Mississippi Maternal Health Momnibus Act; create.

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To: Public Health and Human
Services; Appropriations A
MISSISSIPPI LEGISLATURE REGULAR SESSION 2026

By: Representatives Summers, Butler-
Washington, James-Jones

HOUSE BILL NO. 1493

AN ACT BE KNOWN AS THE MISSISSIPPI MATERNAL HEALTH MOMNIBUS 1
ACT; TO PROVIDE FOR A VARIETY OF MATERNAL HEALTH SERVICES FOR 2
PREGNANT AND POSTPARTUM WOMEN; TO AMEND SECTION 27-65-111, 3
MISSISSIPPI CODE OF 1972, TO EXEMPT FROM SALES TAXATION SALES OF 4
CHILDREN'S DIAPERS, DIAPER BAGS, DIAPER RASH CREAM, BABY WIPES, 5
BABY POWDER AND BABY FORMULA; TO AMEND SECTION 43-13-117, 6
MISSISSIPPI CODE OF 1972, TO PROVIDE MEDICAID COVERAGE FOR CERTAIN 7
SERVICES PROVIDED BY THIS ACT; AND FOR RELATED PURPOSES. 8
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI: 9
SECTION 1. This act shall be known and may be cited as the 10
Mississippi Maternal Health Momnibus Act. 11
PART I. ESTABLISHMENT OF MATERNAL CARE ACCESS GRANT PROGRAM 12
SECTION 2. Definitions. The following definitions apply in 13
Part I: 14
(a) "Culturally respectful congruent" means sensitive 15
to and respectful of the preferred cultural values, beliefs, world 16
view, and practices of the patient, and aware that cultural 17
differences between patients and health care providers or other 18
service providers must be proactively addressed to ensure that 19
patients receive equitable, high-quality services that meet their 20
needs. 21
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(b) "Department" means the Mississippi Department of 22
Human Services. 23
(c) "Postpartum" means the one year period beginning on 24
the last day of a woman's pregnancy. 25
SECTION 3. Establishment of Grant Program. The department 26
shall establish and administer a Maternal Care Access Grant 27
Program to award competitive grants to eligible entities to 28
establish or expand programs for the prevention of maternal 29
mortality and severe maternal morbidity among black women. The 30
department shall establish eligibility requirements for program 31
participation that shall, at a minimum, require that applicants be 32
community based organizations offering programs and resources 33
aligned with evidence based practices for improving maternal 34
health outcomes for black women. 35
SECTION 4. Outreach and Application Assistance. Beginning 36
July 1, 2027, the department shall (a) conduct outreach to 37
encourage eligible applicants to apply for grants under this 38
program and (b) provide application assistance to eligible 39
applicants on best practices for applying for grants under this 40
program. In conducting the outreach required by this section, the 41
department shall give special consideration to eligible applicants 42
that meet the following criteria: 43
(i) Are based in, and provide support for, 44
communities with high rates of adverse maternal health outcomes 45
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and significant racial and ethnic disparities in maternal health 46
outcomes. 47
(ii) Are led by black women. 48
(iii) Offer programs and resources that are 49
aligned with evidence based practices for improving maternal 50
health outcomes for black women. 51
SECTION 5. Grant Awards. In awarding grants under this 52
section, the department shall, to the extent possible, award 53
grants to recipients to reflect different areas of the state. The 54
department shall not award a single grant for less than Ten 55
Thousand Dollars ($10,000) or more than Fifty Thousand Dollars 56
($50,000) per grant recipient. In selecting grant recipients, the 57
department shall give special consideration to eligible applicants 58
that meet all of the following criteria: 59
(a) Meet all of the criteria specified in Section 4 of 60
this act. 61
(b) Offer programs and resources designed in 62
consultation with and intended for black women. 63
(c) Offer programs and resources in the communities in 64
which they are located that include any of the following 65
activities: 66
(i) Promoting maternal mental health and maternal 67
substance use disorder treatments that are aligned with evidence 68
based practices for improving maternal mental health outcomes for 69
black women. 70
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(ii) Addressing social determinants of health for 71
women in the prenatal and postpartum periods, including, but not 72
limited to, any of the following: 73
1. Inadequate housing. 74
2. Transportation barriers. 75
3. Poor nutrition and a lack of access to 76
healthy foods. 77
4. Need for lactation support. 78
5. Need for lead abatement and other efforts 79
to improve air and water quality. 80
6. Lack of access to child care. 81
7. Need for baby supplies such as diapers, 82
formula, clothing, baby and child equipment, and safe car seat 83
installation. 84
8. Need for wellness and stress management 85
programs. 86
9. Education about maternal health and well 87
being. 88
10. Need for coordination across safety net 89
and social support services and programs. 90
11. Barriers to employment. 91
(iii) Promoting evidence based health literacy and 92
pregnancy, childbirth, and parenting education for women in the 93
prenatal and postpartum periods, including group based programs 94
and peer support groups. 95
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(iv) Providing individually tailored support from 96
doulas and other perinatal health workers to women from pregnancy 97
through the postpartum period. 98
(v) Providing culturally respectful congruent 99
training to perinatal health workers such as doulas, community 100
health workers, peer supporters, certified lactation consultants, 101
nutritionists and dietitians, social workers, home visitors, and 102
navigators. 103
(vi) Conducting or supporting research on issues 104
affecting black maternal health. 105
(vii) Developing other programs and resources that 106
address community specific needs for women in the prenatal and 107
postpartum periods and are aligned with evidence based practices 108
for improving maternal health outcomes for black women. 109
SECTION 6. Technical Assistance to Grant Recipients. The 110
department shall provide technical assistance to grant recipients 111
regarding all of the following: 112
(a) Capacity building to establish or expand programs 113
to prevent adverse maternal health outcomes among black women. 114
(b) Best practices in data collection, measurement, 115
evaluation, and reporting. 116
(c) Planning centered around sustaining programs 117
implemented with grant funds to prevent maternal mortality and 118
severe maternal morbidity among black women when the grant funds 119
have been expended. 120
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PART II. IMPLICIT BIAS IN HEALTH CARE 121
SECTION 7. Department to establish implicit bias training 122
program for health care professionals engaged in perinatal care. 123
(1) The following definitions apply in Part II: 124
(a) "Health care professional" means a licensed 125
physician or other health care provider licensed, registered, 126
accredited, or certified to perform perinatal care and regulated 127
under the authority of a health care professional licensing 128
authority. 129
(b) "Health care professional licensing authority" 130
means the State Department of Health or an agency, board, council, 131
or committee with the authority to impose training or education 132
requirements or licensure fees as a condition of practicing in 133
this state as a health care professional. 134
(c) "Implicit bias" means a bias in judgment or 135
behavior that results from subtle cognitive processes, including 136
implicit prejudice and implicit stereotypes, that often operate at 137
a level below conscious awareness and without intentional control. 138
(d) "Implicit prejudice" means prejudicial negative 139
feelings or beliefs about a group that a person holds without 140
being aware of them. 141
(e) "Implicit stereotypes" means the unconscious 142
attributions of particular qualities to a member of a certain 143
social group that are influenced by experience and based on 144
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learned associations between various qualities and social 145
categories, including race and gender. 146
(f) "Perinatal care" means the provision of care during 147
pregnancy, labor, delivery, and postpartum and neonatal periods. 148
(g) "Perinatal facility" means a hospital, clinic, or 149
birthing center that provides perinatal care in this state. 150
(2) The department, in collaboration with (a) community 151
based organizations led by black women that serve primarily black 152
birthing people and (b) a historically black college or university 153
or other institution that primarily serves minority populations, 154
shall create or identify an evidence based implicit bias training 155
program for health care professionals involved in perinatal care. 156
The implicit bias training program shall include, at a minimum, 157
all of the following components: 158
(i) Identification of previous or current unconscious 159
biases and misinformation. 160
(ii) Identification of personal, interpersonal, 161
institutional, structural, and cultural barriers to inclusion. 162
(iii) Corrective measures to decrease implicit bias at 163
the interpersonal and institutional levels, including ongoing 164
policies and practices for that purpose. 165
(iv) Information about the effects of implicit bias, 166
including, but not limited to, ongoing personal effects of racism 167
and the historical and contemporary exclusion and oppression of 168
minority communities. 169
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(v) Information about cultural identity across racial 170
or ethnic groups. 171
(vi) Information about how to communicate more 172
effectively across identities, including racial, ethnic, 173
religious, and gender identities. 174
(vii) Information about power dynamics and 175
organizational decision making. 176
(viii) Trauma informed care best practices and an 177
emphasis on shared decision making between providers and patients. 178
(ix) Information about health inequities within the 179
perinatal care field, including information on how implicit bias 180
impacts maternal and infant health outcomes. 181
(x) Perspectives of diverse, local constituency groups 182
and experts on particular racial, identity, cultural, and provider 183
community relations issues in the community. 184
(xi) Information about socioeconomic bias. 185
(xii) Information about reproductive justice. 186
(3) Notwithstanding any other provision of law to the 187
contrary, all health care professionals are required to complete 188
the implicit bias training program established under this section 189
as follows: 190
(a) Health care professionals who hold a current 191
license, registration, accreditation, or certification on December 192
31, 2026, shall complete the training program no later than 193
December 31, 2027. 194
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(b) Health care professionals issued an initial 195
license, registration, accreditation, or certification on or after 196
January 1, 2027, shall complete the training program no later than 197
one (1) year after the date of issuance. 198
A health care professional licensing authority shall not 199
renew the license, registration, accreditation, or certification 200
of a health care professional unless the health care professional 201
provides proof of completion of the training program established 202
under this section within the twenty four month period leading up 203
to the date of the renewal application. 204
(4) The department is encouraged to seek opportunities to 205
make the implicit bias training program established under this 206
section available to all health care professionals and to promote 207
its use among the following groups: 208
(a) All maternity care providers and any employees who 209
interact with pregnant and postpartum individuals in the provider 210
setting, including front desk employees, sonographers, schedulers, 211
health system employed lactation consultants, hospital or health 212
system administrators, security staff, and other employees. 213
(b) Undergraduate programs that funnel into health 214
professions schools. 215
(c) Providers of the Special Supplemental Nutrition 216
Program for Women, Infants, and Children (WIC) under Section 17 of 217
the Child Nutrition Act of 1966. 218
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(d) Obstetric emergency simulation trainings or related 219
trainings. 220
(e) Emergency department employees, emergency medical 221
technicians, and other specialized health care providers who 222
interact with pregnant and postpartum individuals. 223
(5) The department shall collect the following information 224
for the purpose of informing ongoing improvements to the implicit 225
bias training program: 226
(a) Data on the causes of maternal mortality. 227
(b) Rates of maternal mortality, including rates 228
distinguished by age, race, ethnicity, socioeconomic status, and 229
geographic location within this state. 230
(c) Other factors that the department deems relevant 231
for assessing and improving the implicit bias training program. 232
SECTION 8. Rights of perinatal care patients. (1) A 233
patient receiving care at a perinatal care facility, defined as a 234
hospital, clinic, or birthing center that provides perinatal care 235
in this state, has the following rights: 236
(i) To be informed of continuing health care 237
requirements following discharge. 238
(ii) To be informed that, if the patient so 239
authorizes, and to the extent permitted by law, the hospital or 240
health care facility may provide to a friend or family member 241
information about the patient's continuing health care 242
requirements following discharge. 243
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(iii) To actively participate in decisions 244
regarding the patient's medical care and the right to refuse 245
treatment. 246
(iv) To receive appropriate pain assessment and 247
treatment. 248
(v) To receive care and treatment free from 249
discrimination on the basis of age, race, ethnicity, color, 250
religion, ancestry, disability, medical condition, genetic 251
information, marital status, sex, gender identity, gender 252
expression, sexual orientation, socioeconomic status, citizenship, 253
nationality, immigration status, primary language, or language 254
proficiency. 255
(vi) To receive information on how to file a 256
complaint with the Division of Health Facilities Licensure of the 257
State Department of Health about any violation of these rights. 258
(2) Each perinatal care facility shall provide to each 259
perinatal care patient upon admission to the facility, or as soon 260
as reasonably practical following admission to the facility, a 261
written copy of the rights enumerated in subsection (1) of this 262
section. The facility may provide this information to the patient 263
by electronic means, and it may be provided with other notices 264
regarding patient rights." 265
PART III. SUPPORTING AND DIVERSIFYING LACTATION CONSULTANT 266
TRAINING PROGRAMS 267
SECTION 9. (1) The following definitions apply in Part III: 268
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(a) "Historically Black Colleges and Universities" or 269
"HBCUs" means institutions of higher education that were founded 270
to educate black citizens who were historically restricted from 271
attending predominantly white institutions of higher education. 272
(b) "Lactation consultants" means educators or 273
counselors trained in breast feeding or chest feeding practices, 274
lactation care, and lactation services. 275
(c) "Lactation services" means the clinical application 276
of scientific principles and a multidisciplinary body of evidence 277
for evaluation, problem identification, treatment, education, and 278
consultation to childbearing families regarding lactation care and 279
services. 280
(d) "Maternity care services" means health care related 281
to an individual's pregnancy, childbirth, or postpartum recovery. 282
(e) "Preceptor" means a person who is a certified 283
lactation consultant and meets the requirements of the 284
International Board of Lactation Consultant Examiners to supervise 285
lactation consultants in training during the training period. 286
SECTION 10. The State Department of Health shall provide 287
technical assistance to Jackson State University, Alcorn State 288
University, Mississippi Valley State University, Tougaloo College 289
and Rust College with respect to the following: 290
(a) Developing culturally appropriate training content 291
for the lactation consultant training programs funded by state 292
appropriations. 293
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(b) Recruiting persons from historically marginalized 294
populations to enroll in the lactation consultant training 295
programs offered at these universities and colleges. 296
(c) Recruiting historically underutilized providers to 297
serve as teachers and preceptors in the lactation consultant 298
training programs offered at these universities and colleges. 299
(d) Identifying rural and medically underserved areas 300
of the state experiencing a shortage of lactation consultants in 301
order to recruit program graduates to work in these areas. 302
PART IV. PERINATAL EDUCATION GRANT PROGRAM 303
SECTION 11. Definitions. The following definitions apply in 304
Part IV: 305
(a) "Department" means the State Department of Health. 306
(b) "Perinatal education program" means a program that 307
operates for the primary purpose of educating pregnant women and 308
their families about healthy pregnancy, preparation for labor and 309
birth, breast feeding, newborn care, or any combination of these. 310
SECTION 12. Establishment of Grant Program. The department 311
shall establish and administer a Perinatal Education Grant Program 312
to award competitive grants to eligible entities to establish or 313
expand perinatal education programs in rural, underserved, or low 314
wealth areas of the state. The department shall establish 315
eligibility requirements for program participation, which shall, 316
at a minimum, require that applicants be community-based 317
organizations that offer perinatal education and resources aligned 318
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with evidence based practices for improving maternal health 319
outcomes for black women. 320
SECTION 13. Outreach and Application Assistance. Beginning 321
September 1, 2027, the department shall (a) conduct outreach to 322
encourage eligible applicants to apply for grants under this 323
program and (b) provide application assistance to eligible 324
applicants on best practices for applying for grants under this 325
program. In conducting the outreach required by this section, the 326
department shall give special consideration to eligible applicants 327
that meet the following criteria: 328
(i) Are based in, and provide support for, 329
communities with high rates of adverse maternal health outcomes 330
and significant racial and ethnic disparities in maternal health 331
outcomes. 332
(ii) Are led by black women. 333
(iii) Offer programs and resources that are 334
aligned with evidence-based practices for improving maternal 335
health outcomes for black women. 336
SECTION 14. Grant Awards. In awarding grants under this 337
section, to the extent possible, the grant recipients shall 338
reflect different areas of the state. The department shall not 339
award a single grant for less than Ten Thousand Dollars 340
($10,000.00) or more than Fifty Thousand Dollars ($50,000.00) per 341
grant recipient. 342
PART V. MOMNIBUS INITIATIVE 343
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SECTION 15. The Legislature shall appropriate to the State 344
Department of Health the sum of Six Million Five Hundred Thousand 345
Dollars ($6,500,000.00) for each of the next two (2) fiscal years 346
to create a Momnibus Initiative. The purpose of the Momnibus 347
Initiative is to fund efforts to expand access to maternal and 348
infant health care and parenting programs, supports, and services 349
to families residing in geographic areas of the state where there 350
is limited or no access to maternity care services, including 351
obstetric providers, a hospital or birth center, prenatal care, or 352
postpartum care. As part of this initiative, the department shall 353
allocate and use the funds appropriated for the initiative to 354
award directed grants on a competitive basis to nonprofit, 355
community based, and faith based organizations that offer 356
programs, supports, and services aligned with evidence based 357
practices for a healthy pregnancy through the postpartum period, 358
infant health and care, and parenting programs, supports, and 359
services. The department shall establish an application process 360
and eligibility criteria for awarding the grants authorized under 361
this section. 362
PART VI. MEDICAID COVERAGE OF MATERNAL HEALTH SERVICES 363
SECTION 16. Depression screening for pregnant women. The 364
Mississippi Medicaid Program shall reimburse for depression 365
screening of a pregnant woman. The Division of Medicaid shall 366
apply for any federal waiver, Medicaid state plan amendments, or 367
other authority necessary to implement this section. 368
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SECTION 17. Coverage of prenatal, delivery, and postpartum 369
services. The Mississippi Medicaid Program shall reimburse for 370
prenatal, delivery, and postpartum services separately in lieu of 371
a global payment or an all inclusive payment methodology for 372
maternity services. Prenatal, delivery, and postpartum services 373
include, without limitation: 374
(a) Office visits; 375
(b) Laboratory fees; 376
(c) Physician ordered testing; 377
(d) Blood work; 378
(e) Remote monitoring; 379
(f) Fetal nonstress tests; and 380
(g) Continuous glucose monitors or other services for 381
gestational diabetes when medically necessary. 382
SECTION 18. Blood pressure monitoring for pregnant and 383
postpartum women. The Mississippi Medicaid Program shall provide 384
coverage and reimbursement for self measurement blood pressure 385
monitoring services for pregnant women and postpartum women. Self 386
measurement blood pressure monitoring services shall include: 387
(a) Validated blood pressure monitoring devices, such 388
as a blood pressure cuff and replacement cuffs, as medically 389
necessary, to diagnose or treat hypertension; 390
(b) Patient education and training on the setup and use 391
of a self measurement blood pressure measurement device that is 392
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validated for clinical accuracy, device calibration, and the 393
procedure for obtaining self measurement readings; and 394
(c) Collection of data reports by the patient or 395
caregiver for submission to a health care provider to communicate 396
blood pressure readings and create or modify treatment plans. 397
SECTION 19. Reimbursement for remote ultrasound procedures. 398
(1) The Mississippi Medicaid Program shall reimburse for 399
medically necessary remote ultrasound procedures utilizing 400
established Current Procedural Terminology (CPT) codes for remote 401
ultrasound procedures when the patient is in a residence or other 402
off site location from the health care provider of the patient and 403
the same standard of care is met. This subsection shall apply to 404
the fee for service categories of the program and the managed care 405
plan within the program. 406
(2) A remote ultrasound procedure shall be reimbursable when 407
the health care provider uses digital technology that: 408
(a) Collects medical and other forms of health data 409
from a patient and electronically transmits the information 410
securely to a health care provider in a different location for 411
interpretation and recommendation; 412
(b) Is compliant with the Health Insurance Portability 413
and Accountability Act of 1996, 42 USC Section 1320d et seq., as 414
it existed on July 1, 2026; and 415
(c) Is approved by the United States Food and Drug 416
Administration. 417
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SECTION 20. Coverage for certain services provided by 418
doulas. The Mississippi Medicaid Program shall reimburse doulas 419
for home visitation related to prenatal care and postpartum care. 420
SECTION 21. Implementation and rules. The Division of 421
Medicaid shall: 422
(a) Apply for any federal waiver, Medicaid state plan 423
amendments, or other authority necessary to implement this Part; 424
and 425
(b) Adopt rules as necessary to implement this Part. 426
PART VII COMPREHENSIVE AND EQUITABLE MATERNAL HEALTH CARE 427
SECTION 22. (1) As used in this section, the term: 428
(a) "Distant site" means a site at which an obstetric 429
provider is located while providing health care services by means 430
of telemedicine, which may include the home of such 431
obstetric provider. 432
(b) "Limited maternity care county" means a county in 433
this state that has fewer than two (2) hospitals or birth centers 434
offering obstetric care or fewer than sixty (60) obstetric 435
providers per ten thousand (10,000) births. 436
(c) "Maternity care desert" means a county in this 437
state that does not have a hospital or birth center offering 438
obstetric care or an obstetric provider. 439
(d) "Obstetric provider" means a licensed physician or 440
advanced practice registered nurse who is licensed to practice 441
obstetrics and gynecology in this state. 442
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(e) "Telemedicine" means the use of electronic 443
information and telecommunications technologies that include, at 444
minimum, audio and video equipment to enable two way, real-time 445
interactive communication between a patient and an obstetric 446
provider at a distant site, which services are compliant with 447
federal Health Insurance Portability and Accountability Act of 448
1996 (HIPAA) privacy, security, and breach notification rules. 449
Such term shall include audio-only, telephone communication only 450
when two-way, real-time audio-visual communication is unavailable 451
to or inaccessible by the patient or is infeasible, impractical, 452
or otherwise not medically advisable, as determined by the 453
obstetric provider providing telemedicine services to the patient. 454
(f) "Virtual prenatal care" means at home prenatal 455
health care for a pregnant woman provided by an obstetric provider 456
facilitated through the use of telemedicine and home monitoring 457
devices or other equipment, as deemed appropriate by such 458
obstetric provider. Such term includes consultations and 459
monitoring, including, but not limited to, monitoring for 460
conditions such as diabetes and hypertension; mental health 461
evaluations; nutritional evaluations; and guidance on personal 462
care. 463
(2) The State Department of Health shall develop, implement, 464
and conduct a three-year pilot program to provide virtual prenatal 465
care to pregnant women in limited maternity care counties and 466
maternity care deserts to improve birth outcomes and to decrease 467
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maternal morbidity and mortality. The pilot program shall begin 468
on July 1, 2027, and shall provide up to five (5) virtual prenatal 469
care visits for each eligible pregnant woman. Such eligibility 470
shall be established based on criteria, terms, and conditions as 471
determined by the department. 472
(3) This section shall be contingent upon appropriations 473
made by the Legislature specifically for the department for the 474
purposes set forth in this section. 475
SECTION 23. (1) For purposes of this section, the term: 476
(a) "Limited maternity care county" means a county in 477
this state that has fewer than two (2) hospitals or birth centers 478
offering obstetric care or fewer than sixty (60) obstetric 479
providers per ten thousand (10,0000) births. 480
(b) "Maternity care desert" means a county in this 481
state that does not have a hospital or birth center offering 482
obstetric care or an obstetric provider. 483
(c) "Obstetric provider" means a physician or advanced 484
practice registered nurse licensed to practice obstetrics and 485
gynecology in this state. 486
(d) "Postpartum care" means healthcare for a woman for 487
a period of one year following a birth, miscarriage, stillbirth, 488
or neonatal death. Such term includes physiological assessments, 489
mental health evaluations, nutritional evaluations, and guidance 490
on personal and newborn care. Such term includes at least four 491
(4) visits with an obstetric provider as follows: 492
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(i) An initial visit within twenty four (24) hours 493
of a birth, miscarriage, stillbirth, or neonatal death; 494
(ii) A follow-up visit within the first three (3) 495
weeks postpartum; 496
(iii) A follow-up visit within the first eight (8) 497
weeks postpartum; 498
(iv) A comprehensive visit no later than twelve 499
(12) weeks postpartum; and 500
(v) Intermediary and ongoing care as needed. 501
(2) The State Department of Health shall develop, implement, 502
and conduct a three year pilot program for the purpose of 503
providing postpartum care through mobile health clinics in limited 504
maternity care counties and maternity care deserts, beginning on 505
July 1, 2027. The department shall establish eligibility 506
criteria, terms, and conditions for such pilot program. 507
(3) This section shall be contingent upon appropriations 508
made by the Legislature specifically for the department for the 509
purposes set forth in this section. 510
SECTION 24. (1) As used in this section, the term: 511
(a) "Eligible participant" means a pregnant or 512
postpartum woman who meets the income eligibility guidelines set 513
forth by the Mississippi WIC (Women, Infants, and Children) 514
program, as of July 1, 2027. 515
(b) "Group prenatal care" means a structured class 516
designed for pregnant women provided in a supportive group setting 517
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and based on an evidence-based model that is focused on equipping 518
pregnant women with essential prenatal knowledge and skills, 519
including, but not limited to, labor and delivery preparation, 520
breastfeeding, lactation, and newborn care. 521
(c) "Group postpartum care" means a structured class 522
designed for postpartum women provided in a supportive group 523
setting focused on equipping such women with essential knowledge 524
and skills for the postpartum period, including, but not limited 525
to, physical recovery, nutrition, emotional well-being, maternal 526
mental health, newborn care, and lactation support. With respect 527
to postpartum women separated from their newborns due to child 528
welfare intervention or any other cause, such term includes 529
counseling sessions and any consultative sessions related to 530
providing reunification assistance. 531
(d) "Postpartum woman" means a woman up to twelve (12) 532
months after the end of a pregnancy. 533
(2) Subject to available funding, the State Department of 534
Health shall develop, implement, and conduct a program to provide 535
group prenatal care and group postpartum care to eligible 536
participants, whether in-person or online. Such program shall 537
begin on July 1, 2027, and shall provide up to five (5) group 538
prenatal care visits and up to five (5) group postpartum care 539
visits for each eligible participant at no cost to such 540
participant. 541
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(3) Any person providing group prenatal care or group 542
postpartum care under the program shall have completed the 543
appropriate training, as determined by the department. 544
SECTION 25. (1) As used in this section, the term: 545
(a) "Health care professional" means a physician or 546
other health care practitioner licensed, accredited, or certified 547
to perform specified physical, mental, or behavioral health care 548
services consistent with his or her scope of practice under the 549
laws of this state. 550
(b) "Implicit bias" means a bias in judgment or 551
behavior that results from subtle cognitive processes, including 552
implicit prejudice and implicit stereotypes that often operate at 553
a level below conscious awareness and without intentional control. 554
(c) "Implicit prejudice" means prejudicial negative 555
feelings or beliefs about a group that a person holds without 556
being aware of them. 557
(d) "Implicit stereotypes" means the unconscious 558
attributions of particular qualities to a member of a certain 559
social group. Implicit stereotypes are influenced by experience 560
and are based on learned associations between various qualities 561
and social categories, including race or gender. 562
(e) "Perinatal care" means the provision of care during 563
pregnancy, labor, delivery, and postpartum and neonatal periods. 564
(f) "Perinatal facility" means a hospital, clinic, or 565
birthing center that provides perinatal care. 566
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(g) "Pregnancy related death" means the death of a 567
woman while pregnant or within three hundred sixty five (365) days 568
of the end of a pregnancy, irrespective of the duration or site of 569
the pregnancy, from any cause related to, or aggravated by, the 570
pregnancy or its management, but not from accidental or incidental 571
causes. 572
(2) Every perinatal facility in this state shall implement 573
an evidence-based implicit bias program for all health care 574
professionals involved in the perinatal care of patients within 575
such facility. 576
(3) An implicit bias program implemented pursuant to 577
subsection (b) of this section shall include: 578
(a) Identification of previous or current unconscious 579
biases and misinformation; 580
(b) Identification of personal, interpersonal, 581
institutional, structural, and cultural barriers to inclusion; 582
(c) Corrective measures to decrease implicit bias at 583
the interpersonal and institutional levels, including ongoing 584
policies and practices for that purpose; 585
(d) Information on the effects, including, but not 586
limited to, ongoing personal effects, of historical and 587
contemporary exclusion and oppression of minority communities; 588
(e) Information about cultural identity across racial 589
or ethnic groups; 590
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(f) Information relative to communicating more 591
effectively across identities, including racial, ethnic, 592
religious, and gender identities; 593
(g) Discussion on power dynamics and organizational 594
decision making; 595
(h) Discussion on health inequities within the 596
perinatal care field, including information on how implicit bias 597
impacts maternal and infant health outcomes; 598
(i) Perspectives of diverse, local constituency groups 599
and experts on particular racial, identity, cultural, and 600
provider-community relations issues in the community; and 601
(j) Information on reproductive justice. 602
(4) (a) A health care professional shall complete initial 603
basic training through the implicit bias program based on the 604
components described in subsection (3) of this section. 605
(b) Upon completion of the initial basic training, a 606
health care professional shall complete a refresher course under 607
the implicit bias program every two years thereafter, or on a more 608
frequent basis if deemed necessary by the perinatal facility, in 609
order to keep current with changing racial, identity, and cultural 610
trends and best practices in decreasing interpersonal and 611
institutional implicit bias. 612
(5) Each perinatal facility in this state shall provide a 613
certificate of training completion to another perinatal facility 614
or a training attendee upon request. A perinatal facility may 615
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accept a certificate of completion from another perinatal facility 616
to satisfy the training requirement provided for in this section 617
from a health care professional who works in more than one (1) 618
perinatal facility. 619
(6) If a health care professional involved in the perinatal 620
care of patients is not directly employed by a perinatal facility, 621
the facility shall offer the training to such health care 622
professional. 623
SECTION 26. (1) As used in this section, the term "maternal 624
near miss" means a woman who survived a near death complication 625
occurring during a pregnancy, during childbirth, or within 626
forty-two (42) days of the end of a pregnancy. 627
(2) The State Department of Health shall create a 628
comprehensive public awareness campaign targeting women located in 629
rural and underserved communities to increase awareness about 630
maternal health by developing and making available on the 631
department's website educational materials and support resources. 632
Such materials and resources shall include, but shall not be 633
limited to: 634
(a) Information on prenatal care, including, but not 635
limited to, nutrition, the importance of prenatal care visits, 636
what to expect during such visits, and key prenatal screenings; 637
(b) Information on common causes of maternal 638
near-misses and strategies to reduce the risk of severe maternal 639
morbidity; 640
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(c) Information on postpartum care, including, but not 641
limited to, nutrition, physical recovery, and newborn care; and 642
(d) A geographically indexed guide on government 643
funded, free, and low-cost services available to support pregnant 644
and postpartum women, including, but not limited to, health care 645
services, educational classes and peer support groups for prenatal 646
and postpartum care, mental health counseling services, 647
transportation assistance programs, and food assistance programs 648
which shall include a description of the services offered and 649
contact information. 650
(3) The department shall maintain a comprehensive webpage on 651
its website dedicated to maternal health that includes all 652
educational materials and support resources identified or 653
created pursuant to this section. 654
SECTION 27. As used in Sections 27 through 30 of this act, 655
the term: 656
(a) "Advisory committee" or "committee" means the 657
Regional Perinatal Center Advisory Committee established pursuant 658
to Section 28 of this act. 659
(b) "Regional perinatal center" means a specially 660
qualified hospital identified by the State Department of Health 661
and designated to a specific geographic region to lead 662
collaboration between hospitals and providers to increase the 663
likelihood that deliveries are performed in a hospital with an 664
appropriate level of care for mothers and infants. 665
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SECTION 28. (1) There is established the Regional Perinatal 666
Center Advisory Committee for the purpose of considering and 667
making recommendations to the State Department of Health 668
concerning the addition, reduction, or transition of regional 669
perinatal centers in this state. The committee shall advise the 670
commissioner on the estimated costs to the department necessary to 671
implement such recommendations. 672
(2) The Regional Perinatal Center Advisory Committee shall 673
be composed of not less than eleven (11) nor more than twenty one 674
(21) members to be appointed by the State Health Officer, who 675
shall appoint one (1) of such members to serve as chairperson. 676
All appointments to the committee shall be for a term of four (4) 677
years. A member shall serve until his or her successor has been 678
duly appointed. The State Health Officer may reappoint any 679
member. 680
(3) The advisory committee shall meet upon the call of the 681
chairperson. 682
(4) Beginning on July 1, 2027, and every four (4) years 683
thereafter, the advisory committee shall assess and make 684
recommendations to the State Health Officer on the adequacy of the 685
regional perinatal system and consider hospital or labor and 686
delivery closures. Such assessment shall evaluate whether: 687
(a) Perinatal facilities in each region are equipped 688
and prepared to stabilize infants and mothers before transport; 689
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(b) Coordination exists between maternity care in each 690
region and regional perinatal centers; 691
(c) All identified high risk pregnancies and deliveries 692
are promptly evaluated in consultation with regional perinatal 693
centers and referred to the appropriate designated regional 694
perinatal center for the proper management and treatment of such 695
conditions as needed; 696
(d) An adequate transport system is available in the 697
region for the transfer of high risk mothers and infants and 698
specifically considers: 699
(i) The distance and travel time between referring 700
hospitals and regional perinatal centers; 701
(ii) The types of vehicles used for transport and 702
whether a need exists for additional vehicles; and 703
(iii) The need for upgraded vehicles and transport 704
equipment; and 705
(e) Each regional perinatal center provides: 706
(i) Consultation for patients requiring special 707
services, including transport; 708
(ii) Coordination and assurance of follow up 709
medical care for maternal and neonatal patients requiring special 710
services; 711
(iii) Educational support to ensure quality care 712
in institutions involved in perinatal health care in the region; 713
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(iv) An annual education plan with all birthing 714
centers in the region; 715
(v) Compilation and analysis of perinatal data 716
from the center and referring hospitals; and 717
(vi) Coordination of perinatal health services 718
within the region. 719
SECTION 29. To be designated as a regional perinatal center 720
a hospital shall notify the State Department of Health of the 721
following: 722
(a) Such hospital's ability to meet the standards for 723
regional perinatal centers; 724
(b) Any additional funding necessary to bring such 725
hospital up to the standards for regional perinatal centers; 726
(c) Any special planning problems in such hospital's 727
perinatal region, including, but not 728
limited to, transportation, shortage of facilities, and personnel; 729
(d) A description of perinatal care currently being 730
provided; 731
(e) A description of services that can be provided by 732
the center in patient care, education, and consultation to 733
hospitals within the perinatal region; and 734
(f) Any other information requested by the department. 735
SECTION 30. Beginning on July 1, 2027, and every four (4) 736
years thereafter, the State Department of Health shall present to 737
the Governor, the Lieutenant Governor and the Speaker of the House 738
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of Representatives a plan for the designated perinatal centers in 739
every region of the state. Such plan shall include funding 740
considerations to aid hospitals in meeting the standards and for 741
continuing requirements, including, but not limited to, patient 742
care, professional education, training programs, and physical 743
facilities. 744
SECTION 31. (1) As used in this section, the term: 745
(a) "Maternal mental health screening" means the use of 746
an independent, evidence-based screening instrument that is in 747
accordance with nationally recognized clinical practice guidelines 748
developed by independent organizations or medical professional 749
societies using a transparent methodology and reporting structure 750
and with a conflict of interest policy. Such guidelines establish 751
standards of care informed by a systematic review of evidence and 752
an assessment of the benefits and risks of alternative care 753
options and include recommendations intended to optimize patient 754
care. 755
(b) "Mental health care provider" means any person 756
licensed under Title 73, Mississippi Code of 1972, to provide 757
prenatal, labor and delivery, or postpartum care, including 758
without limitation physicians, psychiatrists, psychologists, 759
advanced practice registered nurses, physician assistants, 760
licensed clinical social workers, and licensed professional 761
counselors and marriage and family therapists. 762
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(c) "Telehealth services" means services provided via 763
two way, real time interactive communication between a patient and 764
a mental healthcare provider at a distant site through 765
telecommunications equipment, which services are compliant with 766
federal Health Insurance Portability and Accountability Act of 767
1996 (HIPAA) privacy, security, and breach notification rules. 768
(2) Each health benefit policy issued, delivered, or renewed 769
in this state shall provide coverage for medically necessary: 770
(a) Maternal mental health screening during the 771
prenatal period and twelve (12) months postpartum; and 772
(b) Care and treatment for those screenings positive 773
for maternal mental health conditions. 774
(3) All services provided for in this section shall be 775
covered whether provided in person or through telehealth services. 776
(4) The provisions of this section shall apply to all 777
policies, contracts, and certificates executed, delivered, issued 778
for delivery, continued, or renewed in this state on or after July 779
1, 2027. 780
SECTION 32. (1) Except in cases where the woman refuses a 781
maternal mental health screening, a pregnant or postpartum woman 782
seeking health care from a physician or other health care provider 783
shall be screened for perinatal mood and anxiety disorders, as 784
determined necessary: 785
(a) At the pregnant woman's first prenatal visit; 786
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(b) When the pregnant woman is from twenty-eight (28) 787
through thirty-two (32) weeks gestation; 788
(c) Between delivery and discharge from the facility 789
where the pregnant woman gives birth; 790
(d) At the woman's six week postpartum obstetrical 791
visit; 792
(e) If there is a pregnancy loss and at the follow up 793
obstetric visit after such loss; and 794
(f) At a pediatric visit occurring when the infant is 795
three (3) months of age or, if there is no such visit, at the 796
postpartum woman's health care visit any time from three (3) 797
months to one (1) year after pregnancy loss or delivery. 798
(2) The right to refuse the mental health screening 799
described in subsection (1) of this section shall not exist for a 800
patient determined by the physician or other health care provider 801
to be mentally incompetent. 802
(3) (a) The maternal mental health screening provided for 803
in subsection (1) of this section shall be conducted by the 804
physician or other health care provider who is providing prenatal, 805
obstetric, or postpartum care of the pregnant woman or pediatric 806
care of the woman's infant, as deemed necessary by such physician 807
or health care provider. Each such screening shall use 808
questionnaires that conform with nationally recognized clinical 809
practice guidelines and shall be used for the purposes of 810
diagnosis, treatment, appropriate management, or ongoing 811
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monitoring of a woman's mental health, well being, disease, or 812
condition as supported by medical and scientific evidence. 813
(b) Additional maternal mental health screenings, which 814
may be refused, may be conducted at any other point during the 815
pregnancy or the postpartum period as deemed necessary by the 816
physician or other healthcare provider. Appropriate referral 817
information and resources addressing perinatal mood or anxiety 818
disorders shall be provided during such screenings. 819
(4) A physician or other health care provider who provides 820
obstetric or pediatric care shall provide educational materials 821
through electronic or other means on the signs and symptoms of 822
perinatal mood and anxiety disorders to pregnant and postpartum 823
women under his or her care, or to mothers of children under his 824
or her care, as deemed necessary by such physician or health care 825
provider. 826
(5) The provisions of this section shall not preclude any 827
other health care provider acting within his or her scope of 828
practice from screening for maternal mental health conditions or 829
from providing referral information and resources or educational 830
materials on perinatal mood and anxiety disorders. 831
(6) Relative to maternal mental health screenings, the 832
department shall establish a comprehensive quality metrics program 833
that includes: 834
(a) Process measures, including, but not limited to: 835
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(i) Percentage of eligible patients screened at 836
each required interval; 837
(ii) Time from positive screen to first behavioral 838
health contact; 839
(iii) Completion rates for referrals to behavioral 840
health services; and 841
(iv) Utilization rates of telehealth services; 842
(b) Outcome measures, including, but not limited to: 843
(i) Rates of postpartum depression and anxiety 844
identification; 845
(ii) Emergency department utilization for mental 846
health concerns; 847
(iii) Psychiatric hospitalization rates; and 848
(iv) Duration of treatment engagement; 849
(c) Equity measures, including, but not limited to: 850
(i) Screening and treatment rates stratified by 851
race, ethnicity, and geographic location; 852
and 853
(ii) Disparities in access to care and outcomes; 854
and 855
(d) Patient experience measures, including, but not 856
limited to: 857
(i) Satisfaction with screening process; 858
(ii) Perceived barriers to care; and 859
(iii) Experiences with telehealth services. 860
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(7) No later than July 1, 2027, the State Department of 861
Health shall establish a three-year pilot program for remote 862
maternal mental health screening and monitoring. Such program 863
shall: 864
(a) Prioritize high risk populations and rural 865
communities; 866
(b) Include telehealth services; 867
(c) Integrate with existing maternal health programs, 868
including home visiting services; and 869
(d) Collect data on program effectiveness and barriers 870
to care. 871
(8) The department may allocate sufficient funds for the 872
pilot program provided for in subsection (7) of this section to 873
support: 874
(a) Technology infrastructure and support; 875
(b) Provider training and technical assistance; and 876
(c) Program evaluation and reporting. 877
(9) The department shall: 878
(a) Promulgate rules and regulations necessary to 879
implement this section; and 880
(b) Establish a process for monitoring compliance. 881
(10) To implement the provisions of this section, the 882
Division of Medicaid shall, when necessary, submit a Medicaid 883
state plan amendment or waiver request to the United States 884
Department of Health and Human Services. 885
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SECTION 33. (1) It is the intent of the Legislature to 886
advance maternal health outcomes by recognizing doula care as part 887
of the maternal health care workforce. Doula care has been 888
associated with Medicaid cost savings of around One Thousand 889
Dollars ($1,000.00) per birth, a decreased likelihood of cesarean 890
delivery, a reduced need for an epidural during labor, lower 891
preterm birth rates, improved rates of breastfeeding, shorter 892
births, reduced rates of perinatal mood and anxiety disorders, 893
increased positive feelings about the birth experience, and 894
feelings of empowerment about individual pregnancy outcomes. 895
(2) As used in this section, the term "doula" means a 896
professional who provides physical, emotional, and informational 897
support to clients before, during, and after childbirth to help 898
them achieve a healthy and satisfying birth experience and who has 899
completed the appropriate training, as determined by the State 900
Department of Health. 901
(3) The Division of Medicaid shall develop, implement, and 902
conduct a one-year pilot program to provide Medicaid coverage for 903
doula care for pregnant Medicaid recipients. Beginning on July 1, 904
2027, such pilot program may provide reimbursement for up to five 905
(5) doula visits for each pregnant Medicaid recipient, which may 906
include visits for prepartum care, labor and delivery, and 907
postpartum care. 908
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(4) This section shall be contingent upon appropriations 909
made by the Legislature specifically for the purposes set forth in 910
this section. 911
PART VIII. SOCIAL DETERMINANTS IN MATERNAL HEALTH 912
SECTION 34. The State Department of Health, shall, to the 913
extent that state funds are available for such purpose, expand the 914
Mississippi WIC (Women, Infants, and Children) program, 915
established in accordance with Section 17 of the Child Nutrition 916
Act of 1966, 42 USC Section 1786, to cover children who have had 917
their fifth birthday but have not yet attained their sixth 918
birthday. 919
SECTION 35. As used in Sections 35 through 38 of this act, 920
the term: 921
(a) "Early childhood services program" means a program 922
that offers services designed to support the development and well 923
being of infants and toddlers, including, but not limited to, 924
early intervention, early learning, child care, or parenting 925
education. 926
(b) "Early intervention" means services and support for 927
infants and toddlers with developmental delays, chronic health 928
conditions, and disabilities and their families. Such term 929
includes early identification and screening of infants and 930
toddlers for such developmental delays, conditions, and 931
disabilities. 932
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(c) "Eligible program" means an early childhood 933
services program or an essential support services program. 934
(d) "Essential support services program" means a 935
program that offers housing assistance, food assistance, or 936
nonemergency medical transportation services to pregnant and 937
postpartum women in this state. 938
(e) "Grant program" means the Supporting Healthy Moms 939
Grant Program established pursuant to Section 36 of this act. 940
(f) "Infant" or "toddler" means a child under three (3) 941
years of age. 942
(g) "Parenting education" means courses designed for 943
parents of infants and toddlers to enhance parenting skills and 944
knowledge taught by educators possessing the appropriate 945
qualifications, certifications, experience, as determined by the 946
department. 947
(h) "Postpartum woman" means a woman up to one (1) year 948
after the end of pregnancy. 949
(i) "Qualified sponsor" means a nonprofit organization 950
incorporated in this state with a tax exempt status pursuant to 951
Section 501(c)(3) of the Internal Revenue Code of 1986; 952
or governmental sponsor of a program that meets the conditions of 953
this section. 954
SECTION 36. (1) Subject to available funding, the State 955
Department of Health shall establish the Supporting Healthy Moms 956
Grant Program to provide grant funding, on an annual basis, to 957
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qualified sponsors of eligible programs in this state that provide 958
services focused on advancing and addressing social determinants 959
of maternal health and that provide early childhood services. 960
(2) The department shall oversee the grant program and is 961
authorized to contract with an external organization to implement 962
and administer such grant program. 963
SECTION 37. To be considered for a grant under the grant 964
program, a qualified organization shall: 965
(a) Have a primary mission of advancing maternal 966
health, addressing social determinants of maternal health, or 967
providing early childhood services; 968
(b) Have a system of financial accountability 969
consistent with generally accepted accounting principles, 970
including an annual budget; 971
(c) With respect to a nonprofit organization, have a 972
board that hires and supervises a director who manages the 973
organization's operations; 974
(d) Have provided services under an eligible program 975
for a minimum of one (1) year; 976
(e) Provide free services under an eligible program; 977
and 978
(f) Maintain confidentiality of all data, files, and 979
records of clients related to the services provided and in 980
compliance with state and federal laws. 981
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SECTION 38. (1) The department shall approve each grant or 982
expenditure of money from the grant program. 983
(2) The department's decision on the granting of funds from 984
the grant program to qualified sponsors shall be based on a 985
competitive selection process. 986
(3) The grant program may be used for expenditures related 987
to the routine administration of the program; however, in any 988
given year, expenditures for the routine administration of the 989
grant program may not exceed ten percent (10%) of the total amount 990
of money available in the grant fund. 991
SECTION 39. As used in Sections 39 through 43 of this act, 992
the term: 993
(a) "Employer" means any person or entity that employs 994
one or more employees and includes the state and its political 995
subdivisions. 996
(b) "Pregnancy" means medical needs arising from 997
pregnancy, childbirth, or related conditions, including, but not 998
limited to, lactation. 999
(c) "Reasonable accommodations" includes, but is not 1000
limited to, more frequent or longer breaks, time off to recover 1001
from childbirth, acquisition or modification of equipment, 1002
seating, temporary transfer to a less strenuous or hazardous 1003
position, job restructuring, light duty, break time and private 1004
nonbathroom space for expressing breast milk, assistance with 1005
manual labor, or modified work schedules. 1006
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(d) "Undue hardship" means an action requiring 1007
significant difficulty or expense, when considered in light of the 1008
factors set forth in Section 42 of this act. 1009
SECTION 40. (1) It shall constitute an unfair employment 1010
practice for an employer, unless such employer 1011
can demonstrate that an undue hardship on such employer's program, 1012
enterprise, or business would result, to: 1013
(a) Fail or refuse to make a reasonable accommodation 1014
to a job applicant or employee for circumstances related to 1015
pregnancy, if such job applicant or employee so requests; 1016
(b) Take adverse action against a job applicant or an 1017
employee who requests or uses an accommodation; 1018
(c) Deny employment opportunities to a job applicant or 1019
employee, if such denial is based on the need of the employer to 1020
make reasonable accommodations to such job applicant or employee 1021
for circumstances related to pregnancy; 1022
(d) Require a job applicant or employee affected by 1023
pregnancy to accept an accommodation that such job applicant or 1024
employee chooses not to accept; 1025
(e) Require an employee to take leave if another 1026
reasonable accommodation can be provided to such employee for 1027
circumstances related to pregnancy; 1028
(f) Count an absence related to pregnancy against an 1029
employee under a no fault attendance policy; or 1030
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(g) Fail to reinstate such employee to such employee's 1031
original job or to an equivalent position with equivalent pay and 1032
accumulated seniority, retirement, fringe benefits, and 1033
other applicable service credits when such employee's need for 1034
reasonable accommodations ceases. 1035
(2) The employer shall in good faith engage in a timely and 1036
interactive process with the job applicant or employee to 1037
determine effective reasonable accommodations. 1038
(3) (a) An employer shall provide written notice of the 1039
right to be free from discrimination in relation to pregnancy to: 1040
(i) New employees at the commencement of 1041
employment; 1042
(ii) Existing employees within one hundred twenty 1043
(120) days after the effective date of this act; and 1044
(iii) Any employee who notifies such employer of 1045
her pregnancy within ten days of such notification. 1046
(b) Such notice shall be conspicuously posted at an 1047
employer's place of business in an area accessible to employees 1048
and shall be available in English and other languages commonly 1049
spoken in such employer's place of business. 1050
SECTION 41. The employer shall have the burden of proving 1051
undue hardship. In making a determination of undue hardship, the 1052
factors that may be considered include, but shall not be limited 1053
to: 1054
(a) The nature and cost of the accommodation; 1055
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(b) The overall financial resources of the employer, 1056
the overall size of the business of the employer with respect to 1057
the number of employees, and the number, type, and location of its 1058
facilities; and 1059
(c) The effect on expenses and resources or the impact 1060
otherwise of such accommodation upon the operation of the 1061
employer. 1062
SECTION 42. (1) Any individual who is aggrieved by an 1063
unfair employment practice against such individual in violation of 1064
Sections 39 through 43 of this act may institute a civil action 1065
against the persons engaged in such prohibited conduct. Such 1066
action may be maintained in any court of competent jurisdiction 1067
and shall be commenced no later than one (1) year after the 1068
alleged prohibited conduct occurred. 1069
(2) The court may grant as relief, as it deems appropriate, 1070
any permanent or temporary injunction, temporary restraining 1071
order, or other order, including, but not limited to, the hiring 1072
or reinstatement of the plaintiff to such individual's original 1073
position or an equivalent position. The court may award to the 1074
plaintiff back pay. The court may award court costs and 1075
reasonable attorney's fees to the prevailing party. 1076
SECTION 43. Sections 39 through 43 of this act shall not be 1077
construed to preempt, limit, diminish, or otherwise affect any 1078
other provision of law relating to sex discrimination or pregnancy 1079
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or in any way to diminish the coverage for pregnancy under any 1080
other provision of this title. 1081
PART IX. MATERNAL HEALTH DATA COLLECTION, RESEARCH, AND 1082
INNOVATION 1083
SECTION 44. (1) There is established within the State 1084
Department of Health a Severe Maternal Morbidity Review Committee 1085
to collect and track data on severe maternal morbidity and study 1086
and make recommendations on strategies to reduce severe maternal 1087
morbidity. The committee shall be multidisciplinary and composed 1088
of members as deemed appropriate by the department. The committee 1089
may contract with an external organization to assist in 1090
collecting, analyzing, and disseminating severe maternal morbidity 1091
information, organizing and convening meetings of the committee, 1092
and conducting other tasks as may be incident to these activities. 1093
(2) The committee shall, in coordination with the Maternal 1094
Mortality Review Committee: 1095
(a) Collect and track medical records and other 1096
relevant data on severe maternal morbidity, including, but not 1097
limited to, all of the following health conditions: 1098
(i) Obstetric hemorrhage; 1099
(ii) Hypertension; 1100
(iii) Preeclampsia and eclampsia; 1101
(iv) Venous thromboembolism; 1102
(v) Sepsis; 1103
(vi) Cerebrovascular accident; and 1104
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(vii) Amniotic fluid embolism; 1105
(b) Collect and track data on pregnancy related deaths, 1106
including, but not limited to, deaths relative to the conditions 1107
provided in subparagraphs (A) through (G) of paragraph (1) of this 1108
subsection, indirect obstetric deaths, and other maternal 1109
disorders predominantly related to pregnancy and complications 1110
predominantly related to the postpartum period; 1111
(c) Consult with relevant experts to evaluate collected 1112
records and data; 1113
(d) Develop and make recommendations regarding reducing 1114
severe maternal morbidity; 1115
(e) Disseminate findings and recommendations regarding 1116
reducing severe maternal morbidity; and 1117
(f) Not later than July 1, 2027, complete a study on: 1118
(i) Reducing severe maternal morbidity, including, 1119
but not limited to, all of the health conditions set forth in 1120
subparagraphs (i) through (vii) of paragraph (a) of this 1121
subsection; and 1122
(ii) Identifying more effective methods for the 1123
early detection of, and interventions for, other pregnancy related 1124
medical conditions that can lead to an increased risk of severe 1125
maternal morbidity, including, but not limited, to hyperemesis 1126
gravidarum. 1127
(3) (a) Health care providers licensed pursuant to Title 1128
73, Mississippi Code of 1972, and health care facilities licensed 1129
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pursuant to Title 41, Mississippi Code of 1972, shall provide 1130
reasonable access to the committee to all relevant medical records 1131
associated with a case under review by the committee within thirty 1132
(30) days of receiving a request for such records. 1133
(b) A health care provider or health care facility 1134
providing access to medical records pursuant to this section shall 1135
not be held liable for civil damages or be subject to any criminal 1136
or disciplinary action for good faith efforts in providing such 1137
records. 1138
(4) (a) Information, records, reports, statements, notes, 1139
memoranda, or other data collected pursuant to this section shall 1140
not be admissible as evidence in any action of any kind in any 1141
court or before any other tribunal, board, agency, or person. 1142
Such information, records, reports, statements, notes, memoranda, 1143
or other data shall not be exhibited nor their contents disclosed 1144
in any way, in whole or in part, by any officer or representative 1145
of the department or any other person, except as may be necessary 1146
for the purpose of furthering the review of the committee of the 1147
case to which it relates. No person participating in such review 1148
shall disclose, in any manner, the information so obtained except 1149
in strict conformity with such review. 1150
(b) All information, records, reports, statements, 1151
notes, memoranda, or other data obtained by the department, the 1152
committee, and other persons, agencies, or organizations so 1153
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authorized by the department pursuant to this section shall be 1154
confidential. 1155
(5) (a) All proceedings and activities of the committee 1156
under this section, opinions of members of such committee formed 1157
as a result of such proceedings and activities, and records 1158
obtained, created, or maintained pursuant to this section, 1159
including information, records, reports, statements, notes, 1160
memoranda, or other data procured by the department or any other 1161
person, agency, or organization acting jointly or under contract 1162
with the department in connection with the requirements of this 1163
section, shall be confidential and shall not be subject to Section 1164
25-41-1 et seq., relating to open meetings, or Section 25-61-1 et 1165
seq., relating to open records, or subject to subpoena, discovery, 1166
or introduction into evidence in any civil or criminal proceeding; 1167
however, nothing in this section shall be construed to limit or 1168
restrict the right to discover or use in any civil or criminal 1169
proceeding anything that is available from another source and 1170
entirely independent of the committee's proceedings. 1171
(b) Members of the committee shall not be questioned in 1172
any civil or criminal proceeding regarding the information 1173
presented in or opinions formed as a result of a meeting or 1174
communication of the committee; however, nothing in this section 1175
shall be construed to prevent a member of the committee from 1176
testifying to information obtained independently of the committee 1177
or which is public information. 1178
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(6) The data on severe maternal morbidity and on pregnancy 1179
related deaths collected pursuant to paragraphs (a) and (b) of 1180
subsection (2) of this section shall be compiled on a regular 1181
basis for distribution. 1182
PART X. COVERAGE FOR BLOOD PRESSURE MONITORS 1183
SECTION 45. (1) As used in this section, the following 1184
words and phrases shall be defined as provided in this subsection 1185
unless the context clearly indicates otherwise: 1186
(a) "Enrollee" means an individual entitled to receive 1187
health care services under a government program. 1188
(b) "Government program" means a program of government 1189
sponsored or government subsidized health care coverage. 1190
(c) "Postpartum" means within one (1) year of delivery 1191
or the end of pregnancy. 1192
(2) A government program shall provide coverage for 1193
medically necessary home blood pressure monitors that have been 1194
validated for clinical accuracy for pregnant or postpartum 1195
enrollees not more frequently than once every two (2) years. 1196
SECTION 46. (1) As used in this section: 1197
(a) "Health insurance policy" means a policy, 1198
subscriber contract, certificate or plan issued by a health 1199
insurer that provides medical or health care coverage. The term 1200
does not include any of the following: 1201
(i) An accident only policy. 1202
(ii) A credit only policy. 1203
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(iii) A long term care or disability income 1204
policy. 1205
(iv) A specified disease policy. 1206
(v) A Medicare supplement policy. 1207
(vi) A fixed indemnity policy. 1208
(vii) A hospital indemnity policy. 1209
(viii) A dental only policy. 1210
(ix) A vision only policy. 1211
(x) A workers' compensation policy. 1212
(xi) An automobile medical payment policy. 1213
(xii) A policy under which benefits are provided 1214
by the Federal Government to active or former military personnel 1215
and their dependents. 1216
(xiii) Any other similar policy providing for 1217
limited benefits. 1218
(b) "Insurer" means an entity licensed by the 1219
Department of Insurance that offers, issues or renews an 1220
individual or group health insurance policy. 1221
(c) "Postpartum" means within one (1) year of delivery 1222
or the end of pregnancy. 1223
(2) A health insurance policy that is offered, issued or 1224
renewed in this state on or after the effective date of this act 1225
shall provide coverage, including reimbursement, for medically 1226
necessary blood pressure monitors for pregnant or postpartum 1227
insureds for each pregnancy. 1228
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PART XI. DOULA CERTIFICATION 1229
SECTION 47. (1) The State Department of Health, in 1230
collaboration with the Division of Medicaid, shall conduct a study 1231
on certification of doulas that meet the requirements in 1232
subsection (2) of this section, including, but not limited to, 1233
establishment of a doula registry and reimbursement models for 1234
doula services, including Medicaid coverage. The department shall 1235
provide a report on the study, including its recommendations for 1236
legislation, not later than December 31, 2026. 1237
(2) To be certified as a doula, a person must have: 1238
(a) Received a certification to perform doula services 1239
from the Childbirth Education Association, the Doulas of North 1240
America (DONA), the Association of Labor Assistants and Childbirth 1241
Educators (ALACE), Birthworks International, the Childbirth and 1242
Postpartum Professional Association (CAPPA), Childbirth 1243
International, the International Center for Traditional 1244
Childbearing, or Commonsense Childbirth, Inc.; or 1245
(b) Demonstrated: 1246
(i) An understanding of basic anatomy and 1247
physiology as related to pregnancy, the childbearing process, 1248
breastfeeding or chestfeeding, and the postpartum period; 1249
(ii) The capacity to employ different strategies 1250
for providing emotional support, education, and resources during 1251
the perinatal period; 1252
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(iii) Knowledge of and the ability to assist 1253
families with using a wide variety of nonclinical labor coping and 1254
physical comfort strategies; 1255
(iv) An awareness of strategies to foster 1256
effective communication between clients, their families, support 1257
services, and healthcare providers; and 1258
(v) Knowledge of community based, publicly funded 1259
and federally funded, and clinical resources available to the 1260
client for any need outside the doula's scope of practice; 1261
(3) As used in this section, "doula services" means services 1262
that provide continuous emotional and physical support throughout 1263
labor and birth, and intermittently during the prenatal and 1264
postpartum periods. 1265
PART XII. NUTRITION COUNSELING SERVICES 1266
SECTION 48. Definitions. As used in Part XII, the following 1267
terms have the meanings as defined in this section: 1268
(a) "Department" means the State Department of Health. 1269
(b) "Division" means the Division of Medicaid. 1270
(c) "Health care provider" means a physician, nurse 1271
practitioner, certified nurse midwife, physician assistant, 1272
registered dietitian, nutritionist, or other licensed provider 1273
authorized to provide prenatal, perinatal, or postpartum care 1274
under Mississippi law. 1275
(d) "Nutrition counseling" means individualized, health 1276
literacy–appropriate education and planning provided in person, 1277
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virtually, or telephonically by a qualified provider that includes 1278
assessment of dietary intake, nutritional risk, goal setting, and 1279
culturally appropriate guidance to support optimal maternal 1280
dietary practices. 1281
(e) "Maternal care period" means the period from the 1282
date of pregnancy confirmation to twelve (12) months postpartum. 1283
SECTION 49. Integration of Nutrition Counseling into 1284
Maternal Care. (1) All health care providers delivering maternal 1285
care in Mississippi shall incorporate nutrition counseling as an 1286
integrated and reimbursable component of prenatal, perinatal, and 1287
postpartum care consistent with evidence based guidelines. 1288
(2) The department, in collaboration with the division, 1289
shall issue guidance and clinical protocols to standardize 1290
nutrition counseling components, including: 1291
(a) Nutrition risk screening at initial prenatal visit 1292
and each trimester; 1293
(b) Individualized counseling tailored to cultural, 1294
socioeconomic, medical, and obstetric considerations; 1295
(c) Lactation friendly nutrition support and postpartum 1296
dietary guidance; and 1297
(d) Referral pathways to registered dietitians, WIC, 1298
community nutrition programs, and other certified specialists. 1299
SECTION 50. Medicaid Coverage of Nutrition Counseling 1300
Services. (1) The division shall ensure that all Medicaid 1301
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eligible pregnant and postpartum beneficiaries have access to 1302
medically necessary nutrition counseling services. 1303
(2) The division shall: 1304
(a) Establish provider enrollment categories that 1305
include registered dietitians, certified nutrition specialists, 1306
physicians, certified nurse midwives, nurse practitioners, and 1307
other qualified providers; 1308
(b) Define reimbursable service codes and billing 1309
practices for nutrition counseling; 1310
(c) Set reimbursement rates that reflect the cost of 1311
service delivery and support workforce capacity; and 1312
(d) Permit telehealth or virtual delivery of nutrition 1313
counseling where clinically appropriate. 1314
SECTION 51. Private Health Plan Coverage. (1) All health 1315
benefit plans offered, issued, or renewed in Mississippi on or 1316
after the effective date of this act that provide maternity 1317
coverage shall also provide coverage for nutrition counseling 1318
services delivered during pregnancy and up to twelve (12) months 1319
postpartum. Coverage must be on terms no less favorable than 1320
those provided for other maternal care services. 1321
(2) Nutrition counseling coverage under private plans shall 1322
not be subject to cost sharing that materially dissuades use by 1323
enrollees (e.g., high co pays or stringent visit limits 1324
inconsistent with clinical need). 1325
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SECTION 52. Guidance and Training. (1) The department 1326
shall develop and disseminate training and educational resources 1327
to support providers in delivering culturally competent nutrition 1328
counseling. 1329
(2) Training shall address: 1330
(a) Evidence based nutrition standards; 1331
(b) Maternal dietary assessment tools; 1332
(c) Health literacy practices; 1333
(d) Integration with WIC and other community 1334
nutrition resources; and 1335
(e) Documentation and referral workflows. 1336
SECTION 53. Data Collection and Quality Monitoring. (1) 1337
The department, in collaboration with the division and health 1338
systems, shall collect data on utilization of maternal nutrition 1339
counseling services, including: 1340
(a) Number of unique participants; 1341
(b) Frequency and timing of counseling encounters; 1342
(c) Demographic and equity indicators; and 1343
(d) Clinical outcomes tied to maternal nutritional 1344
status (e.g., gestational diabetes management, prenatal weight 1345
gain adherence, birth outcomes). 1346
(2) By December 1 annually, the department shall report to 1347
the Legislature on service delivery, access barriers, quality 1348
metrics, and recommendations for improvement. 1349
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SECTION 54. Implementation Timeline. (1) The department 1350
and the division shall issue initial protocols and implement 1351
coverage requirements no later than January 1, 2027. 1352
(2) The department shall make guidance available to 1353
providers and community partners within six months of enactment. 1354
SECTION 55. Appropriation and Funding. The department and 1355
division are authorized to accept federal funds, grants, and 1356
private support to implement this act. 1357
SECTION 56. Section 27-65-111, Mississippi Code of 1972, is 1358
amended as follows: 1359
27-65-111. The exemptions from the provisions of this 1360
chapter which are not industrial, agricultural or governmental, or 1361
which do not relate to utilities or taxes, or which are not 1362
properly classified as one (1) of the exemption classifications of 1363
this chapter, shall be confined to persons or property exempted by 1364
this section or by the Constitution of the United States or the 1365
State of Mississippi. No exemptions as now provided by any other 1366
section, except the classified exemption sections of this chapter 1367
set forth herein, shall be valid as against the tax herein levied. 1368
Any subsequent exemption from the tax levied hereunder, except as 1369
indicated above, shall be provided by amendments to this section. 1370
No exemption provided in this section shall apply to taxes 1371
levied by Section 27-65-15 or 27-65-21. 1372
The tax levied by this chapter shall not apply to the 1373
following: 1374
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(a) Sales of tangible personal property and services to 1375
hospitals or infirmaries owned and operated by a corporation or 1376
association in which no part of the net earnings inures to the 1377
benefit of any private shareholder, group or individual, and which 1378
are subject to and governed by Sections 41-7-123 through 41-7-127. 1379
Only sales of tangible personal property or services which 1380
are ordinary and necessary to the operation of such hospitals and 1381
infirmaries are exempted from tax. 1382
(b) Sales of daily or weekly newspapers, and 1383
periodicals or publications of scientific, literary or educational 1384
organizations exempt from federal income taxation under Section 1385
501(c)(3) of the Internal Revenue Code of 1954, as it exists as of 1386
March 31, 1975, and subscription sales of all magazines. 1387
(c) Sales of coffins, caskets and other materials used 1388
in the preparation of human bodies for burial. 1389
(d) Sales of tangible personal property for immediate 1390
export to a foreign country. 1391
(e) Sales of tangible personal property to an 1392
orphanage, old men's or ladies' home, supported wholly or in part 1393
by a religious denomination, fraternal nonprofit organization or 1394
other nonprofit organization. 1395
(f) Sales of tangible personal property, labor or 1396
services taxable under Sections 27-65-17, 27-65-19 and 27-65-23, 1397
to a YMCA, YWCA, a Boys' or Girls' Club owned and operated by a 1398
corporation or association in which no part of the net earnings 1399
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inures to the benefit of any private shareholder, group or 1400
individual. 1401
(g) Sales to elementary and secondary grade schools, 1402
junior and senior colleges owned and operated by a corporation or 1403
association in which no part of the net earnings inures to the 1404
benefit of any private shareholder, group or individual, and which 1405
are exempt from state income taxation, provided that this 1406
exemption does not apply to sales of property or services which 1407
are not to be used in the ordinary operation of the school, or 1408
which are to be resold to the students or the public. 1409
(h) The gross proceeds of retail sales and the use or 1410
consumption in this state of drugs and medicines: 1411
(i) Prescribed for the treatment of a human being 1412
by a person authorized to prescribe the medicines, and dispensed 1413
or prescription filled by a registered pharmacist in accordance 1414
with law; or 1415
(ii) Furnished by a licensed physician, surgeon, 1416
dentist or podiatrist to his own patient for treatment of the 1417
patient; or 1418
(iii) Furnished by a hospital for treatment of any 1419
person pursuant to the order of a licensed physician, surgeon, 1420
dentist or podiatrist; or 1421
(iv) Sold to a licensed physician, surgeon, 1422
podiatrist, dentist or hospital for the treatment of a human 1423
being; or 1424
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(v) Sold to this state or any political 1425
subdivision or municipal corporation thereof, for use in the 1426
treatment of a human being or furnished for the treatment of a 1427
human being by a medical facility or clinic maintained by this 1428
state or any political subdivision or municipal corporation 1429
thereof. 1430
"Medicines," as used in this paragraph (h), shall mean and 1431
include any substance or preparation intended for use by external 1432
or internal application to the human body in the diagnosis, cure, 1433
mitigation, treatment or prevention of disease and which is 1434
commonly recognized as a substance or preparation intended for 1435
such use; "medicines" do not include any auditory, prosthetic, 1436
ophthalmic or ocular device or appliance, any dentures or parts 1437
thereof or any artificial limbs or their replacement parts, 1438
articles which are in the nature of splints, bandages, pads, 1439
compresses, supports, dressings, instruments, apparatus, 1440
contrivances, appliances, devices or other mechanical, electronic, 1441
optical or physical equipment or article or the component parts 1442
and accessories thereof, or any alcoholic beverage or any other 1443
drug or medicine not commonly referred to as a prescription drug. 1444
Notwithstanding the preceding sentence of this paragraph (h), 1445
"medicines" as used in this paragraph (h), shall mean and include 1446
sutures, whether or not permanently implanted, bone screws, bone 1447
pins, pacemakers and other articles permanently implanted in the 1448
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human body to assist the functioning of any natural organ, artery, 1449
vein or limb and which remain or dissolve in the body. 1450
The exemption provided in this paragraph (h) shall not apply 1451
to medical cannabis sold in accordance with the provisions of the 1452
Mississippi Medical Cannabis Act and in compliance with rules and 1453
regulations adopted thereunder. 1454
"Hospital," as used in this paragraph (h), shall have the 1455
meaning ascribed to it in Section 41-9-3. 1456
Insulin furnished by a registered pharmacist to a person for 1457
treatment of diabetes as directed by a physician shall be deemed 1458
to be dispensed on prescription within the meaning of this 1459
paragraph (h). 1460
(i) Retail sales of automobiles, trucks and 1461
truck-tractors if exported from this state within forty-eight (48) 1462
hours and registered and first used in another state. 1463
(j) Sales of tangible personal property or services to 1464
the Salvation Army and the Muscular Dystrophy Association, Inc. 1465
(k) From July 1, 1985, through December 31, 1992, 1466
retail sales of "alcohol-blended fuel" as such term is defined in 1467
Section 75-55-5. The gasoline-alcohol blend or the straight 1468
alcohol eligible for this exemption shall not contain alcohol 1469
distilled outside the State of Mississippi. 1470
(l) Sales of tangible personal property or services to 1471
the Institute for Technology Development. 1472
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(m) The gross proceeds of retail sales of food and 1473
drink for human consumption made through vending machines serviced 1474
by full-line vendors from and not connected with other taxable 1475
businesses. 1476
(n) The gross proceeds of sales of motor fuel. 1477
(o) Retail sales of food for human consumption 1478
purchased with food stamps issued by the United States Department 1479
of Agriculture, or other federal agency, from and after October 1, 1480
1987, or from and after the expiration of any waiver granted 1481
pursuant to federal law, the effect of which waiver is to permit 1482
the collection by the state of tax on such retail sales of food 1483
for human consumption purchased with food stamps. 1484
(p) Sales of cookies for human consumption by the Girl 1485
Scouts of America if no part of the net earnings from those sales 1486
inures to the benefit of any private group or individual. 1487
(q) Gifts or sales of tangible personal property or 1488
services to public or private nonprofit museums of art. 1489
(r) Sales of tangible personal property or services to 1490
alumni associations of state-supported colleges or universities. 1491
(s) Sales of tangible personal property or services to 1492
National Association of Junior Auxiliaries, Inc., and chapters of 1493
the National Association of Junior Auxiliaries, Inc. 1494
(t) Sales of tangible personal property or services to 1495
domestic violence shelters which qualify for state funding under 1496
Sections 93-21-101 through 93-21-113. 1497
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(u) Sales of tangible personal property or services to 1498
the National Multiple Sclerosis Society, Mississippi Chapter. 1499
(v) Retail sales of food for human consumption 1500
purchased with food instruments issued the Mississippi Band of 1501
Choctaw Indians under the Women, Infants and Children Program 1502
(WIC) funded by the United States Department of Agriculture. 1503
(w) Sales of tangible personal property or services to 1504
a private company, as defined in Section 57-61-5, which is making 1505
such purchases with proceeds of bonds issued under Section 57-61-1 1506
et seq., the Mississippi Business Investment Act. 1507
(x) The gross collections from the operation of 1508
self-service, coin-operated car washing equipment and sales of the 1509
service of washing motor vehicles with portable high-pressure 1510
washing equipment on the premises of the customer. 1511
(y) Sales of tangible personal property or services to 1512
the Mississippi Technology Alliance. 1513
(z) Sales of tangible personal property to nonprofit 1514
organizations that provide foster care, adoption services and 1515
temporary housing for unwed mothers and their children if the 1516
organization is exempt from federal income taxation under Section 1517
501(c)(3) of the Internal Revenue Code. 1518
(aa) Sales of tangible personal property to nonprofit 1519
organizations that provide residential rehabilitation for persons 1520
with alcohol and drug dependencies if the organization is exempt 1521
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from federal income taxation under Section 501(c)(3) of the 1522
Internal Revenue Code. 1523
(ab) (i) Retail sales of an article of clothing or 1524
footwear designed to be worn on or about the human body and retail 1525
sales of school supplies if the sales price of the article of 1526
clothing or footwear or school supply is less than One Hundred 1527
Dollars ($100.00) and the sale takes place during a period 1528
beginning at 12:01 a.m. on the second Friday in July and ending at 1529
12:00 midnight the following Sunday. This paragraph (ab) shall 1530
not apply to: 1531
1. Accessories including jewelry, handbags, 1532
luggage, umbrellas, wallets, watches, briefcases, garment bags and 1533
similar items carried on or about the human body, without regard 1534
to whether worn on the body in a manner characteristic of 1535
clothing; 1536
2. The rental of clothing or footwear; and 1537
3. Skis, swim fins, roller blades, skates and 1538
similar items worn on the foot. 1539
(ii) For purposes of this paragraph (ab), "school 1540
supplies" means items that are commonly used by a student in a 1541
course of study. The following is an all-inclusive list: 1542
1. Backpacks; 1543
2. Binder pockets; 1544
3. Binders; 1545
4. Blackboard chalk; 1546
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5. Book bags; 1547
6. Calculators; 1548
7. Cellophane tape; 1549
8. Clays and glazes; 1550
9. Compasses; 1551
10. Composition books; 1552
11. Crayons; 1553
12. Dictionaries and thesauruses; 1554
13. Dividers; 1555
14. Erasers; 1556
15. Folders: expandable, pocket, plastic and 1557
manila; 1558
16. Glue, paste and paste sticks; 1559
17. Highlighters; 1560
18. Index card boxes; 1561
19. Index cards; 1562
20. Legal pads; 1563
21. Lunch boxes; 1564
22. Markers; 1565
23. Notebooks; 1566
24. Paintbrushes for artwork; 1567
25. Paints: acrylic, tempera and oil; 1568
26. Paper: loose-leaf ruled notebook paper, 1569
copy paper, graph paper, tracing paper, manila paper, colored 1570
paper, poster board and construction paper; 1571
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27. Pencil boxes and other school supply 1572
boxes; 1573
28. Pencil sharpeners; 1574
29. Pencils; 1575
30. Pens; 1576
31. Protractors; 1577
32. Reference books; 1578
33. Reference maps and globes; 1579
34. Rulers; 1580
35. Scissors; 1581
36. Sheet music; 1582
37. Sketch and drawing pads; 1583
38. Textbooks; 1584
39. Watercolors; 1585
40. Workbooks; and 1586
41. Writing tablets. 1587
(iii) From and after January 1, 2010, the 1588
governing authorities of a municipality, for retail sales 1589
occurring within the corporate limits of the municipality, may 1590
suspend the application of the exemption provided for in this 1591
paragraph (ab) by adoption of a resolution to that effect stating 1592
the date upon which the suspension shall take effect. A certified 1593
copy of the resolution shall be furnished to the Department of 1594
Revenue at least ninety (90) days prior to the date upon which the 1595
municipality desires such suspension to take effect. 1596
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(ac) The gross proceeds of sales of tangible personal 1597
property made for the sole purpose of raising funds for a school 1598
or an organization affiliated with a school. 1599
As used in this paragraph (ac), "school" means any public or 1600
private school that teaches courses of instruction to students in 1601
any grade from kindergarten through Grade 12. 1602
(ad) Sales of durable medical equipment and home 1603
medical supplies when ordered or prescribed by a licensed 1604
physician for medical purposes of a patient. As used in this 1605
paragraph (ad), "durable medical equipment" and "home medical 1606
supplies" mean equipment, including repair and replacement parts 1607
for the equipment or supplies listed under Title XVIII of the 1608
Social Security Act or under the state plan for medical assistance 1609
under Title XIX of the Social Security Act, prosthetics, 1610
orthotics, hearing aids, hearing devices, prescription eyeglasses, 1611
oxygen and oxygen equipment. Payment does not have to be made, in 1612
whole or in part, by any particular person to be eligible for this 1613
exemption. Purchases of home medical equipment and supplies by a 1614
provider of home health services or a provider of hospice services 1615
are eligible for this exemption if the purchases otherwise meet 1616
the requirements of this paragraph. 1617
(ae) Sales of tangible personal property or services to 1618
Mississippi Blood Services. 1619
(af) (i) Subject to the provisions of this paragraph 1620
(af), retail sales of firearms, ammunition and hunting supplies if 1621
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sold during the annual Mississippi Second Amendment Weekend 1622
holiday beginning at 12:01 a.m. on the last Friday in August and 1623
ending at 12:00 midnight the following Sunday. For the purposes 1624
of this paragraph (af), "hunting supplies" means tangible personal 1625
property used for hunting, including, and limited to, archery 1626
equipment, firearm and archery cases, firearm and archery 1627
accessories, hearing protection, holsters, belts and slings. 1628
Hunting supplies does not include animals used for hunting. 1629
(ii) This paragraph (af) shall apply only if one 1630
or more of the following occur: 1631
1. Title to and/or possession of an eligible 1632
item is transferred from a seller to a purchaser; and/or 1633
2. A purchaser orders and pays for an 1634
eligible item and the seller accepts the order for immediate 1635
shipment, even if delivery is made after the time period provided 1636
in subparagraph (i) of this paragraph (af), provided that the 1637
purchaser has not requested or caused the delay in shipment. 1638
(ag) Sales of nonperishable food items to charitable 1639
organizations that are exempt from federal income taxation under 1640
Section 501(c)(3) of the Internal Revenue Code and operate a food 1641
bank or food pantry or food lines. 1642
(ah) Sales of tangible personal property or services to 1643
the United Way of the Pine Belt Region, Inc. 1644
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(ai) Sales of tangible personal property or services to 1645
the Mississippi Children's Museum or any subsidiary or affiliate 1646
thereof operating a satellite or branch museum within this state. 1647
(aj) Sales of tangible personal property or services to 1648
the Jackson Zoological Park. 1649
(ak) Sales of tangible personal property or services to 1650
the Hattiesburg Zoo. 1651
(al) Gross proceeds from sales of food, merchandise or 1652
other concessions at an event held solely for religious or 1653
charitable purposes at livestock facilities, agriculture 1654
facilities or other facilities constructed, renovated or expanded 1655
with funds for the grant program authorized under Section 18, 1656
Chapter 530, Laws of 1995. 1657
(am) Sales of tangible personal property and services 1658
to the Diabetes Foundation of Mississippi and the Mississippi 1659
Chapter of the Juvenile Diabetes Research Foundation. 1660
(an) Sales of potting soil, mulch, or other soil 1661
amendments used in growing ornamental plants which bear no fruit 1662
of commercial value when sold to commercial plant nurseries that 1663
operate exclusively at wholesale and where no retail sales can be 1664
made. 1665
(ao) Sales of tangible personal property or services to 1666
the University of Mississippi Medical Center Research Development 1667
Foundation. 1668
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(ap) Sales of tangible personal property or services to 1669
Keep Mississippi Beautiful, Inc., and all affiliates of Keep 1670
Mississippi Beautiful, Inc. 1671
(aq) Sales of tangible personal property or services to 1672
the Friends of Children's Hospital. 1673
(ar) Sales of tangible personal property or services to 1674
the Pinecrest Weekend Snackpacks for Kids located in Corinth, 1675
Mississippi. 1676
(as) Sales of hearing aids when ordered or prescribed 1677
by a licensed physician, audiologist or hearing aid specialist for 1678
the medical purposes of a patient. 1679
(at) Sales exempt under the Facilitating Business Rapid 1680
Response to State Declared Disasters Act of 2015 (Sections 1681
27-113-1 through 27-113-9). 1682
(au) Sales of tangible personal property or services to 1683
the Junior League of Jackson. 1684
(av) Sales of tangible personal property or services to 1685
the Mississippi's Toughest Kids Foundation for use in the 1686
construction, furnishing and equipping of buildings and related 1687
facilities and infrastructure at Camp Kamassa in Copiah County, 1688
Mississippi. This paragraph (av) shall stand repealed on July 1, 1689
2028. 1690
(aw) Sales of tangible personal property or services to 1691
MS Gulf Coast Buddy Sports, Inc. 1692
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(ax) Sales of tangible personal property or services to 1693
Biloxi Lions, Inc. 1694
(ay) Sales of tangible personal property or services to 1695
Lions Sight Foundation of Mississippi, Inc. 1696
(az) Sales of tangible personal property and services 1697
to the Goldring/Woldenberg Institute of Southern Jewish Life 1698
(ISJL). 1699
(ba) Sales of coins, currency, and bullion. For the 1700
purposes of this paragraph (ba), the following words and phrases 1701
shall have the meanings ascribed in this paragraph (ba) unless the 1702
context clearly indicates otherwise: 1703
(i) "Bullion" means a bar, ingot, or coin: 1704
1. Manufactured, in whole or in part, of 1705
gold, silver, platinum, or palladium; 1706
2. That was or is used solely as a medium of 1707
exchange, security, or commodity by any state, the United States 1708
Government, or a foreign nation; and 1709
3. Sold based on the intrinsic value of the 1710
bar, ingot, or coin as a precious metal or collectible item rather 1711
than its form or representative value as a medium of exchange. 1712
(ii) "Coin or currency" means a coin or currency: 1713
1. Manufactured, in whole or in part, of 1714
gold, silver, other metal, or paper; 1715
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2. That was or is used solely as a medium of 1716
exchange, security, or commodity by any state, the United States 1717
Government, or a foreign nation; and 1718
3. Sold based on the intrinsic value of the 1719
coin or currency as a precious metal or collectible item rather 1720
than its form or representative value as a medium of exchange. 1721
"Coin or currency" does not include a coin or currency that has 1722
been incorporated into jewelry. 1723
(bb) Sales of: 1724
(i) Children's diapers, including single-use 1725
diapers, reusable diapers and reusable diaper inserts; 1726
(ii) Diaper bags, diaper rash cream, baby wipes, 1727
and baby powder; and 1728
(iii) Baby formula. 1729
SECTION 57. Nothing in Section 56 of this act shall affect 1730
or defeat any claim, assessment, appeal, suit, right or cause of 1731
action for taxes due or accrued under the sales tax laws before 1732
the date on which this act becomes effective, whether such claims, 1733
assessments, appeals, suits or actions have been begun before the 1734
date on which this act becomes effective or are begun thereafter; 1735
and the provisions of the sales tax laws are expressly continued 1736
in full force, effect and operation for the purpose of the 1737
assessment, collection and enrollment of liens for any taxes due 1738
or accrued and the execution of any warrant under such laws before 1739
the date on which this act becomes effective, and for the 1740
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imposition of any penalties, forfeitures or claims for failure to 1741
comply with such laws. 1742
SECTION 58. Section 43-13-117, Mississippi Code of 1972, is 1743
amended as follows: 1744
43-13-117. (A) Medicaid as authorized by this article shall 1745
include payment of part or all of the costs, at the discretion of 1746
the division, with approval of the Governor and the Centers for 1747
Medicare and Medicaid Services, of the following types of care and 1748
services rendered to eligible applicants who have been determined 1749
to be eligible for that care and services, within the limits of 1750
state appropriations and federal matching funds: 1751
(1) Inpatient hospital services. 1752
(a) The division is authorized to implement an All 1753
Patient Refined Diagnosis Related Groups (APR-DRG) reimbursement 1754
methodology for inpatient hospital services. 1755
(b) No service benefits or reimbursement 1756
limitations in this subsection (A)(1) shall apply to payments 1757
under an APR-DRG or Ambulatory Payment Classification (APC) model 1758
or a managed care program or similar model described in subsection 1759
(H) of this section unless specifically authorized by the 1760
division. 1761
(2) Outpatient hospital services. 1762
(a) Emergency services. 1763
(b) Other outpatient hospital services. The 1764
division shall allow benefits for other medically necessary 1765
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outpatient hospital services (such as chemotherapy, radiation, 1766
surgery and therapy), including outpatient services in a clinic or 1767
other facility that is not located inside the hospital, but that 1768
has been designated as an outpatient facility by the hospital, and 1769
that was in operation or under construction on July 1, 2009, 1770
provided that the costs and charges associated with the operation 1771
of the hospital clinic are included in the hospital's cost report. 1772
In addition, the Medicare thirty-five-mile rule will apply to 1773
those hospital clinics not located inside the hospital that are 1774
constructed after July 1, 2009. Where the same services are 1775
reimbursed as clinic services, the division may revise the rate or 1776
methodology of outpatient reimbursement to maintain consistency, 1777
efficiency, economy and quality of care. 1778
(c) The division is authorized to implement an 1779
Ambulatory Payment Classification (APC) methodology for outpatient 1780
hospital services. The division shall give rural hospitals that 1781
have fifty (50) or fewer licensed beds the option to not be 1782
reimbursed for outpatient hospital services using the APC 1783
methodology, but reimbursement for outpatient hospital services 1784
provided by those hospitals shall be based on one hundred one 1785
percent (101%) of the rate established under Medicare for 1786
outpatient hospital services. Those hospitals choosing to not be 1787
reimbursed under the APC methodology shall remain under cost-based 1788
reimbursement for a two-year period. 1789
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(d) No service benefits or reimbursement 1790
limitations in this subsection (A)(2) shall apply to payments 1791
under an APR-DRG or APC model or a managed care program or similar 1792
model described in subsection (H) of this section unless 1793
specifically authorized by the division. 1794
(3) Laboratory and x-ray services. 1795
(4) Nursing facility services. 1796
(a) The division shall make full payment to 1797
nursing facilities for each day, not exceeding forty-two (42) days 1798
per year, that a patient is absent from the facility on home 1799
leave. Payment may be made for the following home leave days in 1800
addition to the forty-two-day limitation: Christmas, the day 1801
before Christmas, the day after Christmas, Thanksgiving, the day 1802
before Thanksgiving and the day after Thanksgiving. 1803
(b) From and after July 1, 1997, the division 1804
shall implement the integrated case-mix payment and quality 1805
monitoring system, which includes the fair rental system for 1806
property costs and in which recapture of depreciation is 1807
eliminated. The division may reduce the payment for hospital 1808
leave and therapeutic home leave days to the lower of the case-mix 1809
category as computed for the resident on leave using the 1810
assessment being utilized for payment at that point in time, or a 1811
case-mix score of 1.000 for nursing facilities, and shall compute 1812
case-mix scores of residents so that only services provided at the 1813
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nursing facility are considered in calculating a facility's per 1814
diem. 1815
(c) From and after July 1, 1997, all state-owned 1816
nursing facilities shall be reimbursed on a full reasonable cost 1817
basis. 1818
(d) On or after January 1, 2015, the division 1819
shall update the case-mix payment system resource utilization 1820
grouper and classifications and fair rental reimbursement system. 1821
The division shall develop and implement a payment add-on to 1822
reimburse nursing facilities for ventilator-dependent resident 1823
services. 1824
(e) The division shall develop and implement, not 1825
later than January 1, 2001, a case-mix payment add-on determined 1826
by time studies and other valid statistical data that will 1827
reimburse a nursing facility for the additional cost of caring for 1828
a resident who has a diagnosis of Alzheimer's or other related 1829
dementia and exhibits symptoms that require special care. Any 1830
such case-mix add-on payment shall be supported by a determination 1831
of additional cost. The division shall also develop and implement 1832
as part of the fair rental reimbursement system for nursing 1833
facility beds, an Alzheimer's resident bed depreciation enhanced 1834
reimbursement system that will provide an incentive to encourage 1835
nursing facilities to convert or construct beds for residents with 1836
Alzheimer's or other related dementia. 1837
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(f) The division shall develop and implement an 1838
assessment process for long-term care services. The division may 1839
provide the assessment and related functions directly or through 1840
contract with the area agencies on aging. 1841
The division shall apply for necessary federal waivers to 1842
assure that additional services providing alternatives to nursing 1843
facility care are made available to applicants for nursing 1844
facility care. 1845
(5) Periodic screening and diagnostic services for 1846
individuals under age twenty-one (21) years as are needed to 1847
identify physical and mental defects and to provide health care 1848
treatment and other measures designed to correct or ameliorate 1849
defects and physical and mental illness and conditions discovered 1850
by the screening services, regardless of whether these services 1851
are included in the state plan. The division may include in its 1852
periodic screening and diagnostic program those discretionary 1853
services authorized under the federal regulations adopted to 1854
implement Title XIX of the federal Social Security Act, as 1855
amended. The division, in obtaining physical therapy services, 1856
occupational therapy services, and services for individuals with 1857
speech, hearing and language disorders, may enter into a 1858
cooperative agreement with the State Department of Education for 1859
the provision of those services to handicapped students by public 1860
school districts using state funds that are provided from the 1861
appropriation to the Department of Education to obtain federal 1862
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matching funds through the division. The division, in obtaining 1863
medical and mental health assessments, treatment, care and 1864
services for children who are in, or at risk of being put in, the 1865
custody of the Mississippi Department of Human Services may enter 1866
into a cooperative agreement with the Mississippi Department of 1867
Human Services for the provision of those services using state 1868
funds that are provided from the appropriation to the Department 1869
of Human Services to obtain federal matching funds through the 1870
division. 1871
(6) Physician services. Fees for physician's services 1872
that are covered only by Medicaid shall be reimbursed at ninety 1873
percent (90%) of the rate established on January 1, 2018, and as 1874
may be adjusted each July thereafter, under Medicare. The 1875
division may provide for a reimbursement rate for physician's 1876
services of up to one hundred percent (100%) of the rate 1877
established under Medicare for physician's services that are 1878
provided after the normal working hours of the physician, as 1879
determined in accordance with regulations of the division. The 1880
division may reimburse eligible providers, as determined by the 1881
division, for certain primary care services at one hundred percent 1882
(100%) of the rate established under Medicare. The division shall 1883
reimburse obstetricians and gynecologists for certain primary care 1884
services as defined by the division at one hundred percent (100%) 1885
of the rate established under Medicare. 1886
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(7) (a) Home health services for eligible persons, not 1887
to exceed in cost the prevailing cost of nursing facility 1888
services. All home health visits must be precertified as required 1889
by the division. In addition to physicians, certified registered 1890
nurse practitioners, physician assistants and clinical nurse 1891
specialists are authorized to prescribe or order home health 1892
services and plans of care, sign home health plans of care, 1893
certify and recertify eligibility for home health services and 1894
conduct the required initial face-to-face visit with the recipient 1895
of the services. 1896
(b) [Repealed] 1897
(8) Emergency medical transportation services as 1898
determined by the division. 1899
(9) Prescription drugs and other covered drugs and 1900
services as determined by the division. 1901
The division shall establish a mandatory preferred drug list. 1902
Drugs not on the mandatory preferred drug list shall be made 1903
available by utilizing prior authorization procedures established 1904
by the division. 1905
The division may seek to establish relationships with other 1906
states in order to lower acquisition costs of prescription drugs 1907
to include single-source and innovator multiple-source drugs or 1908
generic drugs. In addition, if allowed by federal law or 1909
regulation, the division may seek to establish relationships with 1910
and negotiate with other countries to facilitate the acquisition 1911
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of prescription drugs to include single-source and innovator 1912
multiple-source drugs or generic drugs, if that will lower the 1913
acquisition costs of those prescription drugs. 1914
The division may allow for a combination of prescriptions for 1915
single-source and innovator multiple-source drugs and generic 1916
drugs to meet the needs of the beneficiaries. 1917
The executive director may approve specific maintenance drugs 1918
for beneficiaries with certain medical conditions, which may be 1919
prescribed and dispensed in three-month supply increments. 1920
Drugs prescribed for a resident of a psychiatric residential 1921
treatment facility must be provided in true unit doses when 1922
available. The division may require that drugs not covered by 1923
Medicare Part D for a resident of a long-term care facility be 1924
provided in true unit doses when available. Those drugs that were 1925
originally billed to the division but are not used by a resident 1926
in any of those facilities shall be returned to the billing 1927
pharmacy for credit to the division, in accordance with the 1928
guidelines of the State Board of Pharmacy and any requirements of 1929
federal law and regulation. Drugs shall be dispensed to a 1930
recipient and only one (1) dispensing fee per month may be 1931
charged. The division shall develop a methodology for reimbursing 1932
for restocked drugs, which shall include a restock fee as 1933
determined by the division not exceeding Seven Dollars and 1934
Eighty-two Cents ($7.82). 1935
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Except for those specific maintenance drugs approved by the 1936
executive director, the division shall not reimburse for any 1937
portion of a prescription that exceeds a thirty-one-day supply of 1938
the drug based on the daily dosage. 1939
The division is authorized to develop and implement a program 1940
of payment for additional pharmacist services as determined by the 1941
division. 1942
All claims for drugs for dually eligible Medicare/Medicaid 1943
beneficiaries that are paid for by Medicare must be submitted to 1944
Medicare for payment before they may be processed by the 1945
division's online payment system. 1946
The division shall develop a pharmacy policy in which drugs 1947
in tamper-resistant packaging that are prescribed for a resident 1948
of a nursing facility but are not dispensed to the resident shall 1949
be returned to the pharmacy and not billed to Medicaid, in 1950
accordance with guidelines of the State Board of Pharmacy. 1951
The division shall develop and implement a method or methods 1952
by which the division will provide on a regular basis to Medicaid 1953
providers who are authorized to prescribe drugs, information about 1954
the costs to the Medicaid program of single-source drugs and 1955
innovator multiple-source drugs, and information about other drugs 1956
that may be prescribed as alternatives to those single-source 1957
drugs and innovator multiple-source drugs and the costs to the 1958
Medicaid program of those alternative drugs. 1959
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Notwithstanding any law or regulation, information obtained 1960
or maintained by the division regarding the prescription drug 1961
program, including trade secrets and manufacturer or labeler 1962
pricing, is confidential and not subject to disclosure except to 1963
other state agencies. 1964
The dispensing fee for each new or refill prescription, 1965
including nonlegend or over-the-counter drugs covered by the 1966
division, shall be not less than Three Dollars and Ninety-one 1967
Cents ($3.91), as determined by the division. 1968
The division shall not reimburse for single-source or 1969
innovator multiple-source drugs if there are equally effective 1970
generic equivalents available and if the generic equivalents are 1971
the least expensive. 1972
It is the intent of the Legislature that the pharmacists 1973
providers be reimbursed for the reasonable costs of filling and 1974
dispensing prescriptions for Medicaid beneficiaries. 1975
The division shall allow certain drugs, including 1976
physician-administered drugs, and implantable drug system devices, 1977
and medical supplies, with limited distribution or limited access 1978
for beneficiaries and administered in an appropriate clinical 1979
setting, to be reimbursed as either a medical claim or pharmacy 1980
claim, as determined by the division. 1981
It is the intent of the Legislature that the division and any 1982
managed care entity described in subsection (H) of this section 1983
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encourage the use of Alpha-Hydroxyprogesterone Caproate (17P) to 1984
prevent recurrent preterm birth. 1985
(10) Dental and orthodontic services to be determined 1986
by the division. 1987
The division shall increase the amount of the reimbursement 1988
rate for diagnostic and preventative dental services for each of 1989
the fiscal years 2022, 2023 and 2024 by five percent (5%) above 1990
the amount of the reimbursement rate for the previous fiscal year. 1991
The division shall increase the amount of the reimbursement rate 1992
for restorative dental services for each of the fiscal years 2023, 1993
2024 and 2025 by five percent (5%) above the amount of the 1994
reimbursement rate for the previous fiscal year. It is the intent 1995
of the Legislature that the reimbursement rate revision for 1996
preventative dental services will be an incentive to increase the 1997
number of dentists who actively provide Medicaid services. This 1998
dental services reimbursement rate revision shall be known as the 1999
"James Russell Dumas Medicaid Dental Services Incentive Program." 2000
The Medical Care Advisory Committee, assisted by the Division 2001
of Medicaid, shall annually determine the effect of this incentive 2002
by evaluating the number of dentists who are Medicaid providers, 2003
the number who and the degree to which they are actively billing 2004
Medicaid, the geographic trends of where dentists are offering 2005
what types of Medicaid services and other statistics pertinent to 2006
the goals of this legislative intent. This data shall annually be 2007
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presented to the Chair of the Senate Medicaid Committee and the 2008
Chair of the House Medicaid Committee. 2009
The division shall include dental services as a necessary 2010
component of overall health services provided to children who are 2011
eligible for services. 2012
(11) Eyeglasses for all Medicaid beneficiaries who have 2013
(a) had surgery on the eyeball or ocular muscle that results in a 2014
vision change for which eyeglasses or a change in eyeglasses is 2015
medically indicated within six (6) months of the surgery and is in 2016
accordance with policies established by the division, or (b) one 2017
(1) pair every five (5) years and in accordance with policies 2018
established by the division. In either instance, the eyeglasses 2019
must be prescribed by a physician skilled in diseases of the eye 2020
or an optometrist, whichever the beneficiary may select. 2021
(12) Intermediate care facility services. 2022
(a) The division shall make full payment to all 2023
intermediate care facilities for individuals with intellectual 2024
disabilities for each day, not exceeding sixty-three (63) days per 2025
year, that a patient is absent from the facility on home leave. 2026
Payment may be made for the following home leave days in addition 2027
to the sixty-three-day limitation: Christmas, the day before 2028
Christmas, the day after Christmas, Thanksgiving, the day before 2029
Thanksgiving and the day after Thanksgiving. 2030
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(b) All state-owned intermediate care facilities 2031
for individuals with intellectual disabilities shall be reimbursed 2032
on a full reasonable cost basis. 2033
(c) Effective January 1, 2015, the division shall 2034
update the fair rental reimbursement system for intermediate care 2035
facilities for individuals with intellectual disabilities. 2036
(13) Family planning services, including drugs, 2037
supplies and devices, when those services are under the 2038
supervision of a physician or nurse practitioner. 2039
(14) Clinic services. Preventive, diagnostic, 2040
therapeutic, rehabilitative or palliative services that are 2041
furnished by a facility that is not part of a hospital but is 2042
organized and operated to provide medical care to outpatients. 2043
Clinic services include, but are not limited to: 2044
(a) Services provided by ambulatory surgical 2045
centers (ASCs) as defined in Section 41-75-1(a); and 2046
(b) Dialysis center services. 2047
(15) Home- and community-based services for the elderly 2048
and disabled, as provided under Title XIX of the federal Social 2049
Security Act, as amended, under waivers, subject to the 2050
availability of funds specifically appropriated for that purpose 2051
by the Legislature. 2052
(16) Mental health services. Certain services provided 2053
by a psychiatrist shall be reimbursed at up to one hundred percent 2054
(100%) of the Medicare rate. Approved therapeutic and case 2055
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management services (a) provided by an approved regional mental 2056
health/intellectual disability center established under Sections 2057
41-19-31 through 41-19-39, or by another community mental health 2058
service provider meeting the requirements of the Department of 2059
Mental Health to be an approved mental health/intellectual 2060
disability center if determined necessary by the Department of 2061
Mental Health, using state funds that are provided in the 2062
appropriation to the division to match federal funds, or (b) 2063
provided by a facility that is certified by the State Department 2064
of Mental Health to provide therapeutic and case management 2065
services, to be reimbursed on a fee for service basis, or (c) 2066
provided in the community by a facility or program operated by the 2067
Department of Mental Health. Any such services provided by a 2068
facility described in subparagraph (b) must have the prior 2069
approval of the division to be reimbursable under this section. 2070
(17) Durable medical equipment services and medical 2071
supplies. Precertification of durable medical equipment and 2072
medical supplies must be obtained as required by the division. 2073
The Division of Medicaid may require durable medical equipment 2074
providers to obtain a surety bond in the amount and to the 2075
specifications as established by the Balanced Budget Act of 1997. 2076
A maximum dollar amount of reimbursement for noninvasive 2077
ventilators or ventilation treatments properly ordered and being 2078
used in an appropriate care setting shall not be set by any health 2079
maintenance organization, coordinated care organization, 2080
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provider-sponsored health plan, or other organization paid for 2081
services on a capitated basis by the division under any managed 2082
care program or coordinated care program implemented by the 2083
division under this section. Reimbursement by these organizations 2084
to durable medical equipment suppliers for home use of noninvasive 2085
and invasive ventilators shall be on a continuous monthly payment 2086
basis for the duration of medical need throughout a patient's 2087
valid prescription period. 2088
(18) (a) Notwithstanding any other provision of this 2089
section to the contrary, as provided in the Medicaid state plan 2090
amendment or amendments as defined in Section 43-13-145(10), the 2091
division shall make additional reimbursement to hospitals that 2092
serve a disproportionate share of low-income patients and that 2093
meet the federal requirements for those payments as provided in 2094
Section 1923 of the federal Social Security Act and any applicable 2095
regulations. It is the intent of the Legislature that the 2096
division shall draw down all available federal funds allotted to 2097
the state for disproportionate share hospitals. However, from and 2098
after January 1, 1999, public hospitals participating in the 2099
Medicaid disproportionate share program may be required to 2100
participate in an intergovernmental transfer program as provided 2101
in Section 1903 of the federal Social Security Act and any 2102
applicable regulations. 2103
(b) (i) 1. The division may establish a Medicare 2104
Upper Payment Limits Program, as defined in Section 1902(a)(30) of 2105
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the federal Social Security Act and any applicable federal 2106
regulations, or an allowable delivery system or provider payment 2107
initiative authorized under 42 CFR 438.6(c), for hospitals, 2108
nursing facilities and physicians employed or contracted by 2109
hospitals. 2110
2. The division shall establish a 2111
Medicaid Supplemental Payment Program, as permitted by the federal 2112
Social Security Act and a comparable allowable delivery system or 2113
provider payment initiative authorized under 42 CFR 438.6(c), for 2114
emergency ambulance transportation providers in accordance with 2115
this subsection (A)(18)(b). 2116
(ii) The division shall assess each hospital, 2117
nursing facility, and emergency ambulance transportation provider 2118
for the sole purpose of financing the state portion of the 2119
Medicare Upper Payment Limits Program or other program(s) 2120
authorized under this subsection (A)(18)(b). The hospital 2121
assessment shall be as provided in Section 43-13-145(4)(a), and 2122
the nursing facility and the emergency ambulance transportation 2123
assessments, if established, shall be based on Medicaid 2124
utilization or other appropriate method, as determined by the 2125
division, consistent with federal regulations. The assessments 2126
will remain in effect as long as the state participates in the 2127
Medicare Upper Payment Limits Program or other program(s) 2128
authorized under this subsection (A)(18)(b). In addition to the 2129
hospital assessment provided in Section 43-13-145(4)(a), hospitals 2130
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with physicians participating in the Medicare Upper Payment Limits 2131
Program or other program(s) authorized under this subsection 2132
(A)(18)(b) shall be required to participate in an 2133
intergovernmental transfer or assessment, as determined by the 2134
division, for the purpose of financing the state portion of the 2135
physician UPL payments or other payment(s) authorized under this 2136
subsection (A)(18)(b). 2137
(iii) Subject to approval by the Centers for 2138
Medicare and Medicaid Services (CMS) and the provisions of this 2139
subsection (A)(18)(b), the division shall make additional 2140
reimbursement to hospitals, nursing facilities, and emergency 2141
ambulance transportation providers for the Medicare Upper Payment 2142
Limits Program or other program(s) authorized under this 2143
subsection (A)(18)(b), and, if the program is established for 2144
physicians, shall make additional reimbursement for physicians, as 2145
defined in Section 1902(a)(30) of the federal Social Security Act 2146
and any applicable federal regulations, provided the assessment in 2147
this subsection (A)(18)(b) is in effect. 2148
(iv) Notwithstanding any other provision of 2149
this article to the contrary, effective upon implementation of the 2150
Mississippi Hospital Access Program (MHAP) provided in 2151
subparagraph (c)(i) below, the hospital portion of the inpatient 2152
Upper Payment Limits Program shall transition into and be replaced 2153
by the MHAP program. However, the division is authorized to 2154
develop and implement an alternative fee-for-service Upper Payment 2155
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Limits model in accordance with federal laws and regulations if 2156
necessary to preserve supplemental funding. Further, the 2157
division, in consultation with the hospital industry shall develop 2158
alternative models for distribution of medical claims and 2159
supplemental payments for inpatient and outpatient hospital 2160
services, and such models may include, but shall not be limited to 2161
the following: increasing rates for inpatient and outpatient 2162
services; creating a low-income utilization pool of funds to 2163
reimburse hospitals for the costs of uncompensated care, charity 2164
care and bad debts as permitted and approved pursuant to federal 2165
regulations and the Centers for Medicare and Medicaid Services; 2166
supplemental payments based upon Medicaid utilization, quality, 2167
service lines and/or costs of providing such services to Medicaid 2168
beneficiaries and to uninsured patients. The goals of such 2169
payment models shall be to ensure access to inpatient and 2170
outpatient care and to maximize any federal funds that are 2171
available to reimburse hospitals for services provided. Any such 2172
documents required to achieve the goals described in this 2173
paragraph shall be submitted to the Centers for Medicare and 2174
Medicaid Services, with a proposed effective date of July 1, 2019, 2175
to the extent possible, but in no event shall the effective date 2176
of such payment models be later than July 1, 2020. The Chairmen 2177
of the Senate and House Medicaid Committees shall be provided a 2178
copy of the proposed payment model(s) prior to submission. 2179
Effective July 1, 2018, and until such time as any payment 2180
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model(s) as described above become effective, the division, in 2181
consultation with the hospital industry, is authorized to 2182
implement a transitional program for inpatient and outpatient 2183
payments and/or supplemental payments (including, but not limited 2184
to, MHAP and directed payments), to redistribute available 2185
supplemental funds among hospital providers, provided that when 2186
compared to a hospital's prior year supplemental payments, 2187
supplemental payments made pursuant to any such transitional 2188
program shall not result in a decrease of more than five percent 2189
(5%) and shall not increase by more than the amount needed to 2190
maximize the distribution of the available funds. 2191
(v) 1. To preserve and improve access to 2192
ambulance transportation provider services, the division shall 2193
seek CMS approval to make ambulance service access payments as set 2194
forth in this subsection (A)(18)(b) for all covered emergency 2195
ambulance services rendered on or after July 1, 2022, and shall 2196
make such ambulance service access payments for all covered 2197
services rendered on or after the effective date of CMS approval. 2198
2. The division shall calculate the 2199
ambulance service access payment amount as the balance of the 2200
portion of the Medical Care Fund related to ambulance 2201
transportation service provider assessments plus any federal 2202
matching funds earned on the balance, up to, but not to exceed, 2203
the upper payment limit gap for all emergency ambulance service 2204
providers. 2205
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3. a. Except for ambulance services 2206
exempt from the assessment provided in this paragraph (18)(b), all 2207
ambulance transportation service providers shall be eligible for 2208
ambulance service access payments each state fiscal year as set 2209
forth in this paragraph (18)(b). 2210
b. In addition to any other funds 2211
paid to ambulance transportation service providers for emergency 2212
medical services provided to Medicaid beneficiaries, each eligible 2213
ambulance transportation service provider shall receive ambulance 2214
service access payments each state fiscal year equal to the 2215
ambulance transportation service provider's upper payment limit 2216
gap. Subject to approval by the Centers for Medicare and Medicaid 2217
Services, ambulance service access payments shall be made no less 2218
than on a quarterly basis. 2219
c. As used in this paragraph 2220
(18)(b)(v), the term "upper payment limit gap" means the 2221
difference between the total amount that the ambulance 2222
transportation service provider received from Medicaid and the 2223
average amount that the ambulance transportation service provider 2224
would have received from commercial insurers for those services 2225
reimbursed by Medicaid. 2226
4. An ambulance service access payment 2227
shall not be used to offset any other payment by the division for 2228
emergency or nonemergency services to Medicaid beneficiaries. 2229
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(c) (i) Not later than December l, 2015, the 2230
division shall, subject to approval by the Centers for Medicare 2231
and Medicaid Services (CMS), establish, implement and operate a 2232
Mississippi Hospital Access Program (MHAP) for the purpose of 2233
protecting patient access to hospital care through hospital 2234
inpatient reimbursement programs provided in this section designed 2235
to maintain total hospital reimbursement for inpatient services 2236
rendered by in-state hospitals and the out-of-state hospital that 2237
is authorized by federal law to submit intergovernmental transfers 2238
(IGTs) to the State of Mississippi and is classified as Level I 2239
trauma center located in a county contiguous to the state line at 2240
the maximum levels permissible under applicable federal statutes 2241
and regulations, at which time the current inpatient Medicare 2242
Upper Payment Limits (UPL) Program for hospital inpatient services 2243
shall transition to the MHAP. 2244
(ii) Subject to approval by the Centers for 2245
Medicare and Medicaid Services (CMS), the MHAP shall provide 2246
increased inpatient capitation (PMPM) payments to managed care 2247
entities contracting with the division pursuant to subsection (H) 2248
of this section to support availability of hospital services or 2249
such other payments permissible under federal law necessary to 2250
accomplish the intent of this subsection. 2251
(iii) The intent of this subparagraph (c) is 2252
that effective for all inpatient hospital Medicaid services during 2253
state fiscal year 2016, and so long as this provision shall remain 2254
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in effect hereafter, the division shall to the fullest extent 2255
feasible replace the additional reimbursement for hospital 2256
inpatient services under the inpatient Medicare Upper Payment 2257
Limits (UPL) Program with additional reimbursement under the MHAP 2258
and other payment programs for inpatient and/or outpatient 2259
payments which may be developed under the authority of this 2260
paragraph. 2261
(iv) The division shall assess each hospital 2262
as provided in Section 43-13-145(4)(a) for the purpose of 2263
financing the state portion of the MHAP, supplemental payments and 2264
such other purposes as specified in Section 43-13-145. The 2265
assessment will remain in effect as long as the MHAP and 2266
supplemental payments are in effect. 2267
(19) (a) Perinatal risk management services. The 2268
division shall promulgate regulations to be effective from and 2269
after October 1, 1988, to establish a comprehensive perinatal 2270
system for risk assessment of all pregnant and infant Medicaid 2271
recipients and for management, education and follow-up for those 2272
who are determined to be at risk. Services to be performed 2273
include case management, nutrition assessment/counseling, 2274
psychosocial assessment/counseling and health education. The 2275
division shall contract with the State Department of Health to 2276
provide services within this paragraph (Perinatal High Risk 2277
Management/Infant Services System (PHRM/ISS)). The State 2278
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Department of Health shall be reimbursed on a full reasonable cost 2279
basis for services provided under this subparagraph (a). 2280
(b) Early intervention system services. The 2281
division shall cooperate with the State Department of Health, 2282
acting as lead agency, in the development and implementation of a 2283
statewide system of delivery of early intervention services, under 2284
Part C of the Individuals with Disabilities Education Act (IDEA). 2285
The State Department of Health shall certify annually in writing 2286
to the executive director of the division the dollar amount of 2287
state early intervention funds available that will be utilized as 2288
a certified match for Medicaid matching funds. Those funds then 2289
shall be used to provide expanded targeted case management 2290
services for Medicaid eligible children with special needs who are 2291
eligible for the state's early intervention system. 2292
Qualifications for persons providing service coordination shall be 2293
determined by the State Department of Health and the Division of 2294
Medicaid. 2295
(20) Home- and community-based services for physically 2296
disabled approved services as allowed by a waiver from the United 2297
States Department of Health and Human Services for home- and 2298
community-based services for physically disabled people using 2299
state funds that are provided from the appropriation to the State 2300
Department of Rehabilitation Services and used to match federal 2301
funds under a cooperative agreement between the division and the 2302
department, provided that funds for these services are 2303
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specifically appropriated to the Department of Rehabilitation 2304
Services. 2305
(21) Nurse practitioner services. Services furnished 2306
by a registered nurse who is licensed and certified by the 2307
Mississippi Board of Nursing as a nurse practitioner, including, 2308
but not limited to, nurse anesthetists, nurse midwives, family 2309
nurse practitioners, family planning nurse practitioners, 2310
pediatric nurse practitioners, obstetrics-gynecology nurse 2311
practitioners and neonatal nurse practitioners, under regulations 2312
adopted by the division. Reimbursement for those services shall 2313
not exceed ninety percent (90%) of the reimbursement rate for 2314
comparable services rendered by a physician. The division may 2315
provide for a reimbursement rate for nurse practitioner services 2316
of up to one hundred percent (100%) of the reimbursement rate for 2317
comparable services rendered by a physician for nurse practitioner 2318
services that are provided after the normal working hours of the 2319
nurse practitioner, as determined in accordance with regulations 2320
of the division. 2321
(22) Ambulatory services delivered in federally 2322
qualified health centers, rural health centers and clinics of the 2323
local health departments of the State Department of Health for 2324
individuals eligible for Medicaid under this article based on 2325
reasonable costs as determined by the division. Federally 2326
qualified health centers shall be reimbursed by the Medicaid 2327
prospective payment system as approved by the Centers for Medicare 2328
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and Medicaid Services. The division shall recognize federally 2329
qualified health centers (FQHCs), rural health clinics (RHCs) and 2330
community mental health centers (CMHCs) as both an originating and 2331
distant site provider for the purposes of telehealth 2332
reimbursement. The division is further authorized and directed to 2333
reimburse FQHCs, RHCs and CMHCs for both distant site and 2334
originating site services when such services are appropriately 2335
provided by the same organization. 2336
(23) Inpatient psychiatric services. 2337
(a) Inpatient psychiatric services to be 2338
determined by the division for recipients under age twenty-one 2339
(21) that are provided under the direction of a physician in an 2340
inpatient program in a licensed acute care psychiatric facility or 2341
in a licensed psychiatric residential treatment facility, before 2342
the recipient reaches age twenty-one (21) or, if the recipient was 2343
receiving the services immediately before he or she reached age 2344
twenty-one (21), before the earlier of the date he or she no 2345
longer requires the services or the date he or she reaches age 2346
twenty-two (22), as provided by federal regulations. From and 2347
after January 1, 2015, the division shall update the fair rental 2348
reimbursement system for psychiatric residential treatment 2349
facilities. Precertification of inpatient days and residential 2350
treatment days must be obtained as required by the division. From 2351
and after July 1, 2009, all state-owned and state-operated 2352
facilities that provide inpatient psychiatric services to persons 2353
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under age twenty-one (21) who are eligible for Medicaid 2354
reimbursement shall be reimbursed for those services on a full 2355
reasonable cost basis. 2356
(b) The division may reimburse for services 2357
provided by a licensed freestanding psychiatric hospital to 2358
Medicaid recipients over the age of twenty-one (21) in a method 2359
and manner consistent with the provisions of Section 43-13-117.5. 2360
(24) [Deleted] 2361
(25) [Deleted] 2362
(26) Hospice care. As used in this paragraph, the term 2363
"hospice care" means a coordinated program of active professional 2364
medical attention within the home and outpatient and inpatient 2365
care that treats the terminally ill patient and family as a unit, 2366
employing a medically directed interdisciplinary team. The 2367
program provides relief of severe pain or other physical symptoms 2368
and supportive care to meet the special needs arising out of 2369
physical, psychological, spiritual, social and economic stresses 2370
that are experienced during the final stages of illness and during 2371
dying and bereavement and meets the Medicare requirements for 2372
participation as a hospice as provided in federal regulations. 2373
(27) Group health plan premiums and cost-sharing if it 2374
is cost-effective as defined by the United States Secretary of 2375
Health and Human Services. 2376
(28) Other health insurance premiums that are 2377
cost-effective as defined by the United States Secretary of Health 2378
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and Human Services. Medicare eligible must have Medicare Part B 2379
before other insurance premiums can be paid. 2380
(29) The Division of Medicaid may apply for a waiver 2381
from the United States Department of Health and Human Services for 2382
home- and community-based services for developmentally disabled 2383
people using state funds that are provided from the appropriation 2384
to the State Department of Mental Health and/or funds transferred 2385
to the department by a political subdivision or instrumentality of 2386
the state and used to match federal funds under a cooperative 2387
agreement between the division and the department, provided that 2388
funds for these services are specifically appropriated to the 2389
Department of Mental Health and/or transferred to the department 2390
by a political subdivision or instrumentality of the state. 2391
(30) Pediatric skilled nursing services as determined 2392
by the division and in a manner consistent with regulations 2393
promulgated by the Mississippi State Department of Health. 2394
(31) Targeted case management services for children 2395
with special needs, under waivers from the United States 2396
Department of Health and Human Services, using state funds that 2397
are provided from the appropriation to the Mississippi Department 2398
of Human Services and used to match federal funds under a 2399
cooperative agreement between the division and the department. 2400
(32) Care and services provided in Christian Science 2401
Sanatoria listed and certified by the Commission for Accreditation 2402
of Christian Science Nursing Organizations/Facilities, Inc., 2403
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rendered in connection with treatment by prayer or spiritual means 2404
to the extent that those services are subject to reimbursement 2405
under Section 1903 of the federal Social Security Act. 2406
(33) Podiatrist services. 2407
(34) Assisted living services as provided through 2408
home- and community-based services under Title XIX of the federal 2409
Social Security Act, as amended, subject to the availability of 2410
funds specifically appropriated for that purpose by the 2411
Legislature. 2412
(35) Services and activities authorized in Sections 2413
43-27-101 and 43-27-103, using state funds that are provided from 2414
the appropriation to the Mississippi Department of Human Services 2415
and used to match federal funds under a cooperative agreement 2416
between the division and the department. 2417
(36) Nonemergency transportation services for 2418
Medicaid-eligible persons as determined by the division. The PEER 2419
Committee shall conduct a performance evaluation of the 2420
nonemergency transportation program to evaluate the administration 2421
of the program and the providers of transportation services to 2422
determine the most cost-effective ways of providing nonemergency 2423
transportation services to the patients served under the program. 2424
The performance evaluation shall be completed and provided to the 2425
members of the Senate Medicaid Committee and the House Medicaid 2426
Committee not later than January 1, 2019, and every two (2) years 2427
thereafter. 2428
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(37) [Deleted] 2429
(38) Chiropractic services. A chiropractor's manual 2430
manipulation of the spine to correct a subluxation, if x-ray 2431
demonstrates that a subluxation exists and if the subluxation has 2432
resulted in a neuromusculoskeletal condition for which 2433
manipulation is appropriate treatment, and related spinal x-rays 2434
performed to document these conditions. Reimbursement for 2435
chiropractic services shall not exceed Seven Hundred Dollars 2436
($700.00) per year per beneficiary. 2437
(39) Dually eligible Medicare/Medicaid beneficiaries. 2438
The division shall pay the Medicare deductible and coinsurance 2439
amounts for services available under Medicare, as determined by 2440
the division. From and after July 1, 2009, the division shall 2441
reimburse crossover claims for inpatient hospital services and 2442
crossover claims covered under Medicare Part B in the same manner 2443
that was in effect on January 1, 2008, unless specifically 2444
authorized by the Legislature to change this method. 2445
(40) [Deleted] 2446
(41) Services provided by the State Department of 2447
Rehabilitation Services for the care and rehabilitation of persons 2448
with spinal cord injuries or traumatic brain injuries, as allowed 2449
under waivers from the United States Department of Health and 2450
Human Services, using up to seventy-five percent (75%) of the 2451
funds that are appropriated to the Department of Rehabilitation 2452
Services from the Spinal Cord and Head Injury Trust Fund 2453
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established under Section 37-33-261 and used to match federal 2454
funds under a cooperative agreement between the division and the 2455
department. 2456
(42) [Deleted] 2457
(43) The division shall provide reimbursement, 2458
according to a payment schedule developed by the division, for 2459
smoking cessation medications for pregnant women during their 2460
pregnancy and other Medicaid-eligible women who are of 2461
child-bearing age. 2462
(44) Nursing facility services for the severely 2463
disabled. 2464
(a) Severe disabilities include, but are not 2465
limited to, spinal cord injuries, closed-head injuries and 2466
ventilator-dependent patients. 2467
(b) Those services must be provided in a long-term 2468
care nursing facility dedicated to the care and treatment of 2469
persons with severe disabilities. 2470
(45) Physician assistant services. Services furnished 2471
by a physician assistant who is licensed by the State Board of 2472
Medical Licensure and is practicing with physician supervision 2473
under regulations adopted by the board, under regulations adopted 2474
by the division. Reimbursement for those services shall not 2475
exceed ninety percent (90%) of the reimbursement rate for 2476
comparable services rendered by a physician. The division may 2477
provide for a reimbursement rate for physician assistant services 2478
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of up to one hundred percent (100%) or the reimbursement rate for 2479
comparable services rendered by a physician for physician 2480
assistant services that are provided after the normal working 2481
hours of the physician assistant, as determined in accordance with 2482
regulations of the division. 2483
(46) The division shall make application to the federal 2484
Centers for Medicare and Medicaid Services (CMS) for a waiver to 2485
develop and provide services for children with serious emotional 2486
disturbances as defined in Section 43-14-1(1), which may include 2487
home- and community-based services, case management services or 2488
managed care services through mental health providers certified by 2489
the Department of Mental Health. The division may implement and 2490
provide services under this waivered program only if funds for 2491
these services are specifically appropriated for this purpose by 2492
the Legislature, or if funds are voluntarily provided by affected 2493
agencies. 2494
(47) (a) The division may develop and implement 2495
disease management programs for individuals with high-cost chronic 2496
diseases and conditions, including the use of grants, waivers, 2497
demonstrations or other projects as necessary. 2498
(b) Participation in any disease management 2499
program implemented under this paragraph (47) is optional with the 2500
individual. An individual must affirmatively elect to participate 2501
in the disease management program in order to participate, and may 2502
elect to discontinue participation in the program at any time. 2503
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(48) Pediatric long-term acute care hospital services. 2504
(a) Pediatric long-term acute care hospital 2505
services means services provided to eligible persons under 2506
twenty-one (21) years of age by a freestanding Medicare-certified 2507
hospital that has an average length of inpatient stay greater than 2508
twenty-five (25) days and that is primarily engaged in providing 2509
chronic or long-term medical care to persons under twenty-one (21) 2510
years of age. 2511
(b) The services under this paragraph (48) shall 2512
be reimbursed as a separate category of hospital services. 2513
(49) The division may establish copayments and/or 2514
coinsurance for any Medicaid services for which copayments and/or 2515
coinsurance are allowable under federal law or regulation. 2516
(50) Services provided by the State Department of 2517
Rehabilitation Services for the care and rehabilitation of persons 2518
who are deaf and blind, as allowed under waivers from the United 2519
States Department of Health and Human Services to provide home- 2520
and community-based services using state funds that are provided 2521
from the appropriation to the State Department of Rehabilitation 2522
Services or if funds are voluntarily provided by another agency. 2523
(51) Upon determination of Medicaid eligibility and in 2524
association with annual redetermination of Medicaid eligibility, 2525
beneficiaries shall be encouraged to undertake a physical 2526
examination that will establish a base-line level of health and 2527
identification of a usual and customary source of care (a medical 2528
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home) to aid utilization of disease management tools. This 2529
physical examination and utilization of these disease management 2530
tools shall be consistent with current United States Preventive 2531
Services Task Force or other recognized authority recommendations. 2532
For persons who are determined ineligible for Medicaid, the 2533
division will provide information and direction for accessing 2534
medical care and services in the area of their residence. 2535
(52) Notwithstanding any provisions of this article, 2536
the division may pay enhanced reimbursement fees related to trauma 2537
care, as determined by the division in conjunction with the State 2538
Department of Health, using funds appropriated to the State 2539
Department of Health for trauma care and services and used to 2540
match federal funds under a cooperative agreement between the 2541
division and the State Department of Health. The division, in 2542
conjunction with the State Department of Health, may use grants, 2543
waivers, demonstrations, enhanced reimbursements, Upper Payment 2544
Limits Programs, supplemental payments, or other projects as 2545
necessary in the development and implementation of this 2546
reimbursement program. 2547
(53) Targeted case management services for high-cost 2548
beneficiaries may be developed by the division for all services 2549
under this section. 2550
(54) [Deleted] 2551
(55) Therapy services. The plan of care for therapy 2552
services may be developed to cover a period of treatment for up to 2553
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six (6) months, but in no event shall the plan of care exceed a 2554
six-month period of treatment. The projected period of treatment 2555
must be indicated on the initial plan of care and must be updated 2556
with each subsequent revised plan of care. Based on medical 2557
necessity, the division shall approve certification periods for 2558
less than or up to six (6) months, but in no event shall the 2559
certification period exceed the period of treatment indicated on 2560
the plan of care. The appeal process for any reduction in therapy 2561
services shall be consistent with the appeal process in federal 2562
regulations. 2563
(56) Prescribed pediatric extended care centers 2564
services for medically dependent or technologically dependent 2565
children with complex medical conditions that require continual 2566
care as prescribed by the child's attending physician, as 2567
determined by the division. 2568
(57) No Medicaid benefit shall restrict coverage for 2569
medically appropriate treatment prescribed by a physician and 2570
agreed to by a fully informed individual, or if the individual 2571
lacks legal capacity to consent by a person who has legal 2572
authority to consent on his or her behalf, based on an 2573
individual's diagnosis with a terminal condition. As used in this 2574
paragraph (57), "terminal condition" means any aggressive 2575
malignancy, chronic end-stage cardiovascular or cerebral vascular 2576
disease, or any other disease, illness or condition which a 2577
physician diagnoses as terminal. 2578
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(58) Treatment services for persons with opioid 2579
dependency or other highly addictive substance use disorders. The 2580
division is authorized to reimburse eligible providers for 2581
treatment of opioid dependency and other highly addictive 2582
substance use disorders, as determined by the division. Treatment 2583
related to these conditions shall not count against any physician 2584
visit limit imposed under this section. 2585
(59) The division shall allow beneficiaries between the 2586
ages of ten (10) and eighteen (18) years to receive vaccines 2587
through a pharmacy venue. The division and the State Department 2588
of Health shall coordinate and notify OB-GYN providers that the 2589
Vaccines for Children program is available to providers free of 2590
charge. 2591
(60) Border city university-affiliated pediatric 2592
teaching hospital. 2593
(a) Payments may only be made to a border city 2594
university-affiliated pediatric teaching hospital if the Centers 2595
for Medicare and Medicaid Services (CMS) approve an increase in 2596
the annual request for the provider payment initiative authorized 2597
under 42 CFR Section 438.6(c) in an amount equal to or greater 2598
than the estimated annual payment to be made to the border city 2599
university-affiliated pediatric teaching hospital. The estimate 2600
shall be based on the hospital's prior year Mississippi managed 2601
care utilization. 2602
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(b) As used in this paragraph (60), the term 2603
"border city university-affiliated pediatric teaching hospital" 2604
means an out-of-state hospital located within a city bordering the 2605
eastern bank of the Mississippi River and the State of Mississippi 2606
that submits to the division a copy of a current and effective 2607
affiliation agreement with an accredited university and other 2608
documentation establishing that the hospital is 2609
university-affiliated, is licensed and designated as a pediatric 2610
hospital or pediatric primary hospital within its home state, 2611
maintains at least five (5) different pediatric specialty training 2612
programs, and maintains at least one hundred (100) operated beds 2613
dedicated exclusively for the treatment of patients under the age 2614
of twenty-one (21) years. 2615
(c) The cost of providing services to Mississippi 2616
Medicaid beneficiaries under the age of twenty-one (21) years who 2617
are treated by a border city university-affiliated pediatric 2618
teaching hospital shall not exceed the cost of providing the same 2619
services to individuals in hospitals in the state. 2620
(d) It is the intent of the Legislature that 2621
payments shall not result in any in-state hospital receiving 2622
payments lower than they would otherwise receive if not for the 2623
payments made to any border city university-affiliated pediatric 2624
teaching hospital. 2625
(e) This paragraph (60) shall stand repealed on 2626
July 1, 2024. 2627
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(61) Services described in Section 41-140-3 that are 2628
provided by certified community health workers employed and 2629
supervised by a Medicaid provider. Reimbursement for these 2630
services shall be provided only if the division has received 2631
approval from the Centers for Medicare and Medicaid Services for a 2632
state plan amendment, waiver or alternative payment model for 2633
services delivered by certified community health workers. 2634
(62) Coverage for the services described in Sections 16 2635
through 21, 33 and 48 through 55 of this act. 2636
(B) Planning and development districts participating in the 2637
home- and community-based services program for the elderly and 2638
disabled as case management providers shall be reimbursed for case 2639
management services at the maximum rate approved by the Centers 2640
for Medicare and Medicaid Services (CMS). 2641
(C) The division may pay to those providers who participate 2642
in and accept patient referrals from the division's emergency room 2643
redirection program a percentage, as determined by the division, 2644
of savings achieved according to the performance measures and 2645
reduction of costs required of that program. Federally qualified 2646
health centers may participate in the emergency room redirection 2647
program, and the division may pay those centers a percentage of 2648
any savings to the Medicaid program achieved by the centers' 2649
accepting patient referrals through the program, as provided in 2650
this subsection (C). 2651
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(D) (1) As used in this subsection (D), the following terms 2652
shall be defined as provided in this paragraph, except as 2653
otherwise provided in this subsection: 2654
(a) "Committees" means the Medicaid Committees of 2655
the House of Representatives and the Senate, and "committee" means 2656
either one of those committees. 2657
(b) "Rate change" means an increase, decrease or 2658
other change in the payments or rates of reimbursement, or a 2659
change in any payment methodology that results in an increase, 2660
decrease or other change in the payments or rates of 2661
reimbursement, to any Medicaid provider that renders any services 2662
authorized to be provided to Medicaid recipients under this 2663
article. 2664
(2) Whenever the Division of Medicaid proposes a rate 2665
change, the division shall give notice to the chairmen of the 2666
committees at least thirty (30) calendar days before the proposed 2667
rate change is scheduled to take effect. The division shall 2668
furnish the chairmen with a concise summary of each proposed rate 2669
change along with the notice, and shall furnish the chairmen with 2670
a copy of any proposed rate change upon request. The division 2671
also shall provide a summary and copy of any proposed rate change 2672
to any other member of the Legislature upon request. 2673
(3) If the chairman of either committee or both 2674
chairmen jointly object to the proposed rate change or any part 2675
thereof, the chairman or chairmen shall notify the division and 2676
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provide the reasons for their objection in writing not later than 2677
seven (7) calendar days after receipt of the notice from the 2678
division. The chairman or chairmen may make written 2679
recommendations to the division for changes to be made to a 2680
proposed rate change. 2681
(4) (a) The chairman of either committee or both 2682
chairmen jointly may hold a committee meeting to review a proposed 2683
rate change. If either chairman or both chairmen decide to hold a 2684
meeting, they shall notify the division of their intention in 2685
writing within seven (7) calendar days after receipt of the notice 2686
from the division, and shall set the date and time for the meeting 2687
in their notice to the division, which shall not be later than 2688
fourteen (14) calendar days after receipt of the notice from the 2689
division. 2690
(b) After the committee meeting, the committee or 2691
committees may object to the proposed rate change or any part 2692
thereof. The committee or committees shall notify the division 2693
and the reasons for their objection in writing not later than 2694
seven (7) calendar days after the meeting. The committee or 2695
committees may make written recommendations to the division for 2696
changes to be made to a proposed rate change. 2697
(5) If both chairmen notify the division in writing 2698
within seven (7) calendar days after receipt of the notice from 2699
the division that they do not object to the proposed rate change 2700
and will not be holding a meeting to review the proposed rate 2701
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change, the proposed rate change will take effect on the original 2702
date as scheduled by the division or on such other date as 2703
specified by the division. 2704
(6) (a) If there are any objections to a proposed rate 2705
change or any part thereof from either or both of the chairmen or 2706
the committees, the division may withdraw the proposed rate 2707
change, make any of the recommended changes to the proposed rate 2708
change, or not make any changes to the proposed rate change. 2709
(b) If the division does not make any changes to 2710
the proposed rate change, it shall notify the chairmen of that 2711
fact in writing, and the proposed rate change shall take effect on 2712
the original date as scheduled by the division or on such other 2713
date as specified by the division. 2714
(c) If the division makes any changes to the 2715
proposed rate change, the division shall notify the chairmen of 2716
its actions in writing, and the revised proposed rate change shall 2717
take effect on the date as specified by the division. 2718
(7) Nothing in this subsection (D) shall be construed 2719
as giving the chairmen or the committees any authority to veto, 2720
nullify or revise any rate change proposed by the division. The 2721
authority of the chairmen or the committees under this subsection 2722
shall be limited to reviewing, making objections to and making 2723
recommendations for changes to rate changes proposed by the 2724
division. 2725
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(E) Notwithstanding any provision of this article, no new 2726
groups or categories of recipients and new types of care and 2727
services may be added without enabling legislation from the 2728
Mississippi Legislature, except that the division may authorize 2729
those changes without enabling legislation when the addition of 2730
recipients or services is ordered by a court of proper authority. 2731
(F) The executive director shall keep the Governor advised 2732
on a timely basis of the funds available for expenditure and the 2733
projected expenditures. Notwithstanding any other provisions of 2734
this article, if current or projected expenditures of the division 2735
are reasonably anticipated to exceed the amount of funds 2736
appropriated to the division for any fiscal year, the Governor, 2737
after consultation with the executive director, shall take all 2738
appropriate measures to reduce costs, which may include, but are 2739
not limited to: 2740
(1) Reducing or discontinuing any or all services that 2741
are deemed to be optional under Title XIX of the Social Security 2742
Act; 2743
(2) Reducing reimbursement rates for any or all service 2744
types; 2745
(3) Imposing additional assessments on health care 2746
providers; or 2747
(4) Any additional cost-containment measures deemed 2748
appropriate by the Governor. 2749
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To the extent allowed under federal law, any reduction to 2750
services or reimbursement rates under this subsection (F) shall be 2751
accompanied by a reduction, to the fullest allowable amount, to 2752
the profit margin and administrative fee portions of capitated 2753
payments to organizations described in paragraph (1) of subsection 2754
(H). 2755
Beginning in fiscal year 2010 and in fiscal years thereafter, 2756
when Medicaid expenditures are projected to exceed funds available 2757
for the fiscal year, the division shall submit the expected 2758
shortfall information to the PEER Committee not later than 2759
December 1 of the year in which the shortfall is projected to 2760
occur. PEER shall review the computations of the division and 2761
report its findings to the Legislative Budget Office not later 2762
than January 7 in any year. 2763
(G) Notwithstanding any other provision of this article, it 2764
shall be the duty of each provider participating in the Medicaid 2765
program to keep and maintain books, documents and other records as 2766
prescribed by the Division of Medicaid in accordance with federal 2767
laws and regulations. 2768
(H) (1) Notwithstanding any other provision of this 2769
article, the division is authorized to implement (a) a managed 2770
care program, (b) a coordinated care program, (c) a coordinated 2771
care organization program, (d) a health maintenance organization 2772
program, (e) a patient-centered medical home program, (f) an 2773
accountable care organization program, (g) provider-sponsored 2774
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health plan, or (h) any combination of the above programs. As a 2775
condition for the approval of any program under this subsection 2776
(H)(1), the division shall require that no managed care program, 2777
coordinated care program, coordinated care organization program, 2778
health maintenance organization program, or provider-sponsored 2779
health plan may: 2780
(a) Pay providers at a rate that is less than the 2781
Medicaid All Patient Refined Diagnosis Related Groups (APR-DRG) 2782
reimbursement rate; 2783
(b) Override the medical decisions of hospital 2784
physicians or staff regarding patients admitted to a hospital for 2785
an emergency medical condition as defined by 42 US Code Section 2786
1395dd. This restriction (b) does not prohibit the retrospective 2787
review of the appropriateness of the determination that an 2788
emergency medical condition exists by chart review or coding 2789
algorithm, nor does it prohibit prior authorization for 2790
nonemergency hospital admissions; 2791
(c) Pay providers at a rate that is less than the 2792
normal Medicaid reimbursement rate. It is the intent of the 2793
Legislature that all managed care entities described in this 2794
subsection (H), in collaboration with the division, develop and 2795
implement innovative payment models that incentivize improvements 2796
in health care quality, outcomes, or value, as determined by the 2797
division. Participation in the provider network of any managed 2798
care, coordinated care, provider-sponsored health plan, or similar 2799
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contractor shall not be conditioned on the provider's agreement to 2800
accept such alternative payment models; 2801
(d) Implement a prior authorization and 2802
utilization review program for medical services, transportation 2803
services and prescription drugs that is more stringent than the 2804
prior authorization processes used by the division in its 2805
administration of the Medicaid program. Not later than December 2806
2, 2021, the contractors that are receiving capitated payments 2807
under a managed care delivery system established under this 2808
subsection (H) shall submit a report to the Chairmen of the House 2809
and Senate Medicaid Committees on the status of the prior 2810
authorization and utilization review program for medical services, 2811
transportation services and prescription drugs that is required to 2812
be implemented under this subparagraph (d); 2813
(e) [Deleted] 2814
(f) Implement a preferred drug list that is more 2815
stringent than the mandatory preferred drug list established by 2816
the division under subsection (A)(9) of this section; 2817
(g) Implement a policy which denies beneficiaries 2818
with hemophilia access to the federally funded hemophilia 2819
treatment centers as part of the Medicaid Managed Care network of 2820
providers. 2821
Each health maintenance organization, coordinated care 2822
organization, provider-sponsored health plan, or other 2823
organization paid for services on a capitated basis by the 2824
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division under any managed care program or coordinated care 2825
program implemented by the division under this section shall use a 2826
clear set of level of care guidelines in the determination of 2827
medical necessity and in all utilization management practices, 2828
including the prior authorization process, concurrent reviews, 2829
retrospective reviews and payments, that are consistent with 2830
widely accepted professional standards of care. Organizations 2831
participating in a managed care program or coordinated care 2832
program implemented by the division may not use any additional 2833
criteria that would result in denial of care that would be 2834
determined appropriate and, therefore, medically necessary under 2835
those levels of care guidelines. 2836
(2) Notwithstanding any provision of this section, the 2837
recipients eligible for enrollment into a Medicaid Managed Care 2838
Program authorized under this subsection (H) may include only 2839
those categories of recipients eligible for participation in the 2840
Medicaid Managed Care Program as of January 1, 2021, the 2841
Children's Health Insurance Program (CHIP), and the CMS-approved 2842
Section 1115 demonstration waivers in operation as of January 1, 2843
2021. No expansion of Medicaid Managed Care Program contracts may 2844
be implemented by the division without enabling legislation from 2845
the Mississippi Legislature. 2846
(3) (a) Any contractors receiving capitated payments 2847
under a managed care delivery system established in this section 2848
shall provide to the Legislature and the division statistical data 2849
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to be shared with provider groups in order to improve patient 2850
access, appropriate utilization, cost savings and health outcomes 2851
not later than October 1 of each year. Additionally, each 2852
contractor shall disclose to the Chairmen of the Senate and House 2853
Medicaid Committees the administrative expenses costs for the 2854
prior calendar year, and the number of full-equivalent employees 2855
located in the State of Mississippi dedicated to the Medicaid and 2856
CHIP lines of business as of June 30 of the current year. 2857
(b) The division and the contractors participating 2858
in the managed care program, a coordinated care program or a 2859
provider-sponsored health plan shall be subject to annual program 2860
reviews or audits performed by the Office of the State Auditor, 2861
the PEER Committee, the Department of Insurance and/or independent 2862
third parties. 2863
(c) Those reviews shall include, but not be 2864
limited to, at least two (2) of the following items: 2865
(i) The financial benefit to the State of 2866
Mississippi of the managed care program, 2867
(ii) The difference between the premiums paid 2868
to the managed care contractors and the payments made by those 2869
contractors to health care providers, 2870
(iii) Compliance with performance measures 2871
required under the contracts, 2872
(iv) Administrative expense allocation 2873
methodologies, 2874
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(v) Whether nonprovider payments assigned as 2875
medical expenses are appropriate, 2876
(vi) Capitated arrangements with related 2877
party subcontractors, 2878
(vii) Reasonableness of corporate 2879
allocations, 2880
(viii) Value-added benefits and the extent to 2881
which they are used, 2882
(ix) The effectiveness of subcontractor 2883
oversight, including subcontractor review, 2884
(x) Whether health care outcomes have been 2885
improved, and 2886
(xi) The most common claim denial codes to 2887
determine the reasons for the denials. 2888
The audit reports shall be considered public documents and 2889
shall be posted in their entirety on the division's website. 2890
(4) All health maintenance organizations, coordinated 2891
care organizations, provider-sponsored health plans, or other 2892
organizations paid for services on a capitated basis by the 2893
division under any managed care program or coordinated care 2894
program implemented by the division under this section shall 2895
reimburse all providers in those organizations at rates no lower 2896
than those provided under this section for beneficiaries who are 2897
not participating in those programs. 2898
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(5) No health maintenance organization, coordinated 2899
care organization, provider-sponsored health plan, or other 2900
organization paid for services on a capitated basis by the 2901
division under any managed care program or coordinated care 2902
program implemented by the division under this section shall 2903
require its providers or beneficiaries to use any pharmacy that 2904
ships, mails or delivers prescription drugs or legend drugs or 2905
devices. 2906
(6) (a) Not later than December 1, 2021, the 2907
contractors who are receiving capitated payments under a managed 2908
care delivery system established under this subsection (H) shall 2909
develop and implement a uniform credentialing process for 2910
providers. Under that uniform credentialing process, a provider 2911
who meets the criteria for credentialing will be credentialed with 2912
all of those contractors and no such provider will have to be 2913
separately credentialed by any individual contractor in order to 2914
receive reimbursement from the contractor. Not later than 2915
December 2, 2021, those contractors shall submit a report to the 2916
Chairmen of the House and Senate Medicaid Committees on the status 2917
of the uniform credentialing process for providers that is 2918
required under this subparagraph (a). 2919
(b) If those contractors have not implemented a 2920
uniform credentialing process as described in subparagraph (a) by 2921
December 1, 2021, the division shall develop and implement, not 2922
later than July 1, 2022, a single, consolidated credentialing 2923
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process by which all providers will be credentialed. Under the 2924
division's single, consolidated credentialing process, no such 2925
contractor shall require its providers to be separately 2926
credentialed by the contractor in order to receive reimbursement 2927
from the contractor, but those contractors shall recognize the 2928
credentialing of the providers by the division's credentialing 2929
process. 2930
(c) The division shall require a uniform provider 2931
credentialing application that shall be used in the credentialing 2932
process that is established under subparagraph (a) or (b). If the 2933
contractor or division, as applicable, has not approved or denied 2934
the provider credentialing application within sixty (60) days of 2935
receipt of the completed application that includes all required 2936
information necessary for credentialing, then the contractor or 2937
division, upon receipt of a written request from the applicant and 2938
within five (5) business days of its receipt, shall issue a 2939
temporary provider credential/enrollment to the applicant if the 2940
applicant has a valid Mississippi professional or occupational 2941
license to provide the health care services to which the 2942
credential/enrollment would apply. The contractor or the division 2943
shall not issue a temporary credential/enrollment if the applicant 2944
has reported on the application a history of medical or other 2945
professional or occupational malpractice claims, a history of 2946
substance abuse or mental health issues, a criminal record, or a 2947
history of medical or other licensing board, state or federal 2948
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disciplinary action, including any suspension from participation 2949
in a federal or state program. The temporary 2950
credential/enrollment shall be effective upon issuance and shall 2951
remain in effect until the provider's credentialing/enrollment 2952
application is approved or denied by the contractor or division. 2953
The contractor or division shall render a final decision regarding 2954
credentialing/enrollment of the provider within sixty (60) days 2955
from the date that the temporary provider credential/enrollment is 2956
issued to the applicant. 2957
(d) If the contractor or division does not render 2958
a final decision regarding credentialing/enrollment of the 2959
provider within the time required in subparagraph (c), the 2960
provider shall be deemed to be credentialed by and enrolled with 2961
all of the contractors and eligible to receive reimbursement from 2962
the contractors. 2963
(7) (a) Each contractor that is receiving capitated 2964
payments under a managed care delivery system established under 2965
this subsection (H) shall provide to each provider for whom the 2966
contractor has denied the coverage of a procedure that was ordered 2967
or requested by the provider for or on behalf of a patient, a 2968
letter that provides a detailed explanation of the reasons for the 2969
denial of coverage of the procedure and the name and the 2970
credentials of the person who denied the coverage. The letter 2971
shall be sent to the provider in electronic format. 2972
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(b) After a contractor that is receiving capitated 2973
payments under a managed care delivery system established under 2974
this subsection (H) has denied coverage for a claim submitted by a 2975
provider, the contractor shall issue to the provider within sixty 2976
(60) days a final ruling of denial of the claim that allows the 2977
provider to have a state fair hearing and/or agency appeal with 2978
the division. If a contractor does not issue a final ruling of 2979
denial within sixty (60) days as required by this subparagraph 2980
(b), the provider's claim shall be deemed to be automatically 2981
approved and the contractor shall pay the amount of the claim to 2982
the provider. 2983
(c) After a contractor has issued a final ruling 2984
of denial of a claim submitted by a provider, the division shall 2985
conduct a state fair hearing and/or agency appeal on the matter of 2986
the disputed claim between the contractor and the provider within 2987
sixty (60) days, and shall render a decision on the matter within 2988
thirty (30) days after the date of the hearing and/or appeal. 2989
(8) It is the intention of the Legislature that the 2990
division evaluate the feasibility of using a single vendor to 2991
administer pharmacy benefits provided under a managed care 2992
delivery system established under this subsection (H). Providers 2993
of pharmacy benefits shall cooperate with the division in any 2994
transition to a carve-out of pharmacy benefits under managed care. 2995
(9) The division shall evaluate the feasibility of 2996
using a single vendor to administer dental benefits provided under 2997
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a managed care delivery system established in this subsection (H). 2998
Providers of dental benefits shall cooperate with the division in 2999
any transition to a carve-out of dental benefits under managed 3000
care. 3001
(10) It is the intent of the Legislature that any 3002
contractor receiving capitated payments under a managed care 3003
delivery system established in this section shall implement 3004
innovative programs to improve the health and well-being of 3005
members diagnosed with prediabetes and diabetes. 3006
(11) It is the intent of the Legislature that any 3007
contractors receiving capitated payments under a managed care 3008
delivery system established under this subsection (H) shall work 3009
with providers of Medicaid services to improve the utilization of 3010
long-acting reversible contraceptives (LARCs). Not later than 3011
December 1, 2021, any contractors receiving capitated payments 3012
under a managed care delivery system established under this 3013
subsection (H) shall provide to the Chairmen of the House and 3014
Senate Medicaid Committees and House and Senate Public Health 3015
Committees a report of LARC utilization for State Fiscal Years 3016
2018 through 2020 as well as any programs, initiatives, or efforts 3017
made by the contractors and providers to increase LARC 3018
utilization. This report shall be updated annually to include 3019
information for subsequent state fiscal years. 3020
(12) The division is authorized to make not more than 3021
one (1) emergency extension of the contracts that are in effect on 3022
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July 1, 2021, with contractors who are receiving capitated 3023
payments under a managed care delivery system established under 3024
this subsection (H), as provided in this paragraph (12). The 3025
maximum period of any such extension shall be one (1) year, and 3026
under any such extensions, the contractors shall be subject to all 3027
of the provisions of this subsection (H). The extended contracts 3028
shall be revised to incorporate any provisions of this subsection 3029
(H). 3030
(I) [Deleted] 3031
(J) There shall be no cuts in inpatient and outpatient 3032
hospital payments, or allowable days or volumes, as long as the 3033
hospital assessment provided in Section 43-13-145 is in effect. 3034
This subsection (J) shall not apply to decreases in payments that 3035
are a result of: reduced hospital admissions, audits or payments 3036
under the APR-DRG or APC models, or a managed care program or 3037
similar model described in subsection (H) of this section. 3038
(K) In the negotiation and execution of such contracts 3039
involving services performed by actuarial firms, the Executive 3040
Director of the Division of Medicaid may negotiate a limitation on 3041
liability to the state of prospective contractors. 3042
(L) The Division of Medicaid shall reimburse for services 3043
provided to eligible Medicaid beneficiaries by a licensed birthing 3044
center in a method and manner to be determined by the division in 3045
accordance with federal laws and federal regulations. The 3046
division shall seek any necessary waivers, make any required 3047
H. B. No. 1493 *HR43/R1950.1* ~ OFFICIAL ~
26/HR43/R1950.1
PAGE 125 (RF\KP)
ST: Mississippi Maternal Health Momnibus Act;
create.
amendments to its State Plan or revise any contracts authorized 3048
under subsection (H) of this section as necessary to provide the 3049
services authorized under this subsection. As used in this 3050
subsection, the term "birthing centers" shall have the meaning as 3051
defined in Section 41-77-1(a), which is a publicly or privately 3052
owned facility, place or institution constructed, renovated, 3053
leased or otherwise established where nonemergency births are 3054
planned to occur away from the mother's usual residence following 3055
a documented period of prenatal care for a normal uncomplicated 3056
pregnancy which has been determined to be low risk through a 3057
formal risk-scoring examination. 3058
(M) This section shall stand repealed on July 1, 2028. 3059
SECTION 59. This act shall take effect and be in force from 3060
and after July 1, 2026. 3061