.8: Reimbursement, 5.8: Reimbursement
Summary: This Administrative Code is being filed to correspond with MS SPA 20-0002 that added coverage and reimbursement of PDN and PCS for Early and Periodic Screening, Diagnosis and Treatment (EPSDT)-eligible beneficiaries. The final filing removes the five percent (5%) reduction language and makes technical corrections.
System Number: 25539
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 3/4/2021   Final Date: 05/05/2021
Effective Date: 7/1/2021   Withdrawal Date:
Rule: Title 23: Medicaid, Part 209: Durable Medical Equipment, Medical Appliances and Medical Supplies, Chapter 1: Durable Medical Equipment and Medical Appliances, Rules 1.3, 1.4, 1.6, 1.20, 1.22 and 1.47.
Summary: This Administrative Code filing: 1) Allows for the reimbursement of Continuous Positive Airway Pressure (CPAP) supplies during the rental period in alignment with Medicare coverage, 2) Clarifies the rental of DME, 3) Updates the reimbursement methodology to correspond with SPA 20-0001, 4) Includes how to request DME and medical supplies not included on the Division of Medicaid’s fee schedule, and 5) Corrects minor technical errors.
System Number: 25537
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 03/31/2021   Final Date: 04/30/2021
Effective Date: 06/01/2021   Withdrawal Date:
Rule: Title 23: Medicaid, Part 209: Durable Medical Equipment, Medical Appliances and Medical Supplies, Chapter 1: Durable Medical Equipment and Medical Appliances, Rules 1.33: Nebulizers and 1.38: Spacer/Aerosol-Holding Chamber
Summary: This Administrative Code filing removes the prior authorization requirement for nebulizers and inhaler spacers. The Division of Medicaid (DOM) will cover four (4) spacers a year without prior authorization, and will no longer require prior authorization on nebulizers based on data from September 2019 to present showing 727 prior authorization requests approved and only 2 requests denied for technical errors.
System Number: 25513
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 3/4/2021   Final Date: 3/31/2021
Effective Date: 5/1/2021   Withdrawal Date: 4/1/2021
Rule: Title 23: Medicaid, Part 209: Durable Medical Equipment, Medical Appliances and Medical Supplies, Chapter 1: Durable Medical Equipment and Medical Appliances, Rules 1.3, 1.4, 1.6, 1.20, 1.22 and 1.47.
Summary: This Administrative Code filing is being submitted to withdraw the proposed rule APA 25433 effective immediately.
System Number: 25444
Notice

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 3/4/2021   Final Date: 3/31/2021
Effective Date: 5/1/2021   Withdrawal Date:
Rule: Title 23: Medicaid, Part 209: Durable Medical Equipment, Medical Appliances and Medical Supplies, Chapter 1: Durable Medical Equipment and Medical Appliances, Rules 1.3, 1.4, 1.6, 1.20, 1.22 and 1.47.
Summary: This Administrative Code filing: 1) Allows for the reimbursement of Continuous Positive Airway Pressure (CPAP) supplies during the rental period in alignment with Medicare coverage, 2) Clarifies the rental of DME, 3) Updates the reimbursement methodology to correspond with SPA 20-0001, 4) Includes how to request DME and medical supplies not included on the Division of Medicaid’s fee schedule, and 5) Corrects minor technical errors.
System Number: 25433
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 3/4/2021   Final Date: 3/31/2021
Effective Date: 5/1/2021   Withdrawal Date:
Rule: Title 23: Medicaid, Part 202: Hospital Services, Chapter 2: Outpatient Services, Rule 2.2: Outpatient Hospital Services, 2.6: Mental Health Services.
Summary: This Administrative Code final file adds reimbursement of a facility fee and professional fees for Intensive Outpatient Services and Partial Hospitalization Services in an outpatient hospital setting.
System Number: 25432
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 02/03/2021   Final Date: 3/1/2021
Effective Date: 4/1/2021   Withdrawal Date:
Rule: Title 23, Part 200: General Provider Information, Chapter 4: Provider Enrollment, Rule 4.2 and 4.5
Summary: This administrative code is being filed to update and clarify the Division of Medicaid’s license verification requirements. This filing complies with 42 C.F.R. § 455.412 which requires that state agencies must have methods to ensure that a provider is properly licensed in the state, the provider’s license has not expired and there are no current limitations on the provider’s license.
System Number: 25385
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 2/3/2021   Final Date: 3/1/2021
Effective Date: 4/1/2021   Withdrawal Date:
Rule: Title 23: Medicaid, Part 213: Therapy Services, Chapters 1: Physical Therapy, 2: Occupational Therapy, 3: Outpatient Speech-Language Pathology, Rules 1.7 – 1.8, 2.6 – 2.7, 3.6 – 3.7
Summary: Administrative Code 21-002 Therapy Services is being filed to 1) remove language requiring prior authorization for evaluations/re-evaluations, and 2) remove the language requiring the number of units/minutes per visit in the Plan of Care.
System Number: 25386
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 2/3/2021   Final Date: 3/1/2021
Effective Date: 4/1/2021   Withdrawal Date:
Rule: Title 23: Medicaid, Part 224: Immunizations, Chapter 1: General, Rules 1.1 – 1.6
Summary: This Administrative Code is being filed to correspond with MS State Plan Amendment (SPA) 20-0013 that updates vaccine coverage to include administration by pharmacists.
System Number: 25384
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 1/19/2021   Final Date: 2/26/2021
Effective Date: 4/1/2021   Withdrawal Date:
Rule: Title 23: Medicaid, Part 306: Third Party Recovery, Chapter 1: Third Party Recovery, Rules 1.1 – 1.5.
Summary: This Administrative Code is being submitted to allow the Division of Medicaid (DOM) to allow for cost avoidance of prenatal claims in compliance with the Bipartisan Budget Act of 2018, add the process for providers to request an override of the third party liability edit and update language to reflect current practices, to correspond with SPA 20-0009 effective October 1, 2020.
System Number: 25383
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 09/15/2020   Final Date: 02/03/2021
Effective Date: 02/03/2021   Withdrawal Date: 02/03/2021
Rule: Title 23: Medicaid, Part 224: Immunizations, Chapter 1: General, Rules 1.3 – 1.7.
Summary: This Administrative Code is being filed to correspond with MS State Plan Amendment (SPA) 20-0013 that updates vaccine coverage to include administration by pharmacists.
System Number: 25116
Notice  |  Full Text

2020

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 12/28/20 Final Date: 01/25/21
Effective Date: 03/01/21 Withdrawal Date:
Rule: Title 23: Medicaid, Part 205: Hospice Services, Chapter 1: Program Overview, Rule 1.10: Dual Eligibles
Summary: This Administrative Code filing adds verbiage requiring hospice providers to notify the Division of Medicaid within five (5) calendar days of a dual eligible beneficiary’s election and discharge date.
System Number: 25331
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 11/04/2020 Final Date: 12/01/2020
Effective Date: 01/01/2021 Withdrawal Date:
Rule: Title 23, Part 223: Early and Periodic Screening, Diagnosis and Treatment, Chapter 6: Expanded Rehabilitative Services, Rule 6.6: Documentation
Summary: This administrative code filing is being submitted to make corrections to system number 25156. The frequency of treatment plan reviews has been changed from every three (3) months to every six (6) months and additional providers have been added to the medication monitoring documentation requirements to be consistent with who can prescribe medications.
System Number: 25258
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/09/2020   Final Date: 12/01/2020
Effective Date: 01/01/2021   Withdrawal Date:
Rule: Title 23: Medicaid, Part 225: Telemedicine, Chapter 2: Remote Patient Monitoring Services, Rule 2.3: Covered Services
Summary: This Administrative Code is being emergency filed to provide immediate coverage for Remote Patient Monitoring for all chronic diseases as defined by the Centers for Medicare and Medicaid Services (CMS), as well as sickle cell in compliance with state law. This was emergency filed to allow for emergency coverage during the PHE as well as going forward in compliance with state law.
System Number: 25257
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/01/2020   Final Date: 10/28/2020
Effective Date: 12/01/2020   Withdrawal Date:
Rule: Title 23: Medicaid, Part 200: General Provider Information, Chapter 1: General Administrative Rules for Providers, Rule 1.12: National Correct Coding Initiative (NCCI) Edits.
Summary: This Administrative Code is being filed to require providers to follow the Medicaid National Correct Coding Initiative (NCCI) policy and edits.
System Number: 25217
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 09/03/2020   Final Date: 10/01/20
Effective Date:   Withdrawal Date: 10/26/2020
Rule: Title 23: Medicaid, Part 211: Federally Qualified Health Centers, Chapter 1: General, Rule 1.1 – 1.6
Summary: The Division of Medicaid is withdrawing this Administrative Code, system number 25160, to allow CMS time to approve corresponding SPA 20-0008, and make any necessary edits.
System Number: 25213
Notice

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 09/03/2020   Final Date: 10/01/2020
Effective Date:  Withdrawal Date: 10/26/2020
Rule: Title 23 Medicaid, Part 212: Rural Health Clinic, Chapter 1: General, Rules 1.1 – 1.7
Summary: The Division of Medicaid is withdrawing this Administrative Code, system number 25159, to allow CMS time to approve corresponding SPA 20-0007 RHC Services, and make any necessary edits.
System Number: 25212
Notice

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 09/25/2020   Final Date: 10/21/2020
Effective Date: 12/01/2020   Withdrawal Date:
Rule: Title 23: Medicaid, Part 200: General Provider Information, Chapter 1: General Administrative Rules for Providers, Rule 1.6: Timely Filing
Summary: This Administrative Code is being filed to require providers to submit claims to the Division of Medicaid for any claims recouped from providers by the CCOs within three hundred sixty five (365) days of the date of service or within ninety (90) calendar days of the recoupment from the CCO when the beneficiary moves from enrollment in a CCO to fee-for-service.
System Number: 25202
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 09/25/2020   Final Date: 10/21/2020
Effective Date: 12/01/2020   Withdrawal Date:
Rule: Title 23 Medicaid, Part 202: Hospital Services, Chapter 1: Inpatient Hospitals, Rule 1.14: Inpatient Hospital Payments
Summary: This Administrative Code filing corresponds with the following two (2) SPAs: 1) SPA 19-0019 Graduate Medical Education (GME) that revised 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. 2) SPA 20-0018 that allows the Division of Medicaid to address calculations for GME payments for a hospital during a cap building period effective June 1, 2020.
System Number: 25201
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 09/21/2020   Final Date: 10/21/2020
Effective Date: 12/01/2020   Withdrawal Date:
Rule: Title 23: Medicaid, Part 223: Early and Periodic Screening, Diagnosis, and Treatment, Chapter 4: Private Duty Nursing, Rule 4.2: Provider Requirements
Summary: This Administrative Code filing 1) removes the one year of experience requirement and 2) renames the proposal packet.
System Number: 25200
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/05/2018   Final Date:
Effective Date:   Withdrawal Date: 10/20/2020
Rule: Title 23: Medicaid, Part 212: Rural Health Clinics, Chapter 1: General, Rule 1.8: Early and Periodic Screening, Diagnosis and Treatment (EPSDT).
Summary: This proposed filing is being withdrawn because it was combined with system number 25159 final filed on October 1, 2020.
System Number: 25198
Notice

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 09/03/2020   Final Date: 10/01/20
Effective Date: 11/01/2020   Withdrawal Date:
Rule: Title 23: Medicaid, Part 211: Federally Qualified Health Centers, Chapter 1: General, Rule 1.1 – 1.6
Summary: This Administrative Code is being submitted to correspond with SPA 20-0008 FQHC Services which includes the coverage and reimbursement methodology for FQHC services in a school setting, telehealth, group therapy and mobile units.
System Number: 25160
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 09/03/2020   Final Date: 10/01/2020
Effective Date: 11/01/2020   Withdrawal Date:
Rule: Title 23 Medicaid, Part 212: Rural Health Clinic, Chapter 1: General, Rules 1.1 – 1.7
Summary: This Administrative Code is being submitted to correspond with SPA 20-0007 RHC Services which includes the coverage and reimbursement methodology for RHC services in a school setting, telehealth, group therapy and mobile units.
System Number: 25159
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 09/03/2020   Final Date: 10/01/2020
Effective Date: 11/01/2020   Withdrawal Date:
Rule: Title 23: Medicaid, Part 202: Hospital Services, Chapter 2: Outpatient Services, Rule 2.2: Outpatient Hospital Services, Rules 2.6: Mental Health Services.
Summary: This Administrative Code corresponds with SPA 20-0022 Mental Health Services Coverage and Reimbursement. This filing is being submitted to allow acute partial hospitalization services to be provided in the outpatient department of a hospital and/or acute free-standing psychiatric facility.
System Number: 25158
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 09/03/2020   Final Date: 10/01/2020
Effective Date: 11/01/2020   Withdrawal Date:
Rule: Title 23: Medicaid, Part 223: Early and Periodic Screening, Diagnosis, and Treatment, Chapter 1: General, Rule 1.3: Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Provider Participation Requirements, Rule 1.5: Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Screenings.
Summary: This Administrative Code is being filed to add verbiage outlining 1) provider requirements to enroll as an off-site EPSDT provider and 2) the requirements a provider must follow while performing EPSDT off-site screenings.
System Number: 25157
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/03/2020   Final Date: 10/01/2020
Effective Date: 11/01/2020   Withdrawal Date:
Rule: Title 23: Medicaid, Part 223: Early and Periodic Screening, Diagnosis and Treatment Services, Chapter 6: Expanded Rehabilitative Services, Rules 6.1-6.6.
Summary: This filing is being submitted to move language for expanded rehabilitative services for Early and Periodic Screening, Diagnosis and Treatment (EPSDT) beneficiaries from Part 206: Mental Health Services to Part 223: EPSDT Services, effective November 1, 2020. This filing corresponds with MS SPA 20-0022 Community Mental Health Services Coverage and Reimbursement, effective September 1, 2020.
System Number: 25156
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/03/2020   Final Date: 10/1/2020
Effective Date: 11/1/2020   Withdrawal Date:
Rule: Title 23: Medicaid, Part 206: Mental Health Services, Chapter 1: Community Mental Health Services, Rules 1.1 – 1.6
Summary: This Administrative Code corresponds with SPA 20-0022 Mental Health Services Coverage and Reimbursement. This filing is being submitted to align language and coverage with the Mississippi Department of Mental Health’s Standards of Operations which are effective September 1, 2020, to allow certain providers that are able to practice independently to enroll and provide community mental health services outside of a community or private mental health center, to replace Intensive Outpatient Programs (IOP) services with Intensive Community Outreach and Recovery Teams (I-CORT) services and allow acute partial hospitalization services to be provided in the outpatient department of a hospital, acute free standing psychiatric facility or other appropriate outpatient settings. This final filing includes changes based on public comments requesting clarifications and minor corrections.
System Number: 25155
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 09/03/2020   Final Date: 09/29/2020
Effective Date: 11/01/2020   Withdrawal Date:
Rule: Title 23: Medicaid, Part 214: Pharmacy Services, Chapter 2: Pharmacy Disease Management, Rule 2.1: Provider Enrollment and Pharmacy Participation
Summary: This Administrative Code is being filed to update the participation and enrollment requirement for pharmacists providing disease management services.
System Number: 25146
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/5/2020   Final Date: 831/2020
Effective Date: 10/1/2020   Withdrawal Date:
Rule: Title 23: Medicaid, Part 201: Transportation Services, Chapter 1: Emergency Transportation Services, Rule 1.5: Reimbursement
Summary: The Administrative Code is being filed to revise the reimbursement methodology for emergency ground ambulance transportation.
System Number: 25087
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/5/2020   Final Date: 8/31/2020
Effective Date: 10/1/2020   Withdrawal Date:
Rule: Title 23 Medicaid, Part 209: Durable Medical Equipment, Chapter 1: Durable Medical Equipment and Appliances, Rule 1.13: Battery and Battery Charger and Rule 1.47: Wheelchairs
Summary: This Administrative Code filing adds clarification that a battery is included in the cost of all durable medical equipment, except for custom wheelchairs, which will be reimbursed separately.
System Number: 25088
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/5/2020   Final Date: August 31, 2020
Effective Date: 10/1/2020   Withdrawal Date:
Rule: Title 23: Medicaid, Part 200: General Provider Information, Chapter 4: Provider Enrollment, Rule 4.2: Conditions of Participation
Summary: This Administrative Code is being filed to add language clarifying that providers with license limitations will be denied enrollment.
System Number: 25086
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 7/2/2020   Final Date: 7/28/2020
Effective Date: 9/1/2020   Withdrawal Date:
Rule: Title 23 Medicaid, Part 200: General Provider Information, Chapter 4: Provider Enrollment, Rule: 4.2, 4.3, 4.8
Summary: This Administrative Code is being filed to add guidance on what constitutes a change of ownership and requires providers to give DOM notice of changes of ownership within thirty-five (35) days of the change.
System Number: 25023
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 07/02/2020   Final Date: 07/28/2020
Effective Date: 09/01/2020   Withdrawal Date:
Rule: Title 23, Part 206, Rules 1.2-1.5, Rule 2.2
Summary: This Administrative Code is being filed to remove the requirement for signature of a supervisor on documentation of all services provided by provisionally credentialed mental healthcare professionals in a community mental health center setting; removal of IQ requirement for MYPAC eligibility. Removing Day Support Services as this is no longer a reimbursable service. Timeframe requirements for MYPAC diagnostic evaluations have been added.
System Number: 25024
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/5/2020   Final Date: 7/1/2020
Effective Date: 8/1/2020   Withdrawal Date:
Rule: Title 23: Medicaid, Part 225, Chapter 1, Rules 1.1 – 1.7
Summary: This final file Admin. Code (1) removes RHCs and FQHCs as distant telehealth providers and (2) includes additional non-covered telehealth services
System Number: 24972
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/5/2020   Final Date: 7/1/2020
Effective Date: 8/1/2020   Withdrawal Date:
Rule: Title 23: Medicaid, Part 209: Durable Medical Equipment, Chapter 1: Durable Medical Equipment and Medical Supplies, Rule 1.9, Chapter 2: Medical Supplies, Rule(s) 2.1, 2.2
Summary: This Administrative Code filing adds verbiage regarding beneficiary signature requirements for DME and/or medical supplies delivery during a national or statewide emergency.
System Number: 24971
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 06/04/2020 Final Date: 06/30/2020
Effective Date: 08/01/2020 Withdrawal Date:
Rule: Title 23: Medicaid, Part 306: Third Party Recovery, Chapter 1: Third Party Recovery, Rule 1.8: Estate Recovery Requirements
Summary: This Administrative Code filing moves language from Part 102 Rules 7.10-7.13 adding a new rule 1.8 outlining the process of recovery from a Medicaid recipient’s estate.
System Number: 24966
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 06/04/2020   Final Date: 06/30/2020
Effective Date: 08/01/2020   Withdrawal Date:
Rule: Title 23: Medicaid, Part 300: Appeals, Chapter 2: Beneficiary Right to Appeal and Fair Hearing, Rules 2.1 – 2.23
Summary: This Administrative Code filing moves language from Part 100 and creates a new Chapter 2 and new rules 2.1-2.23 to address a beneficiary’s right to appeal and a fair hearing.
System Number: 24965
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 06/03/2020   Final Date: 06/29/2020
Effective Date: 08/01/2020   Withdrawal Date:
Rule: Title 23 Medicaid, Part 102: Non-Financial Requirements, Chapter 1 – 9
Summary: This Administrative Code is being filed to remove all outdated references to families, children and CHIP (FCC) programs to modified adjusted gross income (MAGI); to update all regulatory citations, and to remove all examples. Also, to move Rules 7.10-7.13 to Part 306.
System Number: 24964
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 06/03/2020   Final Date: 06/29/2020
Effective Date: 08/01/2020   Withdrawal Date:
Rule: Title 23: Medicaid, Part 100: General Provisions, Chapter 1 – 5, Rules 1.1-1.3, 2.1-2.2, 3.1-3.10, 4.1-4.2, 5.1-5.21
Summary: This Administrative Code filing 1) includes the MS Department of Child Protection Services (MDCPS) which is responsible for the former duties of the MS Department of Human Services and updates MDCPS’s duties, 2) condensed the rights of applicants and beneficiaries with the emphasis placed on HIPAA requirements, 3) includes language for agency-wide privacy and security training, and 4) moved language from Chapters 4 and 5 to Part 300.
System Number: 24963
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 06/02/2020   Final Date: 06/29/2020
Effective Date: 08/01/2020   Withdrawal Date:
Rule: Title 23: Medicaid, Part 200; General Provider Information, Chapter 1, Rule 1.8: Administrative Reviews for Claims, Chapter 3, Rule 3.3: Beneficiary Retroactive Eligibility.
Summary: This Administrative Code (1) revises the timeframe providers can submit a claim for services rendered during a period of retroactive eligibility, and (2) addresses the timeframe providers must obtain authorization for services rendered during a period of retroactive eligibility.
System Number: 24962
Notice Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 06/02/2020   Final Date: 06/29/2020
Effective Date: 08/01/2020   Withdrawal Date:
Rule: Title 23 Medicaid, Part 214: Pharmacy Signatures, Chapter 1: General Pharmacy, Rule 1.12: Beneficiary Signature
Summary: This Admin. Code filing adds verbiage regarding beneficiary signature requirements for prescription drug delivery during a national or statewide emergency.
System Number: 24961
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 04/24/20 Final Date:
Effective Date: Withdrawal Date: 06/26/20
Rule: Title 23: Medicaid, Part 200: General Provider Information, Chapter 4: Provider Enrollment, Rules Rule: 4.2, 4.3, 4.8
Summary: This Administrative Code filing is being submitted to withdraw the proposed rule APA 24857 effective immediately.
System Number: 24959
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 01/31/2020   Final Date: 05/12/2020
Effective Date: 07/01/2020   Withdrawal Date:
Rule: Title 23: Medicaid, Part 223: Early and Periodic Screening, Diagnosis and Treatment (EPSDT), Chapter 4: Private Duty Nursing, Rules 4.1-4.7, 4.9, Chapter 5: Personal Care Services, Rules 5.1-5.7, 5.9.
Summary: Due to COVID-19, the Division of Medicaid is delaying the effectiveness of Title 23: Medicaid, Part 223, Chapter 4 and 5, Rules 4.1-4.7, 4.9, 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.
System Number: 24884
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 03/03/2020   Final Date: 03/30/2020
Effective Date: 05/01/2020   Withdrawal Date:
Rule: Title 23 Medicaid, Part 223: Early and Periodic Screening, Diagnosis, and Treatment, Chapter 3: Prescribed Pediatric Extended Care (PPEC) Services, Rule 3.2: Provider Requirements.
Summary: Technical correction removing the Medicare certification requirement
System Number: 24813
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 03/03/20   Final Date: 03/30/2020
Effective Date:  05/01/20   Withdrawal Date:
Rule: Title 23: Medicaid, Part 203: Physician Services, Chapter 1: General, Rule 1.11: Physician Verbal Orders.
Summary: This Administrative Code is being filed to add a new rule and language defining the proper usage of physician verbal orders.
System Number:  24812
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 01/31/2020   Final Date: 03/26/2020
Effective Date:  06/01/2020   Withdrawal Date:
Rule: Title 23: Medicaid, Part 223: Early and Periodic Screening, Diagnosis and Treatment (EPSDT), Chapter 4: Private Duty Nursing, Rules 4.1-4.7, 4.9, Chapter 5: Personal Care Services, Rules 5.1-5.7, 5.9.
Summary: Due to COVID-19, the Division of Medicaid is delaying the effectiveness of Title 23: Medicaid, Part 223, Chapter 4 and5, Rules 4.1-4.7, 4.9, 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.
System Number: 24809
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 01/31/2020   Final Date: 02/28/2020
Effective Date:  04/01/2020   Withdrawal Date:
Rule: Title 23: Medicaid, Part 200: General Provider Information, Chapter 4: Provider Enrollment, Rule 4.2: Conditions of Participation
Summary: This Administrative Code is being filed to include language allowing the Division of Medicaid to disenroll out-of-state providers that do not bill the Division of Medicaid within a three (3) year period, except for certain providers as determined by Division of Medicaid. This Administrative Code is being filed to add language requiring providers to verify with the NET Broker that non-emergency transportation is used for Medicaid covered services only.
System Number: 24770
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 01/23/2020   Final Date: 02/21/2020
Effective Date:  04/01/2020   Withdrawal Date:
Rule:Title 23: Medicaid, Part 201: Transportation Services, Chapter 1: Emergency Transportation Services, Rule 1.6: Documentation.
Summary: This Administrative Code filing is being submitted to remove the prior authorization requirement for emergency ambulance transportation.
System Number: 24760
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 01/22/2020   Final Date: 02/19/2020
Effective Date: 04/01/2020   Withdrawal Date:
Rule: Title 23, Medicaid Part 200: General Provider Enrollment, Chapter 1: General Administrative Rules for Providers, Rule 1.9 – 1.11, Chapter 5: General, Rule 5.7: Electronic Health Records.
Summary: This Administrative Code is being filed to define an authorized provider representative, add language allowing the use of electronic signatures and define acceptable usage of electronic signatures.
System Number: 24753
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 01/21/2020   Final Date: 02/18/2020
Effective Date:  04/01/2020   Withdrawal Date:
Rule: Title 23: Medicaid, Part 207: Institutional Long-Term Care, Chapter 2: Nursing Facility, Rule 2.1: General and Rule 2.3: Remedies and Termination of Agreements
Summary: This Administrative Code is being submitted to include the remedies available to the Division of Medicaid and Mississippi Department of Health (MSDH) when deficiencies are found on a survey conducted by MSDH.
System Number: 24744
Notice | Full Text

2019

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 01/28/20  Final Date:
Effective Date:   Withdrawal Date: 1/31/2020
Rule: Title 23: Medicaid, Part 200: General Provider Information, Chapter 4: Provider Enrollment, Rule 4.2: Conditions of Participation.
Summary: This Administrative Code is being filed to include language allowing the Division of Medicaid to disenroll out-of-state providers that do not bill the Division of Medicaid within a three (3) year period, except for certain providers as determined by Division of Medicaid.
System Number: 24715
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 01/24/20   Final Date:
Effective Date:    Withdrawal Date: 1/31/2020
Rule: Title 23: Medicaid, Part 200: General Provider Information, Chapter 4: Provider Enrollment, Rule 4.2: Conditions of Participation.
Summary: This Administrative Code filing is being submitted to add language requiring providers to verify with the NET Broker that non-emergency transportation is used for Medicaid covered services only.
System Number: 24714
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 09/05/2019  Final Date: 12/20/2019
Effective Date:  02/01/2020  Withdrawal Date:
Rule: Title 23: Medicaid, Part 223: Early and Periodic Screening, Diagnosis, and Treatment (EPSDT), Chapter 3: Prescribed Pediatric Extended Care (PPEC) Services, Rule 3.1: Definitions, Rule 3.2: Provider Requirements, Rule 3.3: Covered Services, Rule 3.4: Non-covered Services, Rule 3.5: Reimbursement,  Rule 3.6: Documentation.
Summary: This administrative code is being filed to include coverage and reimbursement language for PPEC services in the Mississippi Administrative Code, Title 23 under Part 203: Early and Periodic Screening, Diagnosis, and Treatment (EPSDT).
System Number: 24657
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 11/01/2019  Final Date: 11/27/2019
Effective Date:  01/01/2020  Withdrawal Date:
Rule: Title 23: Medicaid, Part 200: General Provider Information, Chapter 4: Provider Enrollment, Rule 4.1: Definitions, 4.2: Conditions of Participation, 4.4: Effective Date of Provider Agreement and Provider Agreement Termination.
Summary: This administrative code is being filed to clarify out-of-state provider enrollment requirements and specify effective dates for provider agreements. This filing removes 1) “completed” from the submittal application requirement, 2) clarifies Rule 4.2.B.1.d mileage requirement, and 3) replaces the provider producing required documentation of screening results with DOM verification of screening results.
System Number: 24619
Notice Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 11/01/2019  Final Date: 11/27/2019
Effective Date:  01/01/2020  Withdrawal Date:
Rule: Title 23: Medicaid, Part 300: Appeal, Chapter 1: Appeals, Rule 1.4: Provider Peer Review Protocol.
Summary: This administrative code filing incorporates the review process of the new UM/QIO which (1) replaces “healthcare provider” with “provider” in the Rule name and throughout the document, (2) replaces the requirement for a peer review panel with a peer review consultant, (3) increases the peer review levels to IV by adding a Request for Reconsideration Review, and (4) other minor edits to the language.
System Number: 24618
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/28/2019  Final Date: 11/26/2019
Effective Date:  01/01/2020  Withdrawal Date:
Rule: Title 23: Medicaid, Part 213: Therapy Services, Chapter 1: Physical Therapy, Chapter 2: Occupational Therapy, Chapter 3: Outpatient Speech-Language Pathology, Rule 1.11:  Documentation, Rule 2.9: Documentation, and Rule 3.9: Documentation.
Summary: This administrative code filing is being submitted to clarify that progress notes for therapy services must be documented at least weekly.
System Number: 24592
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/3/2019   Final Date: 11/1/2019
Effective Date:  12/1/2019   Withdrawal Date:
Rule: Title 23: Medicaid, Part 203: Physician Services, Chapter 7: Nurse Practitioner, Rules 7.1: Provider Enrollment and 7.2: Nurse Practitioner Services and Reimbursement, Chapter 8: Physician Assistant, 8.1: Physician Assistant Enrollment Requirements, and 8.2: Physician Assistant Services and Reimbursement.
Summary: This administrative code is being filed to add language regarding the requirement that advanced practice registered nurses (APRNs), also referred to as nurse practitioners (NPs), and physician assistants (PAs) provide a copy of protocols and practice settings approved by the appropriate licensure board upon enrollment as a Mississippi Medicaid Provider.
System Number: 24539
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/3/2019  Final Date: 11/1/2019
Effective Date: 12/1/2019  Withdrawal Date:
Rule: Title 23: Medicaid, Part 202: Hospital Services, Chapter 2: Outpatient Services, Rule 2.2: Outpatient Hospital Services
Summary: This Administrative Code is being filed to add a prior authorization requirement for certain physician administered drugs (PAD) as determined by the Division of Medicaid.
System Number: 24537
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/3/2019   Final Date: 11/1/2019
Effective Date:  12/01/2019   Withdrawal Date:
Rule: Title 23: Medicaid, Part 203: Physician Services, Chapter 2: Physician Administered Drugs and Implantable Drug System Devices, Rule 2.1: Covered Services
Summary: This Administrative Code is being filed to add a prior authorization requirement for certain physician administered drugs (PAD) as determined by the Division of Medicaid.
System Number: 24538
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 09/05/2019   Final Date: 10/14/2019
Effective Date:  12/01/2019   Withdrawal Date:
Rule: Title 23: Medicaid, Part 200: General Provider Information, Chapter 4: Provider Enrollment, Rule 4.1: Definitions, 4.2: Conditions of Participation, 4.4: Effective Date of Provider Agreement and Provider Agreement Termination.
Summary: This Administrative Code final filing specifies effective dates for provider agreements. This filing removes the proposed revisions for out-of-state provider enrollment requirements.
System Number: 24487
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/4/2019 Final Date: 9/30/2019
Effective Date: 11/1/2019 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 207: Institutional Long-Term Care, Chapter 2: Nursing Facilities, Rule 2.5: Reimbursement and Rule 2.8: Temporary Leave
Summary: This Administrative Code is being filed to clarify the nursing facility home/therapeutic and inpatient hospital temporary leave days.
System Number: 24439
Notice  |  Full Text

Agency:DIVISION OF MEDICAID
Compilation: No
Proposed Date:7/30/2019   Final Date:8/26/2019
Effective Date:10/1/2019   Withdrawal Date:
Rule:Title 23: Division of Medicaid, Part 209: Durable Medical Equipment, Medical Appliances and Medical Supplies, Chapter 2: Medical Supplies, Rule: 2.2
Summary:This Administrative Code is being filed to clarify the number of incontinent garments covered per day by removing the following language from Miss. Admin. Code Part 209, Rule 2.2.AA.2.c): In extenuating circumstances, where there is documentation that justifies the medical necessity for more than six (6) units per day, a prior authorization request signed by a physician must be submitted to the Division of Medicaid or designee.
System Number:24381
Notice  |  Full Text

Agency:DIVISION OF MEDICAID
Compilation: No
Proposed Date:8/1/2019    Final Date:8/26/2019
Effective Date:10/1/2019    Withdrawal Date:
Rule:Title 23: Division of Medicaid, Part 210: Ambulatory Surgical Centers, Chapter 1: General, Rules 1.4: Covered Services and 1.6: Reimbursement
Summary:This administrative code is being filed to add language describing the current reimbursement methodology for dental procedures and require that the appropriate code set be used when billing for dental services based on the servicing provider type.
System Number:24380
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/1/2019  Final Date: 8/26/2019
Effective Date: 10/1/2019 Withdrawal Date:
Rule: Title 23: Medicaid, Part 200 General Provider Information, Chapter 1: General Administrative Rules for Providers, Rule 1.7: Timely Processing of Claims
Summary: This Administrative Code is being filed to allow up to ninety (90) days for a provider to resubmit a claim if the Division of Medicaid adjusts a claim after the processing period has ended.
System Number: 24377
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/1/2019   Final Date: 8/26/2019
Effective Date:10/1/2019   Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 202: Hospital Services, Chapter 5: Hospital Procedures, New Rule 5.7: Dental Services Provided in a Hospital Setting
Summary: This administrative code is being filed to add language describing the current reimbursement methodology for dental procedures and require that the appropriate code set be used when billing for dental services based on the servicing provider type.
System Number: 24376
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/1/2019   Final Date: 8/26/2019
Effective Date: 10/1/2019   Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 204: Dental Services, Chapter 1: General, Rules 1.11: Dental Services Provided in the Hospital or Ambulatory Surgical Center (ASC) Setting and New Rule 1.18: Dental Reimbursement.
Summary: This administrative code is being filed to add language describing the current reimbursement methodology for dental procedures and require that the appropriate code set be used when billing for dental services based on the servicing provider type.
System Number: 24375
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 7/22/2019   Final Date: 8/22/2019
Effective Date: 10/1/2019   Withdrawal Date:
Rule: Title 23: Medicaid, Part 200: General Provider Information, Chapter 6: Indian Health Services, New Rule 6.6: Cost-Sharing. Summary: This Admin Code is being filed to update the Admin. Code to reflect that there is no cost-sharing imposed on American Indians/Alaskan Natives (AI/ANs).
System Number: 24364
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 7/26/2019   Final Date: 8/22/2019
Effective Date: 10/1/2019   Withdrawal Date:
Rule: Title 23: Medicaid, Part 207: Institutional Long-Term Care, Chapter 3: Long-Term Care Pre-Admission Screening, Rule 3.9: Utilization Review Summary: Miss. Admin. Code 19-030 Utilization Review (UR) in Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IIDs) is being filed to correspond with State Plan Amendment (SPA) 19-0014 Utilization Review (UR) in Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IIDs). This administrative code will allow the Division of Medicaid to change control of the utilization of ICF/IIDs from the Mississippi Department of Health (MDOH) to the Division of Medicaid’s contracted Utilization Management/Quality Improvement Organization (UM/QIO), effective October 1, 2019.
System Number: 24365
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 7/22/2019   Final Date: 8/16/2019
Effective Date: 10/1/2019   Withdrawal Date:
Rule: Title 23: Medicaid, Part: 214 Pharmacy Services, Chapter 1: General Pharmacy, Rule 1.6: Prescription Requirements. Summary: This Administrative Code filing is being submitted to increase the prescription drug limit from five (5) prescription drugs to six (6) prescription drugs per month and add language regarding coverage of prescription drugs for institutionalized long-term care (LTC) beneficiaries and Early and Periodic Screening, Diagnosis and Treatment (EPSDT)-eligible beneficiaries. This Administration Code filing is being filed to correspond with State Plan Amendment (SPA) 19-0004 Prescription Drug Limit Increase that was approved and effective July 1, 2019.
System Number: 24358
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 7/2/2019   Final Date: 7/30/2019
Effective Date: 9/1/2019   Withdrawal Date:
Rule: Title 23: Medicaid, Part: 208: Home and Community Based Services (HCBS) Long-Term Care, Chapter 2: Home and Community Based Services (HCBS) Independent Living Waiver, Rules 2.1: General, Rule 2.2: Eligibility, Rule 2.3: Provider Qualifications, Rule 2.4: Freedom of Choice, Rule 2.5: Quality Management, Rule 2.6: Covered Services, Rule 2.7: Prior Approval/Certification, Rule 2.8: Documentation/Record Maintenance, Rule 2.9: Beneficiary Cost Sharing, Rule 2.10: Reimbursement, Rule 2.11: Due Process Protection, Rule 2.12: Hearings and Appeals, Rule 2.13: Person Centered Planning (PCP), and Rule 2.14: Monitoring Safeguards.
Summary: This Admin Code is being filed to correspond with the Independent (IL) Waiver renewal, effective July 1, 2018.
System Number: 24279
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 7/2/2019   Final Date: 7/29/2019
Effective Date: 9/1/2019   Withdrawal Date:
Rule: Title 23: Medicaid, Part: 207: Institutional Long-Term Care, Chapter 2: Nursing Facility, Rule 2.6: Per Diem, New Rule 2.20: facility Initiated Discharges, and Chapter 3: Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID), Rule 3.5: Per Diem, and Rule 3.13: Facility Initiated Discharges.
Summary: This Administrative Code filing is being filed to include requirements for beneficiary notification and facility documentation when the facility initiates the transfer or discharge of a resident and include all incontinence garments in the per diem rate for nursing facilities and intermediate care facilities for individuals with intellectual disabilities (ICF/IID).
System Number: 24291
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 7/2/2019   Final Date: 7/29/2019
Effective Date: 9/1/2019   Withdrawal Date:
Rule: Title 23: Medicaid, Part: 202: Hospital Services, Chapter 5: Hospital Procedures, Rule 5.1: Hyperbaric Oxygen Therapy.
Summary: This Administrative Code is being filed to mirror Medicare’s coverage and reimbursement of HBOT which: (1) allows for direct supervision of HBOT by a non-physician practitioner (NPP), (2) allows for coverage and reimbursement per beneficiary session of physician or NPP attendance or supervision of HBOT, (3) defines the cardio-pulmonary response (CPR) team, and (4) revises the coverage of medical conditions to those Food and Drug Administration (FDA) approved or that follow medically accepted indications supported by one (1) or more of the official compendia as designated by the Centers for Medicare and Medicaid (CMS) or the Undersea and Hyperbaric Medical Society (UHMS).
System Number: 24290
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/24/2019   Final Date: 7/22/2019
Effective Date: 9/1/2019   Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 211: Federally Qualified Health Centers, Chapter 1: General, Rule 1.2: Service Limits
Summary: This Admin Code filing is being submitted to clarify which “other health professional for mental health services” can perform an FQHC encounter. The language “other health professional for mental health services” is being replaced with “Licensed Professional Counselors (LPCs) and/or Board Certified Behavior Analysts (BCBAs)”.
System Number: 24251
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 05/17/2019   Final Date: 06/13/2019
Effective Date: 08/01/2019   Withdrawal Date:
Rule: Title 23: Medicaid, Part 208: Home and Community Based Services (HCBS) Long-Term Care, Chapter1: Home and Community Based Services (HCBS) Elderly and Disabled Waiver, Rule 1.6: Covered Services
Summary: This administrative code filing is being revised to reflect the increase of the State Plan home health visit limit from twenty-five (25) to thirty-six (36) corresponding with SPA 19-0005 Home Health Visit Increase, effective August 1, 2019.
System Number: 24172
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 05/17/2019   Final Date: 06/13/2019
Effective Date: 08/01/2019   Withdrawal Date:
Rule: Title 23: Medicaid, Part 200: General Provider Information, Chapter 5: General, New Rule 5.7: Electronic Health Record (EHR) and Electronic Signature.
Summary: This Administrative Code filing adds a new rule which requires EHRs and electronic signatures meet certified electronic health record technology (CEHRT) criteria and comply with Health Insurance Portability and Accountability Act (HIPAA) in regards to the access, transfer, storage and signing of EHR, effective August 1, 2019.
System Number: 24171
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 4/8/2019   Final Date: 5/30/2019
Effective Date: 7/1/2019   Withdrawal Date:
Rule: Title 23, Part 200, Chapter 1, New Rules 1.6, 1.7 and 1.8
Summary: This Administrative Code filing is being submitted to add new rules which address the timely filing requirements for providers and the Division of Medicaid’s claims processing policies. This filing includes changes to clarify language based on comments received by the Division of Medicaid.
System Number: 24160
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/2/2019   Final Date: 5/28/2019
Effective Date: 7/1/2019   Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 209: Durable Medical Equipment, Medical Appliances and Medical Supplies, Chapter 2: Medical Supplies, Rule(s): 2.2, 2.5
Summary: This Administrative Code is being filed to move the language in Rule 2.5: Diapers and Underpads to Rule 2.2.AA: Incontinence Garments and revise the language to include the coverage of pull-ons, effective July 1, 2019.
System Number: 24156
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 4/17/2019   Final Date: 5/14/2019
Effective Date: 7/1/2019   Withdrawal Date:
Rule: Title 23: Medicaid, Part 209: Durable Medical Equipment, Medical Appliances and Medical Supplies, Chapter 1: Durable Medical Equipment and Medical Appliances, Rule 1.28: Hospital Beds and Rule 1.29: Hydraulic Lift with Seat or Sling.
Summary: This administrative code is being filed to revise the credentialing requirements for the evaluators conducting on-site evaluations of the location where hospital beds or electrical lifts have been ordered. This revision will allow physical therapists and occupational therapist to conduct these on-site evaluations.
System Number: 24119
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 4/18/2019   Final Date: 5/14/2019
Effective Date: 7/1/2019   Withdrawal Date:
Rule: Title 23: Medicaid, Part 215: Home Health Services, Chapter 1: Home Health Services, Rule 1.3: Covered Services
Summary: This Administrative Code is being filed to correspond with SPA 19-0005 Home Health Visit Increase, which allows the Division of Medicaid (DOM) to increase the number of home health visits from twenty five (25) visits per state fiscal year to thirty-six (36) visits per state fiscal year, effective July 1, 2019.
System Number: 24118
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 04/01/2019   Final Date: 05/01/2019
Effective Date: 06/01/2019   Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 212: Rural Health Clinics, Chapter 1: General, Rule 1.1: Provider Enrollment Requirements, Rule 1.2: Service Limits, Rule 1.3: Covered and Non-Covered Services, Rule 1.4: Reimbursement Methodology, Rule 1.5: Documentation Requirements, Rule 1.6: Co-Mingling, Rule 1.7: Pregnancy Related Eligibles and Rule 1.8: Early and Periodic Screening, Diagnosis, and Treatment (EPSDT).
Summary: This administrative code filing is being submitted 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 pharmacy benefit, effective to correspond with SPA 18-0013 eff. 07/01/18 and to allow Licensed Professional Counselors (LPCs) and Board Certified Behavior Analysts (BCBAs) to provide mental health services in an RHC. This final filing contains non-substantive changes to Rules 1.2 and 1.3 by specifying LPCs and BCBAs as the mental professionals that can perform an encounter in an RHC.
System Number: 24080
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 3/29/2019   Final Date: 4/25/2019
Effective Date: 6/1/2019 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 211: Federally Qualified Health Centers, Chapter 1: General, Rule 1.1: Provider Enrollment Requirements, Rule 1.2: Service Limits, Rule 1.3: Covered and Non-Covered Services, Rule 1.4: Pregnancy-Related Eligibles, Rule 1.5: Reimbursement Methodology, Rule 1.6: Documentation Requirements and Rule 1.7: Early and Periodic Screening, Diagnosis and Treatment. Summary: This administrative code filing is being submitted 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 the pharmacy benefit, effective to correspond with SPA 18-0012 eff. 07/01/18 and to allow Licensed Professional Counselors (LPCs) and Board Certified Behavior Analysts (BCBAs) to provide mental health services in an FQHC .
System Number: 24076
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 3/29/2019   Final Date: 4/25/2019
Effective Date: 6/1/2019   Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 214: Pharmacy Services, Chapter 1: General Pharmacy, Rule 1.16: Clinician Administered Drugs and, Implantable Drug System Devices (CADDs)
Summary: This Administrative Code is being filed to allow the Division of Medicaid to reimburse for certain Physician Administered Drugs (PADs) under the pharmacy benefit to improve beneficiary access. These certain PADs are referred to as CADDs and include, but are not limited to, long-acting reversible contraceptives (LARCs), pregnancy maintaining agents, injectable atypical antipsychotic agents, and chemical dependency treatment agents. CADDs may be billed as either medical or pharmacy point-of-sale (POS) claims. This filing corresponds to State Plan Amendment (SPA) 18-0011 PADs, effective July 1, 2018.
System Number: 24075
Notice  |  EIS  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 3/29/2019   Final Date: 4/24/2019
Effective Date: 6/1/2019   Withdrawal Date:
Rule: Title 23: Medicaid, Part 303: Pre-Admission Screening and Resident Review, Chapter 1: Pre-Admission Screening and Resident Review, Rules 1.1 – 1.10.
Summary: This Administrative Code filing is being submitted to move all PASRR Level I and Level II information from Part 303 to Part 206 and Part 207 and to update language.
System Number: 24073
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 3/29/2019   Final Date: 4/24/2019
Effective Date: 6/1/2019 Withdrawal Date: Rule: Title 23: Medicaid, Part 207: Institutional Long-Term Care Pre-Admission Screening and Resident Review (PASRR) Rules 1.1 -1.6 and 2.7
Summary: This Administrative Code filing is being submitted to (1) remove the physician certification of clinical eligibility requirement (2) Remove the Assisted Living Waiver, Elderly and Disabled Waiver, Independent Living Waiver, and Traumatic Brain Injury/Spinal Cord Injury Waiver’s requirements to complete the PASRR, (3) To define the PASRR Level 1, and (4) Refer providers to Part 206 for the requirements of PASRR Level II.
System Number: 24072
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 3/21/2019   Final Date: 4/17/2019
Effective Date: 6/1/2019   Withdrawal Date:
Rule: Title 23, Part 203, Chapter 1, Rule 1.4 and Chapter 9, Rule 9.5 Summary: This Administrative Code filing is being submitted to increase the combined 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 increased effective July 1, 2019, to correspond with SPA 18-0020 (eff. 01/01/2019).
System Number: 24064
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 2/1/2019   Final Date: 2/27/2019
Effective Date: 4/1/2019   Withdrawal Date:
Rule: Title 23: Medicaid, Part 207: Institutional Long-Term Care, Chapter 4: Psychiatric Residential Treatment Facility, Rules: 4.11
Summary: This filing is to comply with the Cures Act, effective January 1, 2019, which requires psychiatric residential treatment facilities (PRTFs) to ensure EPSDT-eligible beneficiaries receive early and periodic screening, diagnostic, and treatment (EPSDT) services regardless of whether such services are identified in the individual’s plan of care, effective April 1, 2019.
System Number: 23965
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 1/28/2019   Final Date: 2/26/2019
Effective Date: 4/1/2019   Withdrawal Date:
Rule: Title 23: Division of Medicaid; Part 200: General Provider Information; Chapter 4: Provider Enrollment; Rule 4.10: 340B Providers
Summary: This filing is to include language which was omitted with the final filing of system number 23710.
System Number: 23963
Notice Full Text

2018

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 12/6/2018   Final Date: 1/11/2019
Effective Date: 3/1/2019   Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 203: Physician Services, Chapter 4: Surgery, Rule: 4.18 Reduction Mammoplasty
Summary: This Administrative Code is being filed to add primary care physician documentation requirements for reduction mammoplasty and remove that the final determination of medical necessity is made by the surgeon, effective March 1, 2019.
System Number: 23868
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 12/6/2018   Final Date: 1/11/2019
Effective Date: 3/1/2019   Withdrawal Date:
Rule: Title 23: Medicaid, Part 202: Hospital Services, Chapter 1: Inpatient Services, Rule 1.1: Definitions, 1.14: Inpatient Hospital Payments, 1.16: Split Billing
Summary: This Administrative Code is being filed to add clarifying language to the three (3) day payment window rule to instruct providers to split bill for the outpatient services provided outside of the three (3) day window on a claim separate from the inpatient claim, if outpatient services are provided more than three (3) days prior to admission to a beneficiary by the admitting hospital, or an entity wholly owned or operated by the admitting hospital, and the outpatient service dates span to days outside of the three (3) day window the hospital must, effective March 1, 2019.
System Number: 23867
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 12/6/2018   Final Date: 1/11/2019
Effective Date: 3/1/2019   Withdrawal Date:
Rule: Part 222: Maternity Services, Chapter 1: General, Rule: 1.12 Tobacco Cessation Counseling Services (New)
Summary: This Administrative Code is being filed to include language to correspond with SPA 2013-002 Tobacco Cessation for Pregnant Women and to comply with section 4107 of the Affordable Care Act requiring coverage of face-to-face counseling services for cessation of tobacco use by pregnant women, effective March 1, 2019.
System Number: 23866
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 11/30/2018 Final Date: 12/27/2018
Effective Date:  2/1/2019      Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 201: Transportation, Chapter 2: Non-Emergency Transportation (NET) Broker Program, Rule 2.1: Non-Emergency Transportation (NET) Broker Program; Chapter 3: Non-Emergency Transportation (NET) Services Not Covered Under the Broker Program, Rule 3.1: Non-Emergency Transportation (NET) Services Not Covered Under the Broker Program
Summary: This final filing removes prescribed pediatric extended care (PPEC) transportation from the Non-Emergency Transportation (NET) Broker program and includes non-emergency air services in the NET Broker Program effective February 1, 2019 to correspond with the operational effective of the new NET Broker contract.
System Number: 23859
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 11/21/2018   Final Date: 12/19/2018
Effective Date: 2/1/2019   Withdrawal Date:
Rule: Title 23: Medicaid, Part 302: Beneficiary Health Management, Chapter 1: Beneficiary Health Management, Rules 1.1 – 1.7.
Summary: This administrative code is being filed to ensure the appropriate utilization of pharmacy services within the Medicaid program and to improve the identification of inappropriate and/or overutilization of prescribed controlled substances and DEA Schedule I-IV drugs. This filing also revises and moves Part 302 Beneficiary Health Management to Part 305 Program Integrity, Chapter 2.
System Number: 23849
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 11/2/2018   Final Date: 11/28/2018
Effective Date: 1/1/2019   Withdrawal Date:
Rule: Hospital Services, Chapter 2: Outpatient Services, Rules 2.2: Outpatient Hospital Services, 2.8: Outpatient Hospital Rates, and New Rule 2.12: Hospital-Based Physician Clinics.
Summary: This administrative code final filing includes additional clarification language regarding the location of a hospital-based physician clinic.
System Number: 23794
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/5/2018   Final Date: 10/31/2018
Effective Date: 12/01/2018   Withdrawal Date:
Rule: Part 223: Early and Periodic Screening, Diagnosis and Treatment (EPSDT), Chapter 1: General, Rule 1.1: Program Description; Rule 1.5: Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Screenings; Rule 1.6: Documentation Requirements for Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Screenings; Rule 1.8: Reimbursement; Diagnosis and Treatment (EPSDT) Screenings
Summary: This administrative code is being filed to correspond with State Plan Amendment (SPA) 18-0014 EPSDT which revises language to reflect the recommendations in the fourth (4th) edition of the American Academy of Pediatrics (AAP) Bright Futures Periodicity Schedule published in February of 2017. This final filing removes New Rules 1.9 AND 1.10, effective December 1, 2018.
System Number: 23755
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/5/2018   Final Date: 10/31/2018
Effective Date: 12/01/2018   Withdrawal Date:
Rule: Title 23: Medicaid, Part 209: Durable Medical Equipment, Medical Appliances and Medical Supplies, Chapter 1: Durable Medical Equipment and Medical Supplies, Rule 1.35: Oxygen and Oxygen Related Equipment.
Summary: This final filing includes revisions made as a result of public input as follows: (1) adds clarifying language throughout the rule, (2) adds coverage language for portable home compressor systems, and (3) removes language that aligned with Medicare’s home oxygen reimbursement.
System Number: 23756
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/5/2018   Final Date: 10/31/2018
Effective Date: 12/01/2018   Withdrawal Date:
Rule: Part 208: Home and Community Based Services (HCBS) Long Term Care, Chapter 1: HCBS Elderly and Disabled Waiver, Rules: 1.1 – 1.14
Summary: This Administrative Code revision is being filed to revise the language to correspond with the E&D Waiver renewal, effective July 1, 2017.
System Number: 23751

Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/25/2018   Final Date: 10/29/2018
Effective Date: 12/01/2018   Withdrawal Date:
Rule: Part 204, Chapter 1: General, Rule 1.11: Dental Services Provided at a Hospital or Ambulatory Surgical Center (ASC) Setting.
Summary: This administrative code is being filed to clarify when dental services are covered in the outpatient hospital and ASC setting.
System Number: 23749
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/5/2018   Final Date: 10/1/2018
Effective Date: 11/1/2018   Withdrawal Date:
Rule: Miss. Admin. Code Title 23: Medicaid, Part 221: Family Planning and Family Planning Related Services, Chapter 2: 1115(a) Family Planning and Family Planning, Rule 2.2: Eligibility, Rule 2.3: Freedom of Choice, Rule 2.4: Covered Services, Rule 2.5: Non-covered Services and Items, Rule 2.6 Quality Assurance, Rule 2.7: Participant Cost Sharing, Rule 2.8: Primary Care Referrals, Rule 2.9: Documentation/Record Maintenance
Summary: This Administrative Code filing is being submitted to update the language in the Administrative Code to correspond with the Family Planning Waiver Renewal Standard Terms and Conditions (STCs), effective January 1, 2018. The updates include clarifications on billing, services included in preventative medicine codes, documentation regarding education and counseling, and other minor edits.
System Number: 23711
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/5/2018   Final Date: 10/1/2018
Effective Date: 11/1/2018   Withdrawal Date:
Rule: Title 23: Medicaid, Part 200: General Provider Information, Chapter 4: Provider Enrollment Rule(s) 4.10 340B Providers
Summary: This Administrative Code is being filed to define 340B drugs, define a 340B beneficiary, describe the opt-in and opt-out procedure for providers of the 340B program and include the billing requirements for 340B purchased drugs to correspond with SPA 17-002 Pharmacy Reimbursement, effective November 1, 2018.
System Number: 23710
Notice Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/5/2018    Final Date: 10/1/2018
Effective Date: 11/1/2018   Withdrawal Date:
Rule: Title 23: Medicaid, Part 214: Pharmacy Services, Chapter 1: General Pharmacy, Rule 1.5: Reimbursement
Summary: This Administrative Code is being filed to revise language regarding payment methodology for prescription drugs at point-of-sale (POS) pharmacies and describe reimbursement for 340B covered entities to correspond with SPA 17-0002 Pharmacy Reimbursement effective April 1, 2017, proposed effective November 1, 2018.
System Number: 23709
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/16/2018   Final Date: 9/21/2018
Effective Date: 11/1/2018   Withdrawal Date:
Rule: Title 23: Medicaid, Part 202: Hospital Services, Chapter 1: Inpatient Services, Rule 1.14: Inpatient Hospital Payments.
Summary: This Administrative Code is being filed to correspond with State Plan Amendment 18-0004 All Patient Refined Diagnosis Related Group (APR-DRG) effective July 1, 2018. This filing implements a Diagnosis Related Group (DRG) charge cap policy.
System Number: 23664
Notice Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/29/2018   Final Date: 8/9/2018
Effective Date: 9/9/2018   Withdrawal Date:
Rule: Title 23: Medicaid, 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.
Summary: This final filing delays implementation of the removal of long-term care (LTC) residents from the Non-Emergency Transportation (NET) Broker program until February 1, 2019. However, the removal of language allowing NET ambulance services provided to LTC residents to be billed directly to the Division of Medicaid will still be effective September 1, 2018. LTC facilities must utilize the NET broker to provide NET services to residents or place the cost of providing NET services on the cost report. Effective February 1, 2019, LTC facilities cannot use the NET Broker to arrange transportation for residents and must place all NET costs on the cost report. This filing corresponds with the changes to Title 23, Part 207, Chapters 2, 3, and 4.
System Number: 23575
Notice  |  Full Text  |  Comments

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/29/2018   Final Date: 8/2/2018
Effective Date: 9/1/2018   Withdrawal Date:
Rule: Title 23: Medicaid, Part 207: Institutional Long-Term Care, Chapter 2: Nursing Facility, Chapter 3: Intermediate Care Facility for Individuals with Intellectual Disability (ICF/IID), Chapter 4: Psychiatric Residential Treatment Facility (PRTF), Rule 2.6: Per Diem, Rule 2.11: Resident Funds, Rule 3.5: Per Diem, Rule 3.8: Resident Personal Funds, and Rule 4.6: Reimbursement.
Summary: This final filing delays implementation of the removal of long-term care (LTC) residents from the Non-Emergency Transportation (NET) Broker program until February 1, 2018. LTC facilities may utilize the NET broker to provide NET services to residents or place the cost of providing NET services on the cost report. Effective February 1, 2019, LTC facilities cannot use the NET Broker to arrange transportation for residents and must place all NET costs on the cost report.
System Number: 23560
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/29/2018   Final Date: 7/26/2018
Effective Date: 9/1/2018   Withdrawal Date:
Rule: Title 23: Medicaid, Part 202: Hospital Services, Chapter 2: Outpatient Services, Rule 2.3: Emergency Department Visits.
Summary: This administrative code is being filed to clarify how the evaluation and management code must be billed for services rendered in an outpatient hospital emergency department that spans through midnight.
System Number: 23554
Notice Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/22/2018 Final Date: 7/19/2018
Effective Date: 9/1/2018 Withdrawal Date:
Rule: Title 23, Part 215, Rules 1.1-1.10
Summary: The MS Division of Medicaid’s Administrative Code proposed
filing is to amend Title 23: Medicaid, Part 215: Home Health. This
Administrative Code filing 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 normal life activities take place, and (3) to revise the definition of
DME to comply with the Medicaid Home Health Final Rule, published
February 2, 2016.
System Number: 23528
Notice  |  Full Notice

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/22/2018  Final Date: 7/19/2018
Effective Date: 9/1/2018   Withdrawal Date:
Rule: Title 23, Part 209, Chapter 1, Rules 1.3, 1.4,1.6, 1.9, 1.10,1.12-1.21, 1.23-1.33, 1.35-1.45, 1.47, 1.48, 1.51, 1.52, Chapter 2, Rules 2.1, 2.2 and 2.5
Summary: This Administrative Code filing 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 normal life activities take place, (3) to revise the definition of DME to comply with the Medicaid Home Health Final Rule, published February 2, 2016, and (4) to remove language allowing physician assistants and nurse practitioners to order DME. This Administrative Code filing is being submitted to comply with 42 C.F.R. Part 440 effective September 1, 2018.
System Number: 23533
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/21/2018   Final Date: 6/28/2018
Effective Date: 8/1/2018   Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 201: Transportation Services, Chapter 1: Ambulance, Subchapter 1: General, Rule 1.1.1: Ambulance Provider Enrollment Requirements, Rule 1.1.2: Definitions, Rule 1.1.3: Reimbursement, Rule 1.1.4: Documentation Requirements, Rule 1.1.5: Mileage, Rule 1.1.6: Injectable Drugs, Rule 1.1.7: Ambulance Transport of Nursing Facility Residents by Ambulance, Rule 1.1.8: Transport of Dual Eligibles, Rule 1.1.9: Non-Covered Services, 1.1.10: Subscription Programs, Rule 1.1.11: Early and Periodic Screening, Diagnosis and Treatment (EPSDT), Subchapter 2: Emergency (Ground/Air), Rule 1.2.1: Emergency Ground Ambulance, Rule 1.2.2: Multiple Patients/Arrivals, Rule 1.2.3: Air Ambulance, Subchapter 3: Non-Emergency, Rule 1.3.1: Non-Emergency Ground Ambulance, Chapter 2: Non-Emergency Transportation (NET)(Non-Ambulance), Rule 2.1: NET Broker Program, Rule 2.2: Eligibility, Rule 2.3: NET Services, Rule 2.6: NET Driver Requirements, Rule 2.7: Vehicle Requirements
Summary: This final filing (1) changes “or urgent” to emergency fixed-wing ambulance language, (2) removes the prior authorization requirement for emergency or urgent fixed-wing ambulance services, and (3) adds language to require a certificate of medical necessity and compliance with the requirements of the Bureau of Emergency Medical Services for hospital to hospital non-emergency ambulance transportation.
System Number: 23490
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/24/2018   Final Date: 6/20/2018
Effective Date: 8/1/2018   Withdrawal Date:
Rule: Title 23: Medicaid, Part 207: Institutional Long-Term Care, Chapter 2: Nursing Facility, Rule 2.6: Per Diem.
Summary: This Administrative Code is being submitted to include respiratory therapy services in the list of items and services included in the Division of Medicaid’s per diem rates, to correspond with SPA 18-0001 and be in compliance with 42 C.F.R. § 483.65.
System Number: 23445
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/21/2018   Final Date: 6/18/2018
Effective Date: 8/1/2018   Withdrawal Date:
Rule: Medicaid, Part 207: Institutional Long-Term Care, Chapter 2: Nursing Facility, Rule 2.5: Reimbursement and Rule 2.8: Temporary Leave Payment; Chapter 3: Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID), Rule 3.7: Temporary Leave Payment
Summary: This administrative code is being filed to 1) revise the definition of home/therapeutic temporary leave, 2) add clarification language of home/therapeutic and inpatient hospital temporary leave to improve the bed hold record keeping accuracy by the providers and the bed hold reconciliation process that is conducted by Division of Medicaid case mix nurses, and 3) revise the number of home/therapeutic bed hold days allowed for nursing facilities and ICF/IID as required by Miss. Code Ann. § 43-13-117 effective July 1, 2018. Final File: Typo corrected in Rule 2.8. D. 7: unstruck “resident”.
System Number: 23442
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/21/2018   Final Date: 6/18/2018
Effective Date: 8/1/2018   Withdrawal Date:
Rule: Title 23: Medicaid, Part 200: General Provider Information, Chapter 1: General Administrative Rules for Providers, Rule 1.3: Maintenance of Records.
Summary: This Administrative Code adds language which prohibits providers from billing the Division of Medicaid for providing or accessing records substantiating services provided and claims submitted as is required by the Provider Agreement. It also revises the retention of records providers who are required to submit cost reports from five (5) years to three (3) years in compliance with Senate Bill 2836 effective July 1, 2018.
System Number: 23441
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/22/2018   Final Date: 6/18/2018
Effective Date: 8/1/2018   Withdrawal Date:
Rule: Title 23: Medicaid, Part 209: Durable Medical Equipment and Medical Supplies, Chapter 1: Durable Medical Equipment, Rule 1.11: Augmentative Communication Device (ACD)
Summary: This administrative code filing is being filed to revise the requirement of the evaluation and recommendation for an Augmentative Communication Device (ACD) must be completed by a speech-language pathologist (SLP) in conjunction with other health care professionals as appropriate.
System Number: 23440
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/1/2018   Final Date: 5/29/2018
Effective Date: 7/1/2018   Withdrawal Date:
Rule: Title 23: Medicaid, Part 225: Telemedicine, Chapter 1: Telehealth Services, Rule 1.2: General Provider Information, Rule 1.5: Reimbursement. Summary: This Administrative Code is being filed to add Board Certified Behavior Analysts (BCBAs) and Board Certified Behavior Analyst-Doctorals (BCBA-Ds) as a provider of Autism Spectrum Disorder (ASD) services to EPSDT-eligible beneficiaries within their scope of practice via telehealth services. Telehealth services will allow EPSDT-eligible beneficiaries easier access to receive ASD services without having to travel to another geographical site.
System Number: 23394
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 2/28/2018   Final Date: 3/26/2018
Effective Date: 5/1/2018   Withdrawal Date:
Rule: Title 23: Medicaid, Part 213: Therapy Services, Chapter 3: Outpatient Speech-Language Pathology, Rule 3.1: Provider Enrollment Requirements.
Summary: This Administrative Code is being filed to clarify the requirements for providers of speech-language pathology.
System Number: 23242
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 2/1/2018   Final Date: 2/28/2018
Effective Date: 4/1/2018   Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 207: Institutional Long-Term Care, Chapter 2: Nursing Facility, Rule 2.19: Disaster Procedures, Chapter 3: Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID), Rule 3.12: Disaster Procedures.
Summary: This Administrative Code is being filed to revise the disaster procedures language instructing Medicaid certified nursing facility and Medicaid certified intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs) to transfer beneficiaries, in the event of a disaster, to facilities listed in their Mississippi State Department of Health (MSDH) approved Emergency Operations Plan (EOP) effective April 1, 2018.
System Number: 23202
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 1/4/2018   Final Date: 2/1/2018
Effective Date: 4/1/2018   Withdrawal Date:
Rule: Title 23: Part 100: General Provisions, Rules 8.1 – 8.17
Summary: This Administrative Code is being filed to move Chapter 8 from Part 100 to Part 101, Chapter 1.
System Number: 23147
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 1/4/2018   Final Date: 2/1/2018
Effective Date: 4/1/2018   Withdrawal Date:
Rule: Title 23: Medicaid, Part 101: 1.1 – 1.18, 2.1, 3.1 – 3.6, 4.1 – 4.9, 5.1 – 5.3, 6.1, 6.2, 7.1, 8.1 – 8.5, 9.1, 10.1 – 10.3, 11.1 – 11.3, 12.1 – 12.6, 13.1 – 13.3, 14.1, 14.2, 15.1, 15.2
Summary: This Administrative Code filing is being submitted to revise and rewrite Part 101 to reflect changes that are either the direct result of the Affordable Care Act (ACA) or a change initiated by CMS as a result of the ACA.
System Number: 23146
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 1/2/2018   Final Date: 2/1/2018
Effective Date: 4/1/2018   Withdrawal Date:
Rule: Title 23: Medicaid: Part 205: Hospice, Chapter 1: Program Overview; Rules 1.1 – 1.10 and New Rule 1.11
Summary: This Administrative Code is being filed to clarify and update the requirement on physician signatures to more closely resemble Medicare requirements, define the timeframe for submission of paperwork to UM/QIO for prior authorizations and adds language regarding concurrent hospice and waiver services.
System Number: 23144
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 1/2/2018   Final Date: 2/1/2018
Effective Date: 4/1/2018   Withdrawal Date:
Rule: Title 23: Medicaid, Part 200: General Provider Information, Chapter 3: Beneficiary Information, Rule 3.2: Eligibility, Chapter 5: General, Rule 5.3: Wellness Program.
Summary: This Administrative Code is being filed to revise the deemed eligible newborn policy in Title 23, Part 200, Rule 3.2 and remove the pregnant women exclusion of receiving an annual examination in Title 23, Part 200, Rule 5.3 to be in compliance with the Affordable Care Act (ACA).
System Number: 23145
Notice  |  Full Text

2017

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/5/2017 Final Date: 10/31/2017
Effective Date: 12/01/2017 Withdrawal Date:
Rule: Title 23: Medicaid, Part 207: Institutional Long-Term Care, Chapter 2: Nursing Facility, Rule 2.11: Resident Funds and Chapter 3: Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID), Rule 3.8: Resident Personal Funds. Summary: This administrative code filing reflects state law and the Attorney General’s opinion regarding the process of handling funds of residents of long-term care facilities who die intestate and leave no known heirs.
System Number: 23014
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/4/2017 Final Date: 10/31/2017
Effective Date: 12/01/2017 Withdrawal Date:
Rule: Title 23: Medicaid, Part 208: Home and Community-Based Services (HCBS) Long-Term Care, Chapter 5: Home and Community-Based Services (HCBS) Intellectual Disabilities/Developmental Disabilities (ID/DD)Waiver, Rule 5.5: Covered Services and Rule 5.7: Reimbursement. Summary: This administrative code filing is to require ID/DD providers to use the Division of Medicaid’s Electronic Visit Verification (EVV) system, MediKey, for payment of In-Home Respite and Home and Community Supports and to ensure that persons receive these services according to the person’s approved plan of services and supports (PSS).
System Number: 23013
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/30/2017   Final Date: 9/25/2017
Effective Date: 11/01/2017   Withdrawal Date:
Rule: Title 23: Medicaid, Part 222: Maternity Services, Chapter 1: General, New Rule 1.11: Screening, Brief Intervention, and Referral to Treatment (SBIRT) Services.
Summary: This administrative code is being submitted to correspond with SPA 17-0003 SBIRT which allows the Division of Medicaid to provide early intervention services for pregnant women with nondependent substance use and to prevent problematic substance use disorders as requested by ReNew Mississippi.
System Number: 22958
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/2/2017   Final Date: 6/28/2017
Effective Date: 8/1/2017   Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 207: Institutional Long-Term Care, Chapter 2: Nursing Facility, New Rule 2.19: Disaster Procedures, Chapter 3: Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID), New Rule 3.12: Disaster Procedures.
Summary: This Administrative Code filing establishes national emergency preparedness requirements in accordance with 42 C.F.R. § 483.73 for Medicaid certified nursing facilities and 42 C.F.R. § 483.475 for Medicaid certified intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs).
System Number: 32825
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/24/2017   Final Date: 6/26/2017
Effective Date: 8/1/2017   Withdrawal Date:
Rule: Title 23, Part 207, Chapter 3, Rules 3.1-3.11
Summary: This Administrative Code filing is being submitted to remove outpatient treatment that occurs two (2) or more days per week, including dialysis, chemotherapy or treatment for a catastrophic illness, from the home/therapeutic leave day limit in an intermediate care facility for individuals with intellectual disabilities (ICF/IID). This filing also includes a new rule for provider enrollment requirements for ICF/IIDs and changes all references to mentally retarded (MR) to individuals with intellectual disabilities (IID).
System Number: 22824
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/24/2017 Final Date: 6/19/2017
Effective Date: 8/1/2017 Withdrawal Date:
Rule: Title 23: Medicaid, Part 207: Institutional Long-Term Care, Chapter 2: Nursing Facility, Rules 2.6: Per Diem, 2.9 Resident Assessment Instrument.
Summary: This administrative code filing adds language to clarify the requirements of completing Section S in the minimum data set (MDS).
System Number: 22798
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 2/2/2017 Final Date: 2/28/2017
Effective Date: 4/1/2017 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 207: Institutional Long-Term Care, Chapter 2: Nursing Facility, Rule 2.10: Case Mix Reimbursement and Rule 2.15: Ventilator Dependent Care.
Summary: This administrative code filing adds language to Rule 2.10 to clarify the clinical documentation requirements that affect case mix review results and revises Rule 2.15 to clarify that the ventilator dependent care (VDC) add-on rate is only for in-state nursing facilities.
System Number: 22521
Notice  |  Full Text

2016

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 11/4/2016 Final Date: 11/29/2016
Effective Date: 11/29/2016 Withdrawal Date: 11/29/2016
Rule: Withdrawn: Part 207: Institutional Long-Term Care (LTC), Chapter 2: Nursing Facility, Rule 2.6: Per Diem, Rule 2.11: Resident Funds; Chapter 3: Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID), Rule 3.4: Per Diem, Rule 3.7: Resident Funds; Chapter 4: Psychiatric Residential Treatment Facility (PRTF), Rule 4.6: Reimbursement.
Summary: This Administrative Code filing is being withdrawn as proposed on 11/4/16 APA 22375.
System Number: 22418
Notice

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 11/3/2016 Final Date: 11/29/2016
Effective Date: 11/29/2016 Withdrawal Date: 11/29/2016
Rule: Withdrawn Title 23: Medicaid, Part 201: Transportation, Chapter 1: Emergency Transportation, Rule 1.7: Ambulance Transport of Nursing Facility Residents by Ambulance; Chapter 2: Non-Emergency Transportation (NET) (Non-Ambulance), Rule 2.4: Transport of Nursing Facility Residents by NET
Summary: This Administrative Code filing is being withdrawn as proposed on 11/3/16 APA 22367
System Number: 22417
Notice

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/5/2016 Final Date: 11/29/2016
Effective Date: 11/29/2016 Withdrawal Date: 11/29/2016
Rule: Withdrawn: Title 23: Div of Medicaid, Pt 201: Transportation Services, Chap 1: Ambulance, Subchapter 1: General, Rule 1.1.1: Ambulance Provider Enrollment Requirements, Rule 1.1.2: Definitions, Rule 1.1.3: Reimbursement, Rule 1.1.4: Documentation Requirements, Rule 1.1.5: Mileage, Rule 1.1.6: Injectable Drugs, Rule 1.1.7: Ambulance Transport of Nursing Facility Residents by Ambulance, Rule 1.1.8: Transport of Dual Eligibles, Rule 1.1.9: Non-Covered Services, 1.1.10: Subscription Programs, Rule 1.1.11: Early and Periodic Screening, Diagnosis and Treatment (EPSDT), Subchapter 2: Emergency (Ground/Air), Rule 1.2.1: Emergency Ground Ambulance, Rule 1.2.2: Multiple Patients/Arrivals, Rule 1.2.3: Air Ambulance, Subchapter 3: Non-Emergency, Rule 1.3.1: Non-Emergency Ground Ambulance, Chap 2: Non-Emergency Transportation (NET)(Non-Ambulance), Rule 2.1: NET Broker Program, Rule 2.2: Eligibility, Rule 2.3: NET Services, Rule 2.6: NET Driver Requirements, Rule 2.7: Vehicle Requirements
Summary: This Administrative Code filing is being submitted to withdraw the final rule APA 22360 effective immediately.
System Number: 22428
Notice

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 11/3/2016 Final Date: 11/29/2016
Effective Date: 1/1/2017 Withdrawal Date:
Rule: Chapter 1: HCBS Elderly and Disabled (E&D) Waiver Rules 1.1, 1.4, 1.6, New Rule 1.13; Chapter 2: HBCS Independent Living (IL) Waiver, Rules 2.1, 2.5, New Rule 2.12; Chapter 3: HCBS Assisted Living (AL) Waiver, Rules 3.4, 3.6, New Rule 3.15; Chapter 4: HCBS Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) Waiver, Rules 4.1, 4.5, New Rule 4.12; Chapter 5: HCBS Intellectual Disabilities/Developmental Disabilities (ID/DD) Waiver, Rule 5.3, 5.5, 5.8, 5.12, New Rule 5.14; Chapter 7: 1915(i) HCBS, Rule 7.3, 7.5, 7.6, 7.8, 7.9, New Rule 7.10.
Summary: This filing is to comply with 42 CFR §§ 441.301(c), 441.710(a) (1)-(2).
System Number: 22413
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 11/3/2016 Final Date: 11/29/2016
Effective Date: 1/1/2017 Withdrawal Date:
Rule: Title 23: Medicaid, Part 202: Hospital Services, Chapter 4: Organ Transplants, Rule 4.1: Transplant Procedures, Rule 4.2 Organ Acquisition, Rule 4.3: Fundraising, Rule 4.4: Prior Approval, Rule 4.5: Facility Criteria, Rule 4.6: Documentation Requirements, Rule 4.7: Reimbursement, Rule 4.8: Early and Periodic Screening, Diagnosis, and Treatment (EPSDT), Rule 4.9: Cornea Transplant, Rule 4.10: Heart Transplant, Rule 4.11: Heart/Lung Transplant, Rule 4.12: Kidney Transplant, Rule 4.13: Liver Transplant, Rule 4.14: Single Lung Transplant, Rule 4.15: Bilateral Lung Transplant, Rule 4.16: Bone Marrow Transplant, Rule 4.17: Peripheral Stem Cell Transplant, and Rule 4.18: Small Bowel Transplant.
Summary: This administrative code filing removes language that the Division of Medicaid is responsible for payment of inpatient transplant services for beneficiaries enrolled in a Coordinated Care Organization (CCO) to correspond with SPA 15-018, effective December 1, 2015. This filing also removes outdated transplant criteria and references national guidelines for organ specific criteria.
System Number: 22412
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/25/2016 Final Date: 11/22/2016
Effective Date: 1/1/2017 Withdrawal Date:
Rule: Part 103: Resources, Chapter 1: Introduction to Resources, Rule 1.10: Liberalized Resource Policy Overview; Chapter 2: Ownership Interest, Rule 2.9: Verifying Current Market Value (CMV); Chapter 5: Trust Provisions, Rule 5.17: Income Trusts; Chapter 6: Annuities, Rule 6.4: Treatment of Annuities Purchased on or after 2/8/2006. Summary: This Administrative Code filing is being submitted to clarify that annuities purchased by an institutionalized individual or his/her spouse during the 5-year look-back period must name the Division of Medicaid as a remainder beneficiary. It also inserts missing language regarding payment due to the Division of Medicaid in the month of entry into a nursing facility for someone under an Income Trust.
System Number: 22408
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/5/2016 Final Date: 10/31/2016
Effective Date: 12/1/2016 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 201: Transportation Services, Chapter 1: Ambulance, Subchapter 1: General, Rule 1.1.1: Ambulance Provider Enrollment Requirements, Rule 1.1.2: Definitions, Rule 1.1.3: Reimbursement, Rule 1.1.4: Documentation Requirements, Rule 1.1.5: Mileage, Rule 1.1.6: Injectable Drugs, Rule 1.1.7: Ambulance Transport of Nursing Facility Residents by Ambulance, Rule 1.1.8: Transport of Dual Eligibles, Rule 1.1.9: Non-Covered Services, 1.1.10: Subscription Programs, Rule 1.1.11: Early and Periodic Screening, Diagnosis and Treatment (EPSDT), Subchapter 2: Emergency (Ground/Air), Rule 1.2.1: Emergency Ground Ambulance, Rule 1.2.2: Multiple Patients/Arrivals, Rule 1.2.3: Air Ambulance, Subchapter 3: Non-Emergency, Rule 1.3.1: Non-Emergency Ground Ambulance, Chapter 2: Non-Emergency Transportation (NET)(Non-Ambulance), Rule 2.1: NET Broker Program, Rule 2.2: Eligibility, Rule 2.3: NET Services, Rule 2.6: NET Driver Requirements, Rule 2.7: Vehicle Requirements
Summary: This Administrative Code filing is being submitted to update emergency transportation services definitions and requirements. This filing also moves non-emergency ambulance services under the NET Broker program.
System Number: 22360
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/1/2016 Final Date: 9/28/2016
Effective Date: 11/1/2016 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 100: General Provisions, Chapter 6: Improper Payments, Rules 6.1: Types of Improper Payments, 6.2: Reporting an Improper Payment, 6.3: Claims Against Estates; Chapter 7: Quality Control, Rule 7.1: Quality Control Reviews.
Summary: This Administrative Code filing is to move duplicative information located in Miss. Admin. Code Part 100 to Miss. Admin. Code Part 305.
System Number: 22291
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/1/2016 Final Date: 9/28/2016
Effective Date: 11/1/2016 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 305: Program Integrity, Chapter 1: Program Integrity, Rules 1.1: Fraud and Abuse, New Rule 1.2: Fraud, Waste and Abuse, New Rule 1.3: Overpayments, New Rule 1.4: Corrective Action Plan (CAP), New Rule 1.5: Improper Payments Due to Inaccurate Eligibility Information, New Rule 1.6: Medicaid Eligibility Quality Control.
Summary: This Administrative Code filing is being submitted to clarify that interest may be charged by the Division of Medicaid for improper payments and to move duplicative information in Part 100 to Part 305.
System Number: 22290
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/1/2016 Final Date: 9/27/2016
Effective Date: 11/1/2016 Withdrawal Date:
Rule: Title 23: Medicaid, Part 207: Institutional Long-Term Care, Chapter 2: Nursing Facility, Rule 2.6: Per Diem; Chapter 3: Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID), Rule 3.4: Per Diem.
Summary: This Administrative Code filing is being submitted to clarify that oxygen tanks and its contents are included in the per diem. Additionally, this filing removes the term Private from Nursing Facility for the Severely Disabled (NFSD) to correspond with SPA 15-004.
System Number: 22289
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/4/2016 Final Date: 8/30/2016
Effective Date: 10/1/2016 Withdrawal Date:
Rule: Title 23: Medicaid, Part 223: Early and Periodic Screening, Diagnosis, and Treatment (EPSDT), Chapter 1: General, Rule 1.1: Program Description, Rule 1.2: Provider Enrollment and Participation Requirements, Rule 1.3: Early and Periodic Screening Services, Rule 1.4: Periodicity Schedule, Rule 1.5: Screening Components, Rule 1.6: Documentation Requirements for EPSDT Screenings, Rule 1.7: Diagnostic and Treatment Program Services and New Rule 1.8: Reimbursement.
Summary: This filing revises language to require EPSDT providers to conduct periodic screenings and medically necessary interperiodic visits in accordance with the EPSDT Periodicity Schedule as recommended by the American Academy of Pediatrics (AAP) Bright Futures Periodicity Schedule to correspond with SPA 15-017 EPSDT. During this final filing, a change was made to Rule 1.4.C.2 to clarify the good faith effort definition.
System Number: 22221
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 7/13/2016 Final Date: 8/8/2016
Effective Date: 10/1/2016 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 300: Appeals, Chapter 1: Appeals, Rule 1.1: Administrative Hearings for Providers.
Summary: This administrative code filing revises language making the time period for a provider to file a court level appeal of a Division of Medicaid final decision from thirty (30) days to sixty (60) days.
System Number: 22155
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/26/2016 Final Date: 7/28/2016
Effective Date: 7/28/2016 Withdrawal Date: 7/28/2016
Rule: Withdrawn Title 23: Medicaid, Part 214: Pharmacy Services, Chapter 1: General Pharmacy, Rule 1.7: Refills/Renewals of Prescription Drugs
Summary: Medicaid, Part 214: Pharmacy Services, Chapter 1: General Pharmacy, Rule 1.7: Refills/Renewals of Prescription Drugs are being withdrawn as proposed on 5/26/16 APA 22038.
System Number: 22127
Notice

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/26/2016  Final Date: 6/21/2016
Effective Date: 8/1/2016  Withdrawal Date:
Rule: Title 23: Medicaid, Part 214: Pharmacy Services, Chapter 1: General Pharmacy, Rule 1.7: Refills/Renewals of Prescription Drugs
Summary: This filing provides language to allow pharmacy providers to make prescription refill reminders when the pharmacy provider: 1) Obtains written authorization from the beneficiary or the beneficiary’s responsible party to receive prescription refill reminders, 2) Informs the beneficiary or the beneficiary’s responsible party of their freedom of choice of pharmacy providers with each prescription refill reminder, and 3) Offers the beneficiary or the beneficiary’s responsible party the opportunity to choose whether or not to proceed with each prescription refill.
System Number: 22038
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/26/2016  Final Date: 6/21/2016
Effective Date: 8/1/2016  Withdrawal Date:
Rule: Title 23: Medicaid, Part 208: Home and Community-Based Services (HCBS) Long-Term Care, Chapter 1: Home and Community-Based Services (HCBS) Elderly and Disabled (E&D) Waiver, Chapter 2: Home and Community-Based Services (HCBS) Independent Living (IL) Waiver, Chapter 3: Home and Community-Based Services (HCBS) Assisted Living (AL) Waiver, Chapter 4: Home and Community-Based Services (HCBS) Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) Waiver, Chapter 5: Home and Community-Based Services (HCBS) Intellectual Disabilities/Developmental Disabilities Waiver, Rules 1.2: Eligibility, 2.2: Eligibility, 3.2: Eligibility, 4.2: Eligibility, 5.1: Eligibility.
Summary: The filing of this administrative code updates the language of the eligibility categories for home and community-based waiver services.
System Number: 22039
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 2/2/2016 Final Date: 2/29/2016
Effective Date: 4/1/2016 Withdrawal Date:
Rule: Title 23: Medicaid, Part 200: General Provider Information, Chapter 3: Beneficiary Information, Rule 3.1: Eligibility Groups. Summary: This filing adds language for the coverage of dental services and eyeglasses, frames, lenses and contact lenses for pregnant beneficiaries as required by the Affordable Care Act (ACA) and chiropractic, podiatry, dental services and eyeglasses, frames, lenses and contact lenses for beneficiaries enrolled in the Healthier Mississippi Waiver (HMW).
System Number: 21803
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 3/15/2016 Final Date: 4/14/2016
Effective Date: 6/1/2016 Withdrawal Date:
Rule: Title 23: Medicaid, Part 208: Home and Community Based Services (HCBS) Long Term Care, Chapter 1: HCBS Elderly and Disabled Waiver; Rule 1.2: Eligibility, Chapter 2: HCBS Independent Living Waiver; Rule 2.2: Eligibility, Chapter 3: HCBS Assisted Living Waiver; Rule 3.2: Eligibility, Chapter 4: HCBS Traumatic Brain Injury/Spinal Cord Injury Waiver; Rule 4.2: Eligibility, Chapter 5: HCBS Intellectual Disabilities/Developmental Disabilities Waiver; Rule: 5.1: Eligibility Summary: This filing allows persons enrolled in home and community-based services (HCBS) waivers who elect to receive hospice care to receive HCBS waiver services which are non-duplicative of any service rendered through hospice. Persons may receive non-duplicative HCBS waiver services in coordination with hospice services. This filing also renames “participants” to “persons”. A non-substantive change was made to Rule 1.2.A.3. by adding an “A” and an apostrophe to “persons”. Capitalization was also removed from “Persons Nursing Facility”.
System Number: 21879
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 3/15/2016 Final Date: 4/14/2016
Effective Date: 6/1/2016 Withdrawal Date:
Rule: Title 23: Medicaid, Part 200: General Provider Information, Chapter 2: Benefits, Rule 2.2: Non-Covered Services Summary: This filing allows persons enrolled in home and community-based services (HCBS) waivers who elect to receive hospice care to receive HCBS waiver services which are non-duplicative of any service rendered through hospice. Persons may receive non-duplicative HCBS waiver services in coordination with hospice services. This filing also renames “beneficiaries” to “persons”.
System Number: 21877
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 3/15/2016 Final Date: 4/14/2016
Effective Date: 6/1/2016 Withdrawal Date:
Rule: Title 23: Medicaid, Part 205: Hospice Services, Chapter 1: Program Overview, Rule 1.1: General and Rule 1.4: Election, Enrollment, and Revocation Summary: This filing allows persons enrolled in Home and Community-Based Services (HCBS) waivers who elect to receive hospice care to receive HCBS waiver services which are non-duplicative of any service rendered through hospice. Persons may receive non-duplicative HCBS waiver services in coordination with hospice services.
System Number: 21878
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 2/1/2016 Final Date: 2/29/2016
Effective Date: 4/1/2016 Withdrawal Date:
Rule: Title 23: Medicaid, Part 208: Home and Community Based Long-Term Care, Chapter 6: Bridge to Independence (B2I), Rule 6.2: Eligibility. Summary: This administrative code filing adds language requiring that a transitioning person’s residence must pass a U.S. Department of Housing and Urban Development Housing Quality Standards inspection to participate in the Bridge to Independence (B2I) demonstration project.
System Number: 21805
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 3/2/2016 Final Date: 3/28/2016
Effective Date: 5/1/2016 Withdrawal Date:
Rule: Title 23: Medicaid, Part 203: Physician Services, Chapter 2: Physician-Administered Drugs and Implantable Drug System Devices, Rules 2.1: Covered Services, 2.3: Botulinum Toxins A and B, 2.4: Xolair, 2.5: Hyaluronate Joint Injection and 2.6: 17 Alpha-Hydroxyprogesterone Caproate Injections (17-P) and Chapter 4: Surgery, Rules 4.13: Implantable Testosterone Pellets (Testopel) and Rule 4.14: Insertion of Retisert (Fluocinolone Acetonide Intravitreal Implant) Summary: This administrative code filing removes the specific coverage requirements of the physician-administered drugs and implantable drug system devices in Miss. Admin. Code Part 203: Physician Services, Chapter 2: Physician-Administered Drugs, Rules 2.3, 2.4, 2.5, and 2.6 and Chapter 4: Surgery, Rules 4.13 and 4.14 but adds language to refer to the universal rule for physician-administered drugs and implantable drug system devices. This filing also adds Miss. Admin. Code Part 203, Rule 2.1.A.5.
System Number: 21860
Notice  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 3/2/2016 Final Date: 3/2/2016
Effective Date: 3/2/2016 Withdrawal Date:
Rule: Title 23: Medicaid, Part 203: Physician Services, Chapter 2: Physician-Administered Drugs and Implantable Drug System Devices, Rules 2.1: Covered Services, 2.3: Botulinum Toxins A and B, 2.4: Xolair, 2.5: Hyaluronate Joint Injection and 2.6: 17 Alpha-Hydroxyprogesterone Caproate Injections (17-P) and Chapter 4: Surgery, Rules 4.13: Implantable Testosterone Pellets (Testopel) and Rule 4.14: Insertion of Retisert (Fluocinolone Acetonide Intravitreal Implant). Summary: This administrative code filing removes the specific coverage requirements of the physician-administered drugs and implantable drug system devices in Miss. Admin. Code Part 203: Physician Services, Chapter 2: Physician-Administered Drugs, Rules 2.3, 2.4, 2.5, and 2.6 and Chapter 4: Surgery, Rules 4.13 and 4.14 but adds language to refer to the universal rule for physician-administered drugs and implantable drug system devices. This filing also adds Miss. Admin. Code Part 203, Rule 2.1.A.5.
System Number: 21811
Notice  |  EIS  |  Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 2/4/2016 Final Date: 3/2/2016
Effective Date: 5/1/2016 Withdrawal Date:
Rule: Part 225: Telemedicine, Chapter 1: Telehealth Services, Rule 1.2: General Provider Information and Rule 1.5: Reimbursement Summary: This filing adds Licensed Professional Counselors (LPCs) to the list of enrolled Medicaid providers who are eligible to provide telehealth services at a distant site or originating site.
System Number: 21809
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 2/2/2016 Final Date: 2/29/2016
Effective Date: 4/1/2016 Withdrawal Date:
Rule: Title 23: Medicaid, Part 100: General Provisions, Chapter 8: Coverage of Categorically Needy in Mississippi, Rules 8.1-8.17 Summary: This filing provides clarification language of eligibility groups, includes the agency responsible for eligibility certification, and adds new rule 8.11: Hospital Presumptive Eligibility and new rule 8.17: Optional Waiver Coverage- 1915(c) Home and Community-Based Waivers.
System Number: 21804
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 2/2/2016 Final Date: 2/29/2016
Effective Date: 4/1/2016 Withdrawal Date:
Rule: Title 23: Medicaid, Part 217: Vision Services, Chapter 1: General, Rules 1.4: Non-Covered Services Summary: This filing removes language for the non-coverage of eyeglasses, frames, lenses and contact lenses for pregnant beneficiaries required by the Affordable Care Act (ACA) and for beneficiaries enrolled in the Healthier Mississippi Waiver (HMW) to correspond with the approved SPA 13-0019 eff. 01/01/2014 and the 07/24/2015 renewal of the HMW. Non-substantive change made to rule 1.4.B.17.b) to remove duplicative language.
System Number: 21806
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 2/1/2016 Final Date: 2/29/2016
Effective Date: 4/1/2016 Withdrawal Date:
Rule: Title 23: Medicaid, Part 208: Home and Community Based Long-Term Care, Chapter 6: Bridge to Independence (B2I), Rule 6.2: Eligibility. Summary: This administrative code filing adds language requiring that a transitioning person’s residence must pass a U.S. Department of Housing and Urban Development Housing Quality Standards inspection to participate in the Bridge to Independence (B2I) demonstration project.
System Number: 21805
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 1/5/2016 Final Date: 2/4/2016
Effective Date: 4/1/2016 Withdrawal Date:
Rule: Part 207: Institutional Long-Term Care, Chapter 3: Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID), Rule 3.4: Per Diem. Summary: This filing includes language requiring Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IIDs) to notify the resident and the resident’s guardian or legal representative of a transfer or discharge in an easily understood written notice. This filing also requires ICF/IIDs to maintain documentation of a transfer or discharge including reasons for the transfer or discharge, and to provide sufficient preparation and orientation to beneficiaries prior to a transfer or discharge. Added “the Division of Medicaid, or a designated entity” to rule 3.4.D.8., added “calendar” to rule 3.4.F.4.a) and rule 3.4.F.4.a)4), and removed the clause “if the resident is being transferred or discharged due to changes in the residents health” from rule 3.4.F.5.
System Number: 21755
Notice | Full Text

2015

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 11/5/2015 Final Date: 12/1/2015
Effective Date: 1/1/2016 Withdrawal Date:
Rule: Title 23: Medicaid, Part 213: Therapy Services, Chapter 1: Physical Therapy, Rules 1.3: Covered Services, 1.4: Non-Covered Services, 1.5: Assistants, Aides and Students; Chapter 2: Occupational Therapy, Rules 2.3: Covered Services, 2.4: Non-Covered Services; Chapter 3: Outpatient Speech-Language Pathology (Speech Therapy), Rules 3.3: Covered Services, 3.4: Non-covered Services Summary: This filing is to allow (1) a state licensed therapist to supervise up to four (4) assistants at a time during a work day, (2) reimbursement for assistants to provide services in settings other than an outpatient hospital, and (3) reimbursement for student-assisted physical therapy, occupational therapy, speech-language pathology or audiology services as long as the state licensed therapist is supervising no more than one (1) student at a time during a work day.
System Number: 21674
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/27/2015 Final Date: 11/24/2015
Effective Date: 1/1/2016 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 224: Immunizations, Chapter 1: General, Rule 1.1: New Vaccines, Rule 1.2: Tuberculin Skin Test, Rule 1.3: Vaccines for Children, Rule 1.4: Vaccines for Adults, Rule 1.5: Nursing Facility Residents, Rule 1.7: Vaccines Available Through the Pharmacy Venue. Summary: This filing is to include coverage language for the Measles, Mumps, and Rubella (MMR) and Varicella vaccines according to the indications and guidelines of the Centers for Disease Control and Prevention (CDC) for beneficiaries nineteen (19) and older. Non-substantive changes made to Rule 1.5 by replacing “Reserved Moved to Miss. Admin. Code” with “Refer to”, added a description to the CDC acronym in Rule 1.7 and replaced the word “significantly” with the word “separately” in Rules 1.3 and 1.4.
System Number: 21669
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/27/2015 Final Date: 11/24/2015
Effective Date: 1/1/2016 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 219: Laboratory Services, Chapter 1: General, Rule 1.10: Tuberculosis (TB) Testing Summary: This filing amends Rule 1.2: Tuberculin Skin Test to include coverage language for interferon-gamma release assays (IGRA) which are currently covered and to relocate this rule from Part 224: Immunizations to Part 219: Laboratory Services, Rule 1.10: Tuberculosis (TB) Testing.
System Number: 21668
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/27/2015 Final Date: 11/24/2015
Effective Date: 1/1/2016 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 224: Immunizations, Chapter 1: General, Rule 1.1: New Vaccines, Rule 1.2: Tuberculin Skin Test, Rule 1.3: Vaccines for Children, Rule 1.4: Vaccines for Adults, Rule 1.5: Nursing Facility Residents, Rule 1.7: Vaccines Available Through the Pharmacy Venue. Summary: This filing is to include coverage language for the Measles, Mumps, and Rubella (MMR) and Varicella vaccines according to the indications and guidelines of the Centers for Disease Control and Prevention (CDC) for beneficiaries nineteen (19) and older. Non-substantive changes made to Rule 1.5 by replacing “Reserved Moved to Miss. Admin. Code” with “Refer to”, added a description to the CDC acronym in Rule 1.7 and replaced the word “significantly” with the word “separately” in Rules 1.3 and 1.4.
System Number: 21669
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/30/2015 Final Date: 10/27/2015
Effective Date: 12/1/2015 Withdrawal Date:
Rule: Title 23: Medicaid, Part 204: Dental Services, Chapter 2: Oral Surgery, Rule 2.3: Surgical Extractions Summary: This filing is to revise language regarding coverage of medically necessary surgical extractions.
System Number: 21617
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/29/2015 Final Date: 10/26/2015
Effective Date: 12/1/2015 Withdrawal Date:
Rule: Title 23: Medicaid, Part 202: Hospital Services, Chapter 5: Hospital Procedures, Rule 5.6: Hysterectomy Summary: This filing removes language requiring a thirty (30) day waiting period before performing a hysterectomy procedure per 42 CFR § 441.255.
System Number: 21610
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/29/2015 Final Date: 10/26/2015
Effective Date: 12/1/2015 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 218: Hearing Services, Chapter 1: General, Rule 1.3: Bone Anchored Hearing Aid Summary: This filing is to include language for coverage of a non-implantable auditory osseointegrated device (AOD) for beneficiaries under the age of five (5) with certain types of hearing loss.
System Number: 21608
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/2/2015 Final Date: 10/28/2015
Effective Date: 12/1/2015 Withdrawal Date:
Rule: Title 23: Medicaid, Part 202: Hospital Services, Chapter 1: Inpatient Services, Rule 1.3: Prior Authorization of Inpatient Hospital Services Summary: This filing includes language for the requirement of hospitals to notify the Division of Medicaid within five (5) calendar days of a newborn’s birth via the Newborn Enrollment Form located on the Division of Medicaid’s website.
System Number: 21624
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/1/2015 Final Date: 10/27/2015
Effective Date: 12/1/2015 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 207: Institutional Long Term Care, Chapter 3: Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID), Rule 3.2: Provider Enrollment/Provider Agreement Summary: This filing removes time-limited provider agreement language for an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) and includes language for hearings and appeals when an ICF/IID no longer meets the applicable Conditions of Participation as determined by Mississippi State Department of Health (MSDH) and Centers for Medicare and Medicaid Services(CMS).
System Number: 21616
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/30/2015 Final Date: 10/27/2015
Effective Date: 12/1/2015 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 211: Federally Qualified Health Centers, Chapter 1: General, Rule 1.5: Reimbursement Methodology Summary: This filing adds language for reimbursement of an additional fee per completed transmission for telehealth services provided by a Federally Qualified Health Center (FQHC) or FQHC look-alike acting as the originating site to correspond with State Plan Amendment (SPA) 15-003 eff. 01/01/2015.
System Number: 21615
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/30/2015 Final Date: 10/27/2015
Effective Date: 12/1/2015 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 212: Rural Health Clinics, Chapter 1: General, Rule 1.4: Reimbursement Methodology
Summary: This filing adds language for reimbursement of an additional fee per completed transmission for telehealth services
provided by a Rural Health Clinic (RHC) acting as the originating site to correspond with State Plan Amendment (SPA) 15-003 eff. 01/01/2015. Non-substantive change was made to rule 1.4.A.1.d. which adds the word percent.
System Number: 21614
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/29/2015 Final Date: 10/26/2015
Effective Date: 12/1/2015 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 202: Hospital Services, Chapter 2: Outpatient Services, Rule 2.11: Diabetes Self-Management Training (DSMT) Summary: This filing relocates Rule 2.11: Diabetes Self-Management Training (DSMT) from Title 23: Medicaid, Part 202: Hospital Services to New Rule 5.6 in Title 23: Medicaid, Part 200: General Provider Information and removes language which limits DSMT coverage to the outpatient hospital setting to any provider who is a current Mississippi Medicaid provider, located in the State of Mississippi, and accredited by the American Diabetes Association (ADA) or the American Association of Diabetes Educators (AADE).
System Number: 21606
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/29/2015 Final Date: 10/26/2015
Effective Date: 12/1/2015 Withdrawal Date:
Rule: Title 23: Medicaid, Part 200: General Provider Information, Chapter 5: General, New Rule 5.6: Diabetes Self-Management Training (DSMT) Summary: This filing relocates Rule 2.11: Diabetes Self-Management Training (DSMT) from Title 23: Medicaid, Part 202: Hospital Services to New Rule 5.6 in Title 23: Medicaid, Part 200: General Provider Information and removes language which limits DSMT coverage to the outpatient hospital setting to any provider who is a current Mississippi Medicaid provider, located in the State of Mississippi, and accredited by the American Diabetes Association (ADA) or the American Association of Diabetes Educators (AADE). Non-substantive change to rule 5.6.G. which adds a description to the acronym EPSDT.
System Number: 21607
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/29/2015 Final Date: 10/26/2015
Effective Date: 12/1/2015 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 209: Durable Medical Equipment and Medical Supplies, Chapter 1: Durable Medical Equipment, Rule 1.24: External Speech Processor Summary: This filing is to provide coverage language for batteries, replacement parts, and repairs for a non-implantable Auditory Osseoingrated Device (AOD). This filing also corrects a clerical error of referencing an incorrect rule number.
System Number: 21609
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/11/2015 Final Date: 10/21/2015
Effective Date: 12/1/2015 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 200: General Provider Information, Chapter 2: Benefits, Rule 2.2: Non-Covered Services.
Summary: This filing clarifies the exclusion of legally responsible individuals, as defined by the Division of Medicaid, from providing services to beneficiaries. This filing removes language from Part 200, Rule 2.2 which is found in Parts 200: General Provider Information,
203: Physician Services, 214: Pharmacy Services, 215: Home Health Services, and 224: Immunizations. This filing includes language regarding compliance with background checks and excluded individuals as required by the Vulnerable Persons Act. Non-substantive change made by adding language for clarification to rule 2.2.F.
System Number: 21599
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 7/24/2015 Final Date: 8/19/2015
Effective Date: 10/1/2015 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 221: Family Planning and Family Planning Related Services, Chapter 2: 1115(a) Family Planning and Family Planning Related Waiver Services, Rule 2.1: Purpose, Rule 2.2: Eligibility
Summary: This Administrative Code filing is to revise the verbiage for eligibility for Family Planning and Family Planning Related Waiver Services to be consistent with State Plan Amendment (SPA) 13-0019 Modified Adjusted Gross Income (MAGI) Based Eligibility Group.
System Number: 21455
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 7/2/2015 Final Date: 7/28/2015
Effective Date: 9/1/2015 Withdrawal Date:
Rule: Title 23: Medicaid, Part 208: Home and Community Based Services (HCBS), Long Term Care, Chapter 5: HCBS Intellectual Disabilities/Developmental Disabilities Waiver, Rules 5.1-5.13.
Summary: This filing is to update the current administrative code with the changes made during the 1915(c) Intellectual Disabilities/Developmental Disabilities (ID/DD) Home and Community-Based Services Waiver renewal, eff. July 1, 2013. Final filing adopted with changes addressing verbiage per comments received. Substantive changes were made to Rules 5.1: Eligibility, 5.2: Provider Enrollment, 5.4: Evaluation/Reevaluation of Level of Care (LOC), 5.5: Covered Services, 5.8: Serious Events/Incidents and Abuse/Neglect/Exploitation, 5.9: Medication Management and Medical Treatment, 5.12: Grievances and Complaint, and 5.13: Reconsiderations, Appeals, and Hearings. Non-substantive changes were made to Rule 5.10: Documentation and Record Maintenance.
System Number: 21419
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 7/2/2015 Final Date: 7/28/2015
Effective Date: 9/1/2015 Withdrawal Date: Rule: Title 23: Medicaid, Part 208: Home and Community Based Services (HCBS) Long Term Care, Chapter 6: Bridge to Independence (B2I), Rule 6.2: Eligibility and Rule 6.3: Covered Services Summary: This filing is to amend language to correspond with the Center for Medicare and Medicaid Services (CMS) approved Bridge to Independence (B2I) Operational Protocol (OP), effective November 4, 2014.
System Number: 21418
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 7/1/2015 Final Date: 7/27/2015
Effective Date: 9/1/2015 Withdrawal Date: Rule: Title 23: Division of Medicaid, Part 203: Physician Services, Chapter 2: Physician-Administered Drugs and Implantable Drug System Devices, Rule 2.2: Drug Rebates and Rule 2.6: 17 Alpha-Hydroxyprogesterone Caproate Injections (17-P) Summary: This filing is to include language regarding the Division of Medicaid’s authority to recoup monies when an audit determines that an incorrect NDC number was billed and to clarify coverage of 17-P.
System Number: 21417
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/26/2015 Final Date: 7/22/2015
Effective Date: 9/1/2015 Withdrawal Date: Rule: Title 23: Division of Medicaid, Part 204: Dental Services, Chapter 1: General, Rule 1.11: Dental Services Provided in a Hospital Summary: This Administrative Code filing revises Rule 1.11: Dental Services Provided in a Hospital to reflect that the Division of Medicaid currently covers dental treatment in the Ambulatory Surgical Center (ASC) setting and includes the requirement for prior authorization of certain dental procedures in the ASC setting.
System Number: 21404
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/5/2015 Final Date: 6/1/2015
Effective Date: 7/1/2015 Withdrawal Date: Rule: Title 23: Division of Medicaid, Part 221: Family Planning and Family Planning Related Services, Chapter 1: Family Planning and Family Planning Related State Plan Services, Rules: 1.2: Freedom of Choice, 1.4: Covered Services, 1.5: Non-Covered Services, 1.6: Documentation/Record Maintenance, New Rule 1.8: Reimbursement; Chapter 2: 1115(a) Family Planning and Family Planning Related Waiver Services, 2.1: Purpose, 2.2: Eligibility, 2.3: Freedom of Choice, 2.4: Covered Services, 2.5: Non-Covered Services, 2.6: Quality Assurance, 2.9: Documentation/Record Maintenance, New Rule 2.10: Reimbursement
Summary: This filing is to revise language to correspond with the Family Planning Waiver. Per Miss. Code Ann. § 25-43-3.109, Rule 2.2.E. is being amended to include language that a Family Planning Waiver eligible beneficiary is only eligible for Family Planning Waiver services; however, an application for full Medicaid benefits can be filed at any time.
System Number: 21316
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/6/2015 Final Date: 6/1/2015
Effective Date: 7/1/2015 Withdrawal Date: Rule: Title 23: Division of Medicaid; Part 207: Institutional Long Term Care; Chapter 2: Nursing Facility; Rules 2.7: Admission Requirements, 2.9: Resident Assessment-Minimum Data Set (MDS), 2.10: Case Mix Reimbursement, 2.15: Ventilator Dependent Care, 2.16: Therapy Services
Summary: This filing is to update the language to correspond with State Plan Amendment (SPA) 15-004 Nursing Facility Reimbursement. There were non-substantive changes made to rules 2.15: Ventilator Dependent Care and 2.16: Therapy Services.
System Number: 21317
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/6/2015 Final Date: 6/1/2015
Effective Date: 7/1/2015 Withdrawal Date: Rule: Title 23: Division of Medicaid, Part 220: Radiology, Chapter 1: General, Rule 1.4: Teleradiology
Summary: This Administrative Code Filing is to move Miss. Admin. Code Part 220: Radiology, Rule 1.4: Teleradiology to New Part 225: Telemedicine, new Chapter 3: Teleradiology, New Rule 3.1-3.6.
System Number: 21318
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/6/2015 Final Date: 6/1/2015
Effective Date: 7/1/2015 Withdrawal Date:
Rule: Title 23: Medicaid, Part 209: Durable Medical Equipment (DME) and Medical Supplies, Chapter 1: DME, Rule 1.26: Glucose Monitor, Chapter 2: Medical Supplies, Rule 2.1: Medical Supplies, Rule 2.2: Covered Medical Supplies. Non-substantive changes made to Rules 2.3, 2.4, and 2.5.
Summary: This filing is to add coverage language to Rule 1.26 for a continuous glucose monitoring system (CGMS), rename Rule 2.1 and add coverage language to Rule 2.2.C.2. for CGMS medical supplies.
System Number: 21319
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/6/2015 Final Date: 6/1/2015
Effective Date: 7/1/2015 Withdrawal Date:
Rule: Title 23: Medicaid, New Part 225: Telemedicine, New Chapter 1: Telehealth, New Rules 1.1-1.6, New Chapter 2: Remote Patient Monitoring, New Rules 2.1-2.6, New Chapter 3: Teleradiology, New Rules 3.1-3.6, New Chapter 4: Continuous Glucose Monitoring Services, New Rules 4.1-4.6.
Summary: This filing is to add New Part 225: Telemedicine which includes coverage language for telehealth, remote patient monitoring, teleradiology and continuous glucose monitoring services. Although Chapter 3: Teleradiology is a New Chapter, the language is struck from Part 220: Radiology and moved to the New Chapter 3 with revisions. Per Miss. Code Ann. § 25-43-3.109, the proposed filing has been revised to include the definition of telemedicine, clarification for the reimbursement of the telehealth originating site facility fee and removed the certification requirement for a telepresenter.
System Number: 21320
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 4/23/2015 Final Date: 5/19/2015
Effective Date: 7/1/2015 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 100: General Provisions, Chapter 9: Administrative Rules, New Rules 9.1: Public Notice, 9.2: Public Records and 9.5: Public Hearings.
Summary: This filing is to include new rules detailing the Division of Medicaid’s compliance with state and federal regulations regarding providing public notice prior to making submissions to the Centers for Medicare and Medicaid Services (CMS), establishing an official written policy regarding requests for public records in accordance with the Public Records Act and outlining the procedures for holding public hearings for the purpose of allowing the public an opportunity to provide input.
System Number: 21292
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 4/2/2015 Final Date: 4/28/2015
Effective Date: 6/1/2015 Withdrawal Date:
Rule: Title 23: Medicaid, Part 212: Rural Health Clinics (RHC), Chapter 1: General, Rule 1.2: Service Limits, Rule 1.3: Covered Services, Rule 1.4: Reimbursement Methodology, Rule 1.7: Pregnancy Related Eligibles. Non-substantive changes made to Rules 1.5, 1.6, and 1.8.
Summary: This filing includes language to correspond with SPA 2013-033 approved by Centers for Medicare and Medicaid Services (CMS) on August 5, 2014, which allows for an additional payment for certain services during extended office hours outside the Division of Medicaid’s definition of “office hours” and removes Rural Health Clinic (RHC) encounters from the physician visit limit of twelve (12) visits per state fiscal year. Per Miss. Code Ann. § 25-43-3.109 Rule 1.7: Pregnancy Related Eligibles is being amended on this final filing to comply with 42 CFR Part 435.116, 42 CFR Part 491 and SPA 13-0019.
System Number: 21254
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 4/2/2015 Final Date: 4/28/2015
Effective Date: 6/1/2015 Withdrawal Date:
Rule: Title 23: Medicaid, Part 211: Federally Qualified Health Centers (FQHC), Chapter 1: General, Rule 1.1: Provider Enrollment Requirements, Rule 1.2: Service Limits, Rule 1.3: Covered Services, Rule 1.4: Pregnancy-Related Eligibles, Rule 1.5: Reimbursement Methodology and Rule 1.6: Documentation Requirements. Non-substantive changes made to Rule 1.7.
Summary: This filing includes language to correspond with SPA 2013-032 approved by Centers for Medicare and Medicaid Services (CMS) on August 8, 2014, which allows for an additional payment for certain services during extended office hours outside the Division of Medicaid’s definition of “office hours” and removes Federally Qualified Health Center (FQHC) and FQHC look-alike encounters from the physician visit limit of twelve (12) visits per state fiscal year. Per Miss. Code Ann. § 25-43-3.109 Rule 1.4: Pregnancy Related Eligibles is being amended on this final filing to comply with 42 CFR § 435.116, 42 CFR Part 491 and SPA 13-0019.
System Number: 21255
Notice | Full Text

Compilation: No
Proposed Date: 4/2/2015 Final Date: 4/28/2015
Effective Date: 6/1/2015 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 203: Physician Services, Chapter 1: General, Rule 1.4: Physician Office Visits
Summary: This filing removes language referencing the pending approval from Centers for Medicare and Medicaid Services (CMS) for Rural Health Clinics (RHC) and Federally Qualified Health Centers (FQHC) to receive an alternate payment method of reimbursement for encounters occurring outside the Division of Medicaid’s definition of regularly scheduled office hours. State Plan Amendment (SPA) 2013-032 FQHC Reimbursement and SPA 2013-033 RHC Reimbursement were approved in August 2014 allowing this alternate payment method of reimbursement; therefore, this language is being removed.
System Number: 21256
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 4/2/2015 Final Date: 4/28/2015
Effective Date: 6/1/2015 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 306: Third Party Recovery, Chapter 1: Third Party Recovery, Rule 1.1: General. Non-substantive changes to Rules: 1.2, 1.3, 1.4, 1.5, and 1.6.
Summary: This filing is to clarify the definition of Third Party to mirror the definition in 42 CFR § 433.136. Non-substantive changes to include the appropriate CFR citations in the sources have also been included.
System Number: 21226
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 4/2/2015 Final Date: 4/28/2015
Effective Date: 6/1/2015 Withdrawal Date:
Rule: Title 23: Medicaid, Part 200: General Provider Information, Chapter 3: Beneficiary Information, Rule 3.4: Eligibility for Medicare and Medicaid
Summary: This filing is to include, for purposes of reimbursement, co-payments charged by a Medicare Part C plan are considered to be coinsurance as instructed by the Center for Medicare and Medicaid Services (CMS) guidance regarding compliance with 42 U.S.C. § 1396a.
System Number: 21225
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 1/30/2015 Final Date: 2/26/2015
Effective Date: 4/1/2015 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 201: Transportation Services, Chapter 2: Non-Emergency Transportation (NET) (Non-Ambulance), Rule 2.1: NET Broker Program and 2.6: NET Driver Requirements, Non-Substantive changes made to Rules 2.2, 2.3, 2.4, 2.5, and 2.7
Summary: This filing is to clarify the requirements for non-emergency transportation (NET) brokers and drivers regarding fingerprint and background checks.
System Number: 21056
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 1/29/2015 Final Date: 2/24/2015
Effective Date: 4/1/2015 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 224: Immunizations, Chapter 1: General, New Rule 1.6: Vaccines for Pregnant and Postpartum Beneficiaries
Summary: The MS Division of Medicaid’s Administrative Code filing is to amend Title 23: Medicaid, Part 224: Immunizations, Chapter 1: General to add New Rule 1.6: Vaccines for Pregnant and Postpartum Beneficiaries to allow coverage of the tetanus-diptheria-acellular pertussis (Tdap) vaccine to pregnant and postpartum beneficiaries.
System Number: 21054
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 1/29/2015 Final Date: 2/24/2015
Effective Date: 4/1/2015 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 202: Hospital Services, Chapter 2: Outpatient Services, New Rule 2.11: Diabetes Self-Management Training (DSMT)
Summary: The filing of New Rule 2.11 is to add coverage language for Diabetes Self-Management Training (DSMT).
System Number: 21051
Notice | Full Text

2014

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 11/26/2014 Final Date: 12/29/2014
Effective Date: 2/1/2015 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 204: Dental Services, Chapter 2: Oral Surgery, Rule 2.4: Alveoloplasty
Summary: This filing adds language to clarify coverage criteria for Alveoloplasty.
System Number: 20976
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 11/7/2014 Final Date: 12/2/2014
Effective Date: 1/2/2015 Withdrawal Date:
Rule: Title 23: Medicaid, Part 207: Institutional Long Term Care, Chapter 2: Nursing Facility, Rule 2.6 Per Diem/Covered Services, Rule 2.15: Ventilator Dependent Care, New Rule 2.18: Individualized, Resident Specific Custom Manual and/or Custom Motorized/Power Wheelchairs Uniquely Constructed or Substantially Modified for a Specific Resident, and Chapter 3: Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID), Rule 3.4: Per Diem/Covered Services, New Rule 3.10: Individualized, Resident Specific Custom Manual and/or Custom Motorized/Power Wheelchairs Uniquely Constructed or Substantially Modified for a Specific Resident.
Summary: The revision of Rule 2.6 and Rule 3.4 is to clarify the coverage and reimbursement of DME and medical supplies in a long-term care facility. Rule 2.15 is amended to include an established reimbursement per diem rate in addition to the standard per diem rate to nursing facilities, excluding Private Nursing Facilities for the Severely Disabled (PNF-SD), for residents requiring Ventilator Dependent Care (VDC), effective January 1, 2015. The filing of the New Rule 2.18 and New Rule 3.10 is to add coverage and reimbursement for an individualized, resident specific custom manual and/or custom motorized/power wheelchairs uniquely constructed or substantially modified for a specific resident in a long-term care facility outside the per diem rate.
System Number: 20942
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 11/7/2014 Final Date: 12/2/2014
Effective Date: 1/2/2015 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 209: Durable Medical Equipment and Medical Supplies, Chapter 1: Durable Medical Equipment, Rule 1.4: Reimbursement, Rule 1.47: Wheelchairs and Chapter 2: Medical Supplies, Rule 2.2: Covered Medical Supplies.
Summary: This filing removes all Institutional Long Term Care (LTC) facilities Durable Medical Equipment (DME) and medical supply coverage and reimbursement from Title 23, Part 209. This coverage and reimbursement will be addressed in Title 23, Part 207: Institutional Long Term Care effective January 2, 2015. Title 23, Part 209 will only address coverage and reimbursement for outpatient DME and medical supplies.
System Number: 20941
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 11/7/2014 Final Date: 12/2/2014
Effective Date: 1/2/2015 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 222: Maternity Services, Chapter 1: General, Rule 1.1: Maternity Services, Rule 1.2: Multiple Birth Deliveries, and Rule 1.5: Billing for Maternity Services
Summary: The MS Division of Medicaid’s Administrative Code filing is to amend Title 23: Medicaid, Part 222: Maternity Services, Chapter 1: General, Rule 1.1: Maternity Services by adding coverage criteria and reimbursement for medically necessary elective deliveries prior to one (1) week before the treating physician’s expected date of delivery and removing Rule 1.2: Multiple Birth Deliveries and Rule 1.5: Billing for Maternity Services. The Division of Medicaid does not reimburse for non-medically necessary elective deliveries prior to one (1) week before the treating physician’s expected date of delivery.
System Number: 20940
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/28/2014 Final Date: 9/29/2014
Effective Date: 11/1/2014 Withdrawal Date:
Rule: Title 23: Division of Medicaid: Part 103: Resources, Chapter 7: OBRA and DRA Transfer Policy
Summary: This filing is to amend Part 103: Resources, Chapter 7: OBRA and DRA Transfer Policy to clarify language.
System Number: 20801
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/28/2014 Final Date: 9/29/2014
Effective Date: 11/1/2014 Withdrawal Date:
Rule: Title 23: Division of Medicaid; Part 103: Resources, Chapter 6: Annuities
Summary: This filing is to amend Part 103: Resources, Chapter 6: Annuities to clarify language. Non-substantive changes made on Final File.
System Number: 20800
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/28/2014 Final Date: 9/29/2014
Effective Date: 11/1/2014 Withdrawal Date:
Rule: Title 23: Division of Medicaid; Part 103: Resources, Chapter 5: Trust Provisions
Summary: This filing is to amend Part 103: Resources, Chapter 5: Trust Provisions to separate trusts and transfer of assets policy, and clarify language. Non-substantive change make on Final File.
System Number: 20799
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/15/2014 Final Date: 9/10/2014
Effective Date: 11/1/2014 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 214: Pharmacy Services, Chapter 1: General Pharmacy, new Rule 1.13: Retrospective Drug Utilization Review (DUR), new Rule 1.14: Participating Federally Qualified Health Center (FQHC) Providers, and new Rule 1.15: 340B Program; Non-substantive changes made to Rules 1.1-1.4 and 1.6-1.12.
Summary: This final filing is to (1) add New Rule 1.13 to outline the DUR process, (2) add new Rule 1.14 requiring all drugs purchased at discounted prices in an in-house pharmacy of an FQHC be reported and billed and (3) add new Rule 1.15 340B Program. Non-substantive changes made to rules 1.1-1.4 and 1.6-1.12.
System Number: 20767
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/15/2014 Final Date: 9/10/2014
Effective Date: 11/1/2014 Withdrawal Date:
Rule: Title 23: Medicaid,Part 200: General Provider Information, Chapter 4: Provider Enrollment, Rule 4.10: 340B Providers
Summary: This final filing to the Miss. Admin. Code, Title 23: Medicaid, Part 200: General Provider Information, Chapter 4: Provider Enrollment, Rule 4.10: 340B Providers is to remove Miss. Admin. Code Part 200, Chapter 4, Rule 4.10. B, E, F, and J to correspond with the withdrawal of SPA 14-015.
System Number: 20766
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/4/2014 Final Date: 8/29/2014
Effective Date: 10/1/2014 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 305: Program Integrity, Chapter 1: Program Integrity, Rule 1.1: Fraud and Abuse
Summary: The MS Division of Medicaid’s Administrative Code final filing is to amend Title 23: Medicaid, Part 305: Program Integrity, Chapter 1: Program Integrity, Rule 1.1: Fraud and Abuse to include current language to require all provider demand letters for repayment of overpayment be sent via certified mail which will allow the Division of Medicaid to document the date of receipt of the demand letter and uphold the thirty (30) day response time.
System Number: 20742
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/4/2014 Final Date: 8/29/2014
Effective Date: 10/1/2014 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 203: Physician Services, New Chapter 10: Implantable Medical Devices, New Rule 10.1: Skin and Soft Tissue Substitutes
Summary: The MS Division of Medicaid’s Administrative Code final filing is to add New Chapter 10: Implantable Medical Devices and New Rule 10.1: Skin and Soft Tissue Substitutes to Title 23: Medicaid, Part 203: Physician Services to include coverage language and criteria for the use skin and soft tissue substitutes.
System Number: 20741
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/4/2014 Final Date: 8/29/2014
Effective Date: 10/1/2014 Withdrawal Date:
Rule: Title 23: Division of Medicaid; Part 219: Laboratory Services, Chapter 1: General, Rule 1.9: Genetic Testing
Summary: The MS Division of Medicaid’s Administrative Code final filing is to amend Title 23: Medicaid, Part 219: Laboratory Services, Chapter 1: General, to add New Rule 1.9: Genetic testing. This filing establishes criteria for coverage of genetic testing by the Division of Medicaid and requires prior authorization (PA) by the Utilization Management Quality Improvement Organization for medical necessity, effective October 1, 2014.
System Number: 20740
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 7/11/2014 Final Date: 8/15/2014
Effective Date: 8/15/2014 Withdrawal Date: 8/15/2014
Rule: Title 23: Division of Medicaid, Part 214: Pharmacy Services, Chapter 1: General Pharmacy, Rule 1.5 Reimbursement, new Rule 1.13: Retrospective Drug Utilization Review (DUR), new Rule 1.14: Participating Federally Qualified Health Center (FQHC) Providers, and new Rule 1.15: 340B Program WITHDRAWN
Summary: This filing is being withdrawn. APA System Number 20636
System Number: 20715
Notice

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 7/10/2014 Final Date: 8/15/2014
Effective Date: 8/15/2014 Withdrawal Date: 8/15/2014
Rule: Title 23: Medicaid, Part 200: General Provider Information, Chapter 4: Provider Enrollment, Rule 4.10: 340B WITHDRAWN
Summary: Title 23, Part 200, Chapter 4, Rule 4.10 is being withdrawn as proposed on 07/10/2014 APA 20634.
System Number: 20716
Notice

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 7/10/2014 Final Date: 8/7/2014
Effective Date: 10/1/2014 Withdrawal Date:
Rule: Title 23: Division of Medicaid; Part 200: General Provider Information, Chapter 2: Benefits, Rule 2.2: Non-Covered Services
Summary: This filing is to add language to include procedures, products and services for conditions and indications that are non-covered services and to include language for Home and Community Based Services (HCBS) waivers non-covered services.
System Number: 20696
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 7/2/2014 Final Date: 7/29/2014
Effective Date: Withdrawal Date:
Rule: Title 23: Medicaid, Part 300: Appeals, Chapter 1: Appeals, New Rule 1.5: Review for Medical Necessity and/or Independent Verification and Validation (IV&V).
Summary: The MS Division of Medicaid’s Administrative Code proposed filing is to add a new rule to Title 23: Medicaid, Part 300: Appeals, Chapter 1: Appeals, New Rule 1.5: Review for Medical Necessity and/or Independent Verification and Validation (IV&V). This filing is to include the appeal rights for providers who are dissatisfied with final administrative decisions of the Division of Medicaid relating to disallowances as a result of a review for medical necessity or Independent Verification and Validation (IV&V) decision described in Miss. Admin. Code Part 202, Rule 1.18.A.
System Number: 20670
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 7/2/2014 Final Date: 7/29/2014
Effective Date: 9/1/2014 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 202: Hospital Services, Chapter 1: Inpatient Services, New Rule 1.18: Review for Medical Necessity and/or Independent Verification and Validation (IV&V)
Summary: The MS Division of Medicaid’s Administrative Code proposed filing is to amend Title 23: Medicaid, Part 202: Hospital Services, Chapter 1: Inpatient Services by adding New Rule 1.18: Review for Medical Necessity and/or Independent Verification and Validation (IV&V).
System Number: 20669
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/26/2014 Final Date: 7/22/2014
Effective Date: 9/1/2014 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 100: General, Chapter 2: Agency Duties, Rule 2.1: Duties of the Division of Medicaid, New Chapter 9: Administrative Rules, Rule 2.1: Duties of the Division of Medicaid, Rule 9.3: Declaratory Opinions and New Rule 9.4: Oral Proceedings
Summary: The MS Division of Medicaid’s Administrative Code proposed filing is to amend Title 23: Medicaid, Part 100: General, Chapter 2: Agency Duties, Rule 2.1: Duties of the Division of Medicaid, and to add New Chapter 9: Administrative Rules, New Rule 9.3: Declaratory Opinions and New Rule 9.4: Declaratory Opinions as required by Miss. Code. Ann. § 25-43-2.103.
System Number: 20662
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/26/2014 Final Date: 7/22/2014
Effective Date: 9/1/2014 Withdrawal Date:
Rule: Title 23: Division of Medicaid; Part 103: Resources, Chapter 4: Countable Resources; New Rules 4.21 and 4.22
Summary: The MS Division of Medicaid’s Administrative Code proposed filing is to amend Title 23: Medicaid, Part 103: Resources, Chapter 4: Countable Resources, New Rule 4.21 and New Rule 4.22. This filing addresses the countablity of entrance fees to continuing care retirement communities and the exclusion of long term care coverage for individuals with substantial home equity. These rules are new to the Administrative Code but have been Medicaid policy since 2008. The effective date of this filing will revert back to the effective date of SPA 2008-003, July 1, 2014.
System Number: 20661
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/25/2014 Final Date: 9/30/2014
Effective Date: 9/30/2014 Withdrawal Date: 9/30/2014
Rule: Title 23: Medicaid, Part 203: Physician Services, Chapter 1: General, New Rule 1.11: Global Packaging WITHDRAWN (Administrative Bulletin Number 20743)
Summary: The MS Division of Medicaid’s Administrative Code final filing is to establish policies for Global Package coverage. Global Package is an edit that allows for lump sum payment which includes all necessary services normally furnished by the “same physician” before, during and after a procedure and all evaluation and management (E&M) visits related to a procedure based on an assigned post-op period by Centers of Medicare and Medicaid Services (CMS). WITHDRAWN (Administrative Bulletin System Number 20743)
System Number: 20802
Notice
Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/25/2014 Final Date: 7/21/2014
Effective Date: 9/1/2014 Withdrawal Date:
Rule: Title 23: Medicaid, Part 102: Non-Financial Requirements, Chapter 3: Aliens, Rule 3.9
Summary: The MS Division of Medicaid’s (DOM) Administrative Code proposed filing is to amend Title 23: Medicaid, Part 102: Non-Financial Requirements, Chapter 3: Aliens, Rule 3.9: Requirement for Forty (40) Qualifying Quarters. Rule 3.9.D. removes the requirement for certain classes of aliens to have forty (40) qualifying quarters (QQ) of work coverage under the Social Security Act (SSA). This is a change required by the Centers for Medicare and Medicaid Services (CMS) for the Affordable Care Act (ACA)-related State Plan Amendment (SPA) for Citizenship & Immigration Status (S89), approved as 13-0023-MM6 with an effective date of January 1, 2014.
System Number: 20656
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/25/2014 Final Date: 8/29/2014
Effective Date: 10/1/2014 Withdrawal Date:
Rule: Title 23: Medicaid, Part 203: Physician Services, Chapter 1: General, New Rule 1.11: Global Packaging
Summary: The MS Division of Medicaid’s Administrative Code final filing is to establish policies for Global Package coverage. Global Package is an edit that allows for lump sum payment which includes all necessary services normally furnished by the “same physician” before, during and after a procedure and all evaluation and management (E&M) visits related to a procedure based on an assigned post-op period by Centers of Medicare and Medicaid Services (CMS).
System Number: 20743
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/1/2014 Final Date: 5/27/2014
Effective Date: 7/1/2014 Withdrawal Date:
Rule: Title 23: Medicaid, Part 214: Pharmacy Services, Chapter 1: General Pharmacy, Rule1.3: Drugs Subject to Exclusion or Otherwise Restricted.
Summary: Effective January 1, 2014, section 2502 of the Affordable Care Act (ACA) amends section 1927(d)(2) of the Social Security Act by removing barbiturates, benzodiazepines and all drugs used for smoking cessation from the list of drugs a state Medicaid program may exclude from the coverage or otherwise restrict. This filing removes barbiturates and benzodiazepines from the list of excluded or otherwise restricted drugs in Miss. Admin. Code Part 214, Chapter 1, Rule 1.3.
System Number: 20555
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 4/30/2014 Final Date: 5/28/2014
Effective Date: 7/1/2014 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 211: Federally Qualified Health Centers, Chapter 1: General, Rule 1.1: Provider Enrollment/Requirements
Summary: This filing of Title 23: Division of Medicaid, Chapter 1: General Rule, Rule 1.1: Provider Enrollment/Requirements is being amended to include language clarification for determining effective date of the Federally Qualified Health Centers (FQHC) provider agreement.
System Number: 20557
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 4/30/2014 Final Date: 5/28/2014
Effective Date: 7/1/2014 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 212: Rural Health Clinics, Chapter 1: General, Rule 1.1: Provider Enrollment Requirements.
Summary: The filing of Title 23: Division of Medicaid, Part 212: Rural Health Clinics, Chapter 1: General Rule 1.1: Provider Enrollment Requirements is being amended to include language clarification for determining effective date of the Rural Health Clinics (RHC) provider agreement.
System Number: 20556
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 3/31/2014 Final Date: 4/29/2014
Effective Date: 6/1/2014 Withdrawal Date:
Rule: Title 23: Medicaid, Part 203: Physician Services, Chapter 2:Physician-Administered Drugs and Implantable Drug System Devices, Rule 2.1: Covered Services, Rule 2.2: Drug Rebates and Rule 2.3: Botulinum Toxins A and B.
Summary: The MS Division of Medicaid’s Administrative Code final filing is being submitted to (1) rename Miss. Admin. Code Part 203, Chapter 2 to Physician Administered Drugs and Implantable Drug System Devices and define these terms; (2) describe coverage which now includes drug wastage; (3) refer to the Miss. Admin. Code Part 200, Rule 4.10 340B providers effective 07/01/2014; and (4) add the diagnoses neurogenic detrusor over activity and chronic migraine headaches and remove nystagmus for the indication of indication for Botulinum Toxins A.
System Number: 20489
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 3/20/2014 Final Date: 4/21/2014
Effective Date: 6/1/2014 Withdrawal Date:
Rule: Part 208: Home and Community Based Services (HCBS) Long Term Care Chapter 6: Bridge to Independence, Rules 6.1-6.5
Summary: The MS Division of Medicaid’s Administrative Code filing is to propose new rules Title 23 Medicaid, Part 208 Home and Community Based Services (HCBS) Long Term Care, Chapter 6: Bridge to Independence Rules 6.1 – 6.5 as a covered service when certain criteria are met.
System Number: 20460
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 3/3/2014 Final Date: 3/28/2014
Effective Date: 5/1/2014 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 216: Dialysis Services, Chapter 1: Dialysis Services, Rules 1.2, 1.3, 1.5, 1.6
Summary: This Ms. Division of Medicaid’s Administrative Code filing is to change the payment methodology for freestanding and hospital-based dialysis centers from a composite rate system to a prospective payment system (PPS) effective January 1, 2014 to correspond with SPA 14-003 and to clarify documentation requirements for dialysis centers effective May 1, 2014.
System Number: 20429
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 2/28/2014 Final Date: 3/25/2014
Effective Date: 5/1/2014 Withdrawal Date:
Rule: Part 208: Home and Community Based Services (HCBS) Long Term Care, Chapter 3: HCBS Assisted Living Waiver, Rules 3.1-3.11, New rules 3.12-3.14
Summary: This MS Division of Medicaid’s Administrative Code filing is to modify Title 23, Part 208, Chapter 3: Assisted Living Waiver to reflect changes in the renewal of the Assisted Living Waiver by the Centers of Medicare and Medicaid (CMS) effective October 1, 2013.
System Number: 20409
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 2/27/2014 Final Date: 4/1/2014
Effective Date: 5/1/2014 Withdrawal Date:
Rule: Title 23: Medicaid, Part 209: Durable Medical Equipment and Medical Supplies, Chapter 1: Durable Medical Equipment, Rules 1.15 and 1.28; Chapter 2: Medical Supplies, Rules 2.2 and 2.3.
Summary: The MS Division of Medicaid’s Administrative Code proposed filing is to comply with the Affordable Care Act (ACA) by revising Title 23: Medicaid, Part 209: Durable Medical Equipment and Medical Supplies, Chapter 1: Durable Medical Equipment, Rule 1.15: Breast Pumps and Chapter 2: Medical Supplies, Rule 2.2: Covered Medical Supplies, Rule 2.3: Non-Covered Medical Supplies to provide coverage for manual breast pumps and supplies and for language clarification. Chapter 1, Rule 1.28: Hospital Beds is being amended for language clarification.
System Number: 20437
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 2/27/2014 Final Date: 3/25/2014
Effective Date: 5/1/2014 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 204: Dental Services, Chapter 1: General, Rules: 1.3, 1.10 (removed), 1.14.
Summary: The MS Division of Medicaid’s Administrative Code filing is to reflect the Medicaid coverage of certain types of analgesia and sedation for dental procedures in a dental office-based setting effective May 1, 2014, with prior authorization (PA) from the Utilization Management/Quality Improvement Organization (UM/QIO).
System Number: 20410
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 2/24/2014 Final Date: 3/31/2014
Effective Date: 5/1/2014 Withdrawal Date:
Rule: Title 23: Medicaid, Part 200: General Provider Information, Chapter 4: Provider Enrollment, New Rule 4.10: 340B Providers
Summary: This proposed filing to the Miss. Admin. Code, Title 23: Medicaid, Part 200: General Provider Information, Chapter 4: Provider Enrollment, Rule 4.10: 340B Providers is a new rule to comply with Sec. 340B of the Public Health Service Act (Pub. L. 102-585), as amended by the Patient Protection and Affordable Care Act (Pub. L. 111-148). Final filing adopted with the change addressing Contract Pharmacies per comments received.
System Number: 20432
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 2/19/2014 Final Date: 3/17/2014
Effective Date: 5/1/2014 Withdrawal Date:
Rule: Part 219: Laboratory Services, Chapter 1: General Rule, 1.2: Independent Laboratory Services
Summary: This filing is a technical change to clarify the language to Part 219: Laboratory Services, Chapter 1: General, Rule 1.2: Independent Laboratory Services to reflect the APR-DRG payment methodology, not a per diem payment, is considered full payment for inpatient hospital services to correlate with SPA 2012-008 effective October 1, 2012.
System Number: 20393
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 2/19/2014 Final Date: 3/17/2014
Effective Date: 5/1/2014 Withdrawal Date:
Rule: Part 200: General Provider Information, Chapter 3: Beneficiary Information, Rule 3.7: Beneficiary Cost Sharing
Summary: This Mississippi Division of Medicaid’s Administrative Code filing is a technical change to clarify the language to Part 200: General Provider Information, Chapter 3: Beneficiary Information, Rule 3.7: Beneficiary Cost Sharing to reflect APR-DRG payment methodology, not a per diem payment, is considered full payment for inpatient hospital services to correlate with SPA 2012-008 effective October 1, 2012.
System Number: 20392
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 2/11/2014 Final Date: 3/13/2014
Effective Date: 5/1/2014 Withdrawal Date:
Rule: Title 23: Medicaid, Part 202: Hospital Services, Chapter 5: Hospital Procedures, Rule 5.6: Hysterectomy
Summary: The MS Division of Medicaid’s Administrative Code 14-009 filing is to add clarification language to Title 23: Medicaid, Part 202: Hospital Services, Chapter 5: Hospital Procedures, Rule 5.6: Hysterectomy. This filing includes specific coverage and documentation requirements for a hysterectomy as required by federal law 42 CFR Part 441, Subpart F.
System Number: 20388
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 1/31/2014 Final Date: 2/28/2014
Effective Date: 4/1/2014 Withdrawal Date:
Rule: Title 23: Medicaid, Part 102: Non-Financial Requirements, Chapter 5: Categorical Eligibility, Rules 5.5, 5.6; Chapter 6: General Eligibility Requirements, Rules 6.3, 6.4, 6.9, 6.10 6.11, 6.16, 6.17, 6.18, 6.35; Chapter 8: Non-Financial Requirements Rules 8.1, 8.2, 8.3, 8.5, 8.6, 8.8.
Summary: This is a technical correction to include Medicaid and CHIP eligibility related provisions required by the Affordable Care Act (ACA).
System Number: 20372
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 1/16/2014 Final Date: 2/18/2014
Effective Date: 4/1/2014 Withdrawal Date:
Rule: Title 23: Medicaid, Part 208: HCBS, LTC, Chapter 7: 1915(i) HCBS, Rules 7.1-7.9
Summary: The new Chapter 7 and new Rules 7.1-7.9 are being proposed filed to correspond with the new SPA 2013-001 1915(i) HCBS State Plan services. According to MS Code Ann. § 25-43-1.103 subparagraph (4) the effective date will revert to the effective date of SPA 2013-001 1915(i) HCBS which is 11/01/2013.
System Number: 20336
Notice | Full Text

2013

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 12/17/2013 Final Date: 1/16/2014
Effective Date: 1/16/2014 Withdrawal Date: 1/16/2014
Rule: WITHDRAWN Title 23: Medicaid, Part 208: HCBS, LTC, Chapter 7: 1915(i) HCBS, Rules 7.1-7.9
Summary: The new Chapter 7 and new Rules 7.1-7.9 are being WITHDRAWN as proposed on 12/17/2013 APA 20216.
System Number: 20255
Notice

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 11/21/2013 Final Date: 12/18/2013
Effective Date: 2/1/2014 Withdrawal Date:
Rule: Title 23: Medicaid, Part 202: Hospital Services, Chapter 2: Outpatient Services, Rule 2.10: Phase II Cardiac Rehabilitation Services
Summary: This filing of the new Rule 2.10 includes coverage provisions for an outpatient hospital physician supervised cardiac rehabilitation (CR) program for beneficiaries who have had one of the qualifying cardiovascular “episodes” based on 42 CFR § 410.49.
System Number: 20219
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 11/6/2013 Final Date: 12/2/2013
Effective Date: 1/1/2014 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 206: Mental Health Services, Chapter 1: Community Mental Health Services, Rule 1.11: Intensive Outpatient Psychiatric (IOP) Services
Summary: To clarify the definition of Intensive Outpatient Psychiatric (IOP) Services as covered in the State Plan Amendment (SPA) 2012-003 effective July 1, 2012.
System Number: 20194
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/31/2013 Final Date: 11/26/2013
Effective Date: 1/1/2014 Withdrawal Date:
Rule: Title 23: Medicaid, Part 22: Radiology, Chapter 1: General rules 1.2 and 1.7-1.11
Summary: This Administrative Code filing is to modify Title 23: Medicaid, Part 22: Radiology, Chapter 1: General, Rules 1.2, 1.7-1.10 and add Rule 1.11 for clarification and to incorporate the CMS framework that establishes criteria for performing PET scans. The effective date is January 1, 2014. Clarification added as a result of comments.
System Number: 20191
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/3/2013 Final Date: 10/31/2013
Effective Date: 12/1/2013 Withdrawal Date:
Rule: Part 200: General Provider Information, Chapter 3: Beneficiary Information, Rule 3.1: Eligibility Groups
Summary: This proposed filing to the MS Administrative Code Title 23: Medicaid, Part 200: General Provider Information, Chapter 3: Beneficiary Information, Rule 3.1: Eligibility Groups is to make a technical change to remove the language “Therapy in a free standing clinic, and” from Rule 3.1.C.3.d.1.v): Excluded Services to comply with the CMS approved benefit package for the Healthier Mississippi waiver effective October 1, 2004 and to include Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) to Rule 3.1.C.3.d.1.v): Long term care services.
System Number: 20123
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 10/3/2013 Final Date: 12/17/2013
Effective Date: 12/17/2013 Withdrawal Date: 12/17/2013
Rule: WITHDRAWN Title 23: Medicaid, Part 208: HCBS, LTC, Chapter 7: 1915(i) HCBS, Rules 7.1-7.9
Summary: The new Chapter 7 and new Rules 7.1-7.9 are being withdrawn as proposed on 10/03/2013 APA 20075.
System Number: 20215
Notice

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/25/2013 Final Date: 10/31/2013
Effective Date: 12/1/2013 Withdrawal Date:
Rule: Admin Code Title 23 Medicaid, Part 206: Mental Health Services, Chapter 2: MYPAC, Rules 2.1-2.10, and New Rule 2.11.
Summary: The MS Division of Medicaid’s Administrative Code filing is to amend Title 23, Part 206: Mental Health Services, Chapter 2: MYPAC to reflect the approval of State Plan Amendment (SPA) 2012-003 Rehabilitation Option. Mississippi Youth Programs Around the Clock (MYPAC), a five year demonstration grant, ended enrollment of new beneficiaries on September 30, 2012. The Division of Medicaid submitted SPA 2012-003 Rehabilitation Option with an effective date of July 1, 2012, to continue MYPAC services after the end of the demonstration grant. To avoid duplication of services, MYPAC services under the State Plan are effective November 1, 2012, to coincide with the operational start date.
System Number: 20122
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/6/2013 Final Date: 10/1/2013
Effective Date: 11/1/2013 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 203: Physician Services, Chapter 1: General, Rule 1.4: Physician Office Visits
Summary: This proposed filling is to modify the MS Division of Medicaid’s Administrative Code filing is to revise Part 203: Physicians’ Services, Chapter 1: General, Rule 1.4: Physician Office Visits. This revision allows for additional reimbursement for scheduled physician office visits during “provider established office hours” which are outside of the Division of Medicaid’s definition of “office hours”.
System Number: 20071
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/4/2013 Final Date: 10/1/2013
Effective Date: 11/1/2013 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 202: Hospital Services, Chapter 2: Outpatient Services, Rule 2.3: Emergency Room Outpatient Services, Rule 2.4: Outpatient (23 hour) Observation Services
Summary: Rule: 2.3.B: Emergency Room Outpatient Visits – deleted “non-emergent visits” to correspond with SPA 2012-009 Ambulatory Payment Classification (APC) and to clarify language regarding an emergency department visit that results in an inpatient hospital admission to correspond to SPA 2012-008. Rule: 2.4.D.2: Updated language to include Electronic Health Record documentation. Rule: 2.4.E: Outpatient (23 hour) Observation Services – clarified language regarding outpatient observation that results in an inpatient hospital admission to correspond to SPA 2012-008.
System Number: 20073
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/4/2013 Final Date: 10/1/2013
Effective Date: 11/1/2013 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 300: Appeals,
Summary: This MS Division of Medicaid’s Administrative Code filing is to revise Part 300: Appeals, Chapter 1: Appeals, Rule 1.1: Administrative Hearings for Providers for clarification and consistency. Rule 1.1.B.6.b) amended on final filing.
System Number: 20072
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/2/2013 Final Date: 9/3/2013
Effective Date: 10/3/2013 Withdrawal Date:
Rule: Title 23: Medicaid, Part101, Ch. 1, 1.2 – 1.3, Ch. 3 , 3.1- 3.10 Ch. 4,4.1, Ch. 5, 5.1-5.4, Ch. 6, 6.1-6.5, Ch. 7, 7.1-7.5, Ch. 8 8.1:, Ch. 9, 9.1-9.4,Ch. 10,10.1 -10.3, Ch. 11, 11.1-11.3, Ch.12,12.1-12.2, Ch. 13:, 13.1,13.2, Ch. 15, 15.1
Summary: This is a technical correction to include Medicaid and CHIP eligibility – related provisions required by the Affordable Care Act (ACA) Specific legal authority authorizing the promulgation of rule: Patient Protection and Affordable Care Act (P.L .111-148) and the Health Care Education Reconciliation Act of 2010 (P.L. 111-152)
System Number: 20014
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/1/2013 Final Date: 9/3/2013
Effective Date: 10/3/2013 Withdrawal Date:
Rule: Title 23: Medicaid, Part 102: Non-financial Requirements, Chapter 1 Residency, Rule 1.11 , Rule 5.5, 5., Chapter 6 General Eligibility Requirements, Rule 6.3, Rule 6., Rule 6.9, Rule 6.10: 6.11:, Rule 6.16:, Rule 6.17, Rule 6.18, Rule 6.35., Chapter 8 Non-Financial Requirements, Rule 8.1:, Rule 8.2:, Rule 8.3, Rule 8.5, Rule 8.6:, Rule 8.8:
Summary: This is a technical correction to include Medicaid and CHIP eligibility – related provisions required by the Affordable Care Act (ACA)
System Number: 20017
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/1/2013 Final Date: 9/3/2013
Effective Date: 10/3/2013 Withdrawal Date:
Rule: Administrative Code Title 23: Medicaid, Part 104 Income, Chapter 1 Introduction to Income, Rule 1.1:, Chapter 11 Introduction to Income_FCC programs, Rule 11.1, Rule 11.2, Rule 11.3, Rule 11.4, Rule 11.5, Chapter 12 Income that Does Not count Under IRS Rules-FCC, Rule 12.1, , Rule 12.2, Rule 12.3, Chapter 13 Income that Counts Under IRS Rules-FCC, Rule 13.1, Chapter 14 Verification of Income-FCC, Rule 14.1, , Rule 14.2
Summary: This is a technical correction to include Medicaid and CHIP eligibility – related provisions required by the Affordable Care Act (ACA)
System Number: 20016
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/1/2013 Final Date: 9/3/2013
Effective Date: 10/3/2013 Withdrawal Date:
Rule: Administrative Code Title 23: Medicaid, Part 100 General Provisions, Chapter 1 Introduction, Rule 1.3 Current Structure, Chapter2 Agency Duties, Rule 2.1 Duties of Division of Medicaid
Summary: This is a technical correction to include Medicaid and CHIP eligibility – related provisions required by the Affordable Care Act (ACA)
System Number: 20015
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/1/2013 Final Date: 9/3/2013
Effective Date: 10/3/2013 Withdrawal Date:
Rule: Administrative Code Title 23: Medicaid, Part 100 General Provisions, Chapter 1 Introduction, Rule 1.3 Current Structure, Chapter2 Agency Duties, Rule 2.1 Duties of Division of Medicaid
Summary: This is a technical correction to include Medicaid and CHIP eligibility – related provisions required by the Affordable Care Act (ACA)
System Number: 20013
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/1/2013 Final Date: 9/3/2013
Effective Date: 10/3/2013 Withdrawal Date:
Rule: Administrative Code Title 23: Medicaid, Part 105 Budgeting, Chapter 1 Introduction to Budgeting-FCC Program Rule 1.1, Rule 1.2, Rule 1.3, Rule 1.4, Chapter 2: Extended Medicaid for Parent(s) and Caretaker Relatives, Rule 2.1 Rule 2.2
Summary: This is an addition to include Medicaid and CHIP eligibility – related provisions required by the Affordable Care Act (ACA)
System Number: 20012
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/1/2013 Final Date: 9/3/2013
Effective Date: 10/3/2013 Withdrawal Date:
Rule: Administrative Code Title 23: Medicaid Part 100, Rule 8.1, Rule 8.2, Rule 8.3, Rule 8.4, Rule 8.5, Rule 8.6, Rule 8.7, Rule 8.8, Rule 8.9, Rule 8.10, Rule 8.11, Rule 8.12, Rule 8.13, Rule 8.14, Rule 8.15
Summary: This is an addition to include Medicaid and CHIP eligibility-related provisions required by the Affordable Care Act (ACA).
System Number: 20011
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 7/31/2013 Final Date: 8/26/2013
Effective Date: 10/1/2013 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 221: Family Planning Services, Chapter 1: General, Rule 1.4: Covered Services
Summary: The revision to Rule 1.4: Covered Services is a non-substantive revision to Rule 1.4 B.4 to change the reference to the Rule: 1.8 Sterilization to Rule 5.3 Sterilization.
System Number: 20000
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 7/31/2013 Final Date: 8/26/2013
Effective Date: 10/1/2013 Withdrawal Date:
Rule: Title 23: Division of Medicaid, Part 202: Hospital Services, Chapter 1: Inpatient Services, Rules: 1.4B.1-6, New Rules: 5.1-5.1
Summary: (1) Moved Rule: 1.4.B.1- 6 to a new Chapter 5: Hospital Procedures, with new Rules: 5.1-5.6 because listed procedures are not limited to the inpatient hospital setting. (2) The language “in an inpatient or outpatient hospital setting in accordance with current standards of medical practice” was added to Rules 5.1-5.4 and 5.6. The language “in an outpatient hospital setting in accordance with current standards of medical practice” was added to Rule 5.5; (3) Rule: 1.8: Sterilization was moved to Rule: 5.3, Hysterectomy was removed from the Rule title and clarified existing language to 5.3.A.4, B.3, C.1, C.2, C.3; (3) Added new Rule 5.6: Hysterectomy. (4) “Revised 10/01/2012” removed from Rules: 5.3 and 5.4 due to non-substantive grammatical change.
System Number: 19999
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/17/2013 Final Date: 7/15/2013
Effective Date: 8/14/2013 Withdrawal Date:
Rule: Part 305 Program Integrity, Chapter 1, Rule 1.1: Fraud and Abuse
Summary: This Administrative Code filing is to make a correction to Title 23: Part 305: Program Integrity, Chapter 1, Rule 1.1: Fraud and Abuse to correspond with Medicaid’s Medical Assistance Participation Agreement signed by providers.
System Number: 19885
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 6/12/2013 Final Date: 7/12/2013
Effective Date: 7/1/2013 Withdrawal Date:
Rule: Part 220, Radiology Chapter 1 General Rule 1.7 – Prior Authorization
Summary: This Administrative Code filing is to modify Title 23, Part 220 Radiology, Chapter 1 General, Rule 1.2 and add new Rules 1.7-1.10 to require prior authorization for certain outpatient advanced imaging procedures by the Division of Medicaid’s Utilization Management/Quality Improvement Organization (UM/QIO) except when performed during an inpatient hospitalization, during an emergency room visit or during a twenty-three (23) hour observation period. According to the SOS APA 25-43-1.103, the effective date is July 1, 2013 to correspond with the approved SPA 2013-007.
System Number: 19884
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/15/2013 Final Date: 6/14/2013
Effective Date: 7/14/2013 Withdrawal Date:
Rule: Part 200 General Provider Information, Chapter 2 Benefits, Rule 2.2B and C Non-Covered Services
Summary: This proposed filing to the MS Administrative Code Title 23 Medicaid, Part 200 General Provider Information, Chapter 2 Benefits, Rule 2.2.B and C Non-Covered Services is to include the three never events in inpatient hospital (SPA 2011-004), outpatient hospital (SPA 2011-006) and other types of healthcare settings (SPA 2012-001). This filing complies with the CMS mandated SPA 2011-004 and SPA 2011-006 effective 10/01/2011 and SPA 2012-001 effective 06/01/2012 and according to MS Code Ann. 25-43-1.103 subparagraph 4. Non-substantive revisions are being made to Rule 2.2A.
System Number: 19830
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/3/2013 Final Date: 5/31/2013
Effective Date: 6/30/2013 Withdrawal Date:
Rule: Title 23 Medicaid, Part 214 Pharmacy Services, Chapter 1: General Pharmacy, Rules 1.3, 1.4, 1.6 and 1.12
Summary: The MS Division of Medicaid’s Administrative Code filing is to modify Title 23: Part 214: Pharmacy Services, Chapter 1: Rule 1.3 – to include specific section modified in 01/01/2013 filing; Rule 1.4: – to include clarification language as well as the add seventy-two (72) hour emergency drug supply verbiage inadvertently omitted in the 04/01/2012 compilation filing. Rule 1.6: to include language regarding recoupment of funds for hard copy prescriptions not written on tamper-resistant pad/paper and add language requiring the NPI must be included on prescription claims for individual providers required with SPA 2012-004 Provider Screening and Enrollment. Rule 1.12: to include verbiage inadvertently omitted in the 04/01/2012 compilation filing.
System Number: 19816
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 4/4/2013 Final Date: 5/1/2013
Effective Date: 5/31/2013 Withdrawal Date:
Rule: Part 208: Home and Community Based Services (HCBS) Chapter 1: HCBS Elderly and Disabled Waiver, Rule 1.3, 4a: Provider Enrollment
Summary: The MS Division of Medicaid’s Administrative Code filing is to include language inadvertently omitted in the 01/01/13 filing reflecting changes in the Elderly and Disabled Wavier approved by CMS 07/01/12.
System Number: 19645
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 4/1/2013 Final Date: 9/25/2013
Effective Date: 9/25/2013 Withdrawal Date: 9/25/2013
Rule: WITHDRAWN – Name or number of rule(s): Admin Code Title 23 Medicaid, Part 206: Mental Health Services, Chapter 2: MYPAC, Rules 2.1-2.2 and Chapter 3: MYPAC-IOP Services, Rules 3.1 -3.10.
Summary: WITHDRAWN – The MS Division of Medicaid’s Administrative Code filing is to amend Title 23, Part 206 Mental Health Services, Chapter 2: Mississippi Youth Programs Around the Clock (MYPAC), Rules 2.1 – 2.2. New rules are proposed for Part 206: Mental Health Services, Chapter 3: Mississippi Youth Programs Around the Clock – Intensive Outpatient Psychiatric (MYPAC-IOP) Services, Rules 3.1 – 3.10 with an effective date of 11/1/12 according to MS Code Ann. § 25-43-1.103.
System Number: 20066
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 3/20/2013 Final Date: 4/25/2013
Effective Date: 5/25/2013 Withdrawal Date:
Rule: Part 214 Pharmacy, Chapter 1 General Pharmacy, Rules 1.3, 1.6 and 1.11
Summary: This filing is to revise Rules 1.3 and 1.6 and add new Rule 1.11 to be in compliance with State Plan Amendment 2013-011 Prescribed Drugs effective date 01/01/2013 according to section 25-43-1.103 subparagraph 4.
System Number: 19626
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 3/6/2013 Final Date: 4/1/2013
Effective Date: 5/1/2013 Withdrawal Date:
Rule: Part 212 Rural Health Clinics, Chapter 1 General, Rule 1.1 Provider Enrollment Requirements
Summary: Rule 1.1A was effective 12/01/2007. This filing is to include information inadvertently omitted in the April 1, 2012 compilation of Administrative Code Title 23 Division of Medicaid.
System Number: 19445
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 2/1/2013 Final Date: 2/28/2013
Effective Date: 4/1/2013 Withdrawal Date:
Rule: Part 202, Chapter 4, Rule 4.17
Summary: This final filing to the MS Administrative Code Title 23 Medicaid, Part 202 Hospital Services, Chapter 4 Organ Transplant , Rule 4.17 Peripheral Stem Cell Transplant is to include criteria for autologous stem cell transplant.
System Number: 19372
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 2/1/2013 Final Date: 2/28/2013
Effective Date: 4/1/2013 Withdrawal Date:
Rule: Part 203, Chapter 4, Rule 4.23
Summary: The MS Division of Medicaid’s Administrative Code filing is to final file Title 23 Medicaid, Part 203 Physician Services, Chapter 4 Surgery, Rule 4.23 Gastric Electrical Stimulation as a covered service when the necessary criteria are met.
System Number: 19371
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 2/1/2013 Final Date: 2/28/2013
Effective Date: 4/1/2013 Withdrawal Date:
Rule: Administrative Code Title 23 Medicaid, Part 201 Transportation Services, Chapter 2 Non-Emergency Transportation (NET), Rule 2.1-2.7
Summary: The MS Division of Medicaid’s Administrative Code filing is for technical corrections, language clarification and to include language inadvertently omitted in the April 1, 2012, compilation filing.
System Number: 19369
Notice | Full Text

2012

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 12/21/2012 Final Date: 1/22/2013
Effective Date: 9/1/2012 Withdrawal Date:
Rule: Administrative Code Title 23: Division of Medicaid Part 202 Hospital Services, Chapter 2 Outpatient Services, Rule 2.3 Emergency Room Outpatient Visits
Summary: This final filing to the MS Administrative Code Title 23 Medicaid, Part 202 Hospital Services, Chapter 2 Outpatient Services, Rule 2.3 Emergency Room Outpatient Visits is to revert to the language filed effective November 1, 2012, to unbundle services and ancillaries for all beneficiaries in the two lowest emergency department evaluation and management code descriptions for non-emergent emergency department visits. The effective date of this final filing is September 1, 2012, coinciding with the CMS approved SPA 2012-009 Hospital Outpatient Ambulatory Payment Classification (OP APC).
System Number: 19307
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 11/2/2012 Final Date: 11/29/2012
Effective Date: 1/1/2013 Withdrawal Date:
Rule: Administrative Code Title 23: Part 209 Durable Medical Equipment and Medical Supplies, Chapter 1: Rules 1.12, 1.13, 1.22, 1.26, 1.47, 1.48, 1.49, 1.51, 1.52 and Chapter 2: Rule 2.2, and 2.5
Summary: The MS Division of Medicaid’s Administrative Code filing is for language clarification to Title 23: Part 209 Durable Medical Equipment and Medical Supplies, Chapter 1: Rules 1.12, 1.13, 1.26 and Chapter 2: Rule 2.2. Chapter 1: Rule 1.22 was moved to Chapter 2: Rule 2.5 with language clarification. Chapter 1 Rule 1.49 was combined with Rule 1.47 for language clarification. Chapter 1: Rules 1.51 and 1.52 were inadvertently not filed with the April 1, 2012, Division of Medicaid’s Compilation filing.
System Number: 19252
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 11/2/2012 Final Date: 11/29/2012
Effective Date: 1/1/2013 Withdrawal Date:
Rule: Administrative Code Title 23: Division of Medicaid Part 202 Hospital Services, Chapter 2 Outpatient Services, Rule 2.3 Emergency Room Outpatient Visits
Summary: The purpose of this modification to the MS Division of Medicaid’s Administrative Code Title 23, Part 202 Hospital Services, Chapter 2.B. Outpatient Services, Rule 2.3 Emergency Room Outpatient Visits is to clarify the original language by stating all services and ancillaries for beneficiaries over the age of (20) twenty are bundled into the two lowest emergency department evaluation and management code descriptions for non-emergent emergency department visits.
System Number: 19251
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 11/2/2012 Final Date: 11/30/2012
Effective Date: 1/1/2013 Withdrawal Date:
Rule: Title 23, Part 202 Hospital Services, Chapter 1 Inpatient Services, Rule 1.13 Out-of-State Facilities; Chapter 4 Organ Transplants, Rule 4.7: Reimbursement
Summary: Chapter 1 Inpatient Services, Rule 1.13 Out-of-State Facilities – amend language to 1.13 B. to be the same language as in 4.7 B. and move payment methodology for “specialized services” to 1.13 C from Rule 4.7 C; Chapter 4 Organ Transplants, Rule 4.7 Reimbursement – adding payment methodology for out-of-state hospitals providing transplant services to beneficiaries enrolled in a Coordinated Care Organization.
System Number: 19258
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 11/1/2012 Final Date: 11/29/2012
Effective Date: 1/1/2013 Withdrawal Date:
Rule: Administrative Code Title 23: Medicaid Part 208 Home and Community Based Services , Long Term Care , Chapter 1: HCBS Elderly and Disabled Waiver
Summary: The MS Division of Medicaid’s Administrative Code filing is to modify Title 23, Part 208, Chapter 1: Home and Community Based Service (HCBS) Elderly and Disabled Waiver (ILW) to clearly reflect changes in the approved Independent Living Waiver approved by The Centers of Medicare and Medicaid effective July 1, 2012.
System Number: 19250
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 11/1/2012 Final Date: 11/29/2012
Effective Date: 1/1/2013 Withdrawal Date:
Rule: Administrative Code Title 23: Division of Medicaid Part 208 Home and Community Based Services, Long Term Care, Chapter 2: HCBS Independent Living Waiver
Summary: The MS Division of Medicaid’s Administrative Code filing is to modify Title 23, Part 208, Chapter 2: Home and Community Based Service (HCBS) Independent Living Waiver (ILW) to clearly reflect changes in the approved Independent Living Waiver approved by The Centers of Medicare and Medicaid effective July 1, 2012.
System Number: 19249
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/14/2012 Final Date: 10/15/2012
Effective Date: 11/14/2012 Withdrawal Date:
Rule: Administrative Code Title 23: Medicaid, Part 103 Resources, Chapter 7 OBRA-93 and DRA Transfer Policy, Rule 7.1 OBRA-93 and DRA Transfer Policy Principles.
Summary: This is a technical correction to reflect the source used to arrive at average private pay nursing facility rates and to add an exemption for non-home transfers that was inadvertently omitted.
System Number: 19168
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 9/7/2012 Final Date: 10/8/2012
Effective Date: 11/7/2012 Withdrawal Date:
Rule: Administrative Code Title 23: Medicaid, Part 103 Resources, Chapter 6 Annuities, Rule 6.2 Treatment of Annuities Purchased Prior to 2/8/2006
Summary: This is a technical correction in the description of how annuities purchased prior to 2/8/2006 are treated for Medicaid eligibility.
System Number: 19163
Notice | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/30/2012 Final Date: 9/27/2012
Effective Date: 11/1/2012 Withdrawal Date:
Rule: Administrative Code Title 23: Division of Medicaid Part 202 Hospital Services, Chapter 2 Outpatient Services, Rule 2.3 Emergency Room Outpatient Visits
Summary: The MS Division of Medicaid’s Administrative Code Title 23, Part 202 Hospital Services, Chapter 2 Outpatient Services, Rule 2.3 Emergency Room Outpatient Visits filing is to remove the six (6) non-emergent emergency room visits limit.
System Number: 19147
Notice | EIS | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/8/2012 Final Date: 9/4/2012
Effective Date: 10/4/2012 Withdrawal Date:
Rule: Administrative Code Title 23: Division of Medicaid Part 304 Audit, Chapter 1 Rule 1.1 Audit Rule
Summary: The MS Division of Medicaid’s Administrative Code filing is to modify Title 23, Part 304 Chapter 1 Rule 1.1 to update the specific records that hospitals should maintain due to the change to the APR-DRG hospital inpatient payment methodology authorized by the 2012 Legislative Session.
System Number: 19101
Notice | EIS | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/6/2012 Final Date: 9/4/2012
Effective Date: 10/4/2012 Withdrawal Date:
Rule: Administrative Code Title 23: Division of Medicaid Part 203 Physician Services, Chapter 9 Rule 9.5
Summary: The MS Division of Medicaid’s Administrative Code filing is to modify Title 23, Part 203 Chapter 9 Rule 9.5 to reflect the removal of the 30-day physician visit limit. The 2012 Legislative Session authorized the removal of the 30-day hospital inpatient service limit due to the implementation of the Inpatient Hospital All Patient Refined Diagnosis Related Group (APR-DRG) payment methodology. The 30-day physician visit limit is also being discontinued.
System Number: 19100
Notice | EIS | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 8/6/2012 Final Date: 9/4/2012
Effective Date: 10/4/2012 Withdrawal Date:
Rule: Administrative Code Title 23: Division of Medicaid Part 202 Hospital Inpatient Services, Chapter 1 Rule 1.1 1.3, 1.4, 1.8 – 1.10, 1.13 – 1.16 and Chapter 4 Rules 4.1, 4.2, 4.4, 4.5, 4.7, 4.8, 4.12, 4.16 and 4.17
Summary: The MS Division of Medicaid’s Administrative Code filing is to modify Title 23, Part 202 Chapter 1 Rules 1.1 , 1.3, 1.4, 1.8 – 1.10, 1.13 – 1.16 and Chapter 4 Rules 4.1 4.2, 4.4, 4.5, 4.7, 4.8, 4.12, 4.16 and 4.17 to reflect implementation of the Inpatient Hospital All Patient Refined Diagnosis Related Group (APR-DRG) payment methodology as authorized during the 2012 Legislative Session. This filing also removes the thirty (30) day inpatient hospital stay limit for adults.
System Number: 19099
Notice | EIS | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 7/6/2012 Final Date: 8/1/2012
Effective Date: 9/1/2012 Withdrawal Date:
Rule: Administrative Code Title 23: Medicaid Part 202 Hospital Services, Chapter 2 Outpatient Services, Rule 2.3, Rule 2.7 and Rule 2.8
Summary: The MS Division of Medicaid’s Administrative Code filing is to modify Title 23, Part 202 Rule 2.3, Rule 2.7 and Rule 2.8 to reflect implementation of the Outpatient Hospital Ambulatory Payment Classification (APC) payment methodology as authorized during the 2012 Legislative Session. This filing also clarifies the six (6) emergency room visits per fiscal year are for non-emergent visits.
System Number: 19032
Notice | EIS | Full Text

Agency: DIVISION OF MEDICAID
Compilation: No
Proposed Date: 5/7/2012 Final Date: 6/1/2012
Effective Date: 7/1/2012 Withdrawal Date:
Rule: Title 23 Part 214 Pharmacy Chapter 1 Rule 1.10 Preferred Drug List
Summary: This Rule was inadvertently not filed with the April 1, 2012, Division of Medicaid’s Compilation filing required by APA Rule 3.2. Additionally, Rule 1.10 was amended with A.4 deleted due to not applicable to PDL which is also addressed under Rule 1.8. The language for B. was changed due to the Pharmacy Benefit Manager no longer existing. The CMS requirement for 24-hour PA review was added on E.
System Number: 18815
Notice | Full Text