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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.

2016 | 2015 | 2014 | 2013 | 2012


2016

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Rule: Withdrawn Title 23: Medicaid, Part 214: Pharmacy Services, Chapter 1: General Pharmacy, Rule 1.7: Refills/Renewals of Prescription Drugs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Part 214: Pharmacy Services, Chapter 1: General Pharmacy, Rule 1.7: Refills/Renewals of Prescription Drugs are being withdrawn as proposed on 5/26/16 APA 22038.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