Creating Logic for Efficiency and Accountability Reform (CLEAR) Act; create.

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To: Accountability,
Efficiency, Transparency
MISSISSIPPI LEGISLATURE REGULAR SESSION 2026

By: Senator(s) McMahan

SENATE BILL NO. 2621

AN ACT TO BE KNOWN AS THE CREATING LOGIC FOR EFFICIENCY AND 1
ACCOUNTABILITY REFORM (CLEAR) ACT; TO CREATE NEW SECTION 5-3-77, 2
MISSISSIPPI CODE OF 1972, TO AUTHORIZE THE PEER COMMITTEE TO 3
ESTABLISH A PROGRAM OF REVIEWING SELECTED NEWLY ADOPTED STATE 4
AGENCY ADMINISTRATIVE RULES; TO PROVIDE THAT SUCH REVIEWS SHALL 5
PRODUCE A REPORT TO THE LEGISLATURE ON NEWLY ADOPTED STATE AGENCY 6
ADMINISTRATIVE RULES AND THEIR CONFORMITY TO THE INTENT OF THE LAW 7
AUTHORIZING THEM, AS WELL AS ANY OTHER MATTER THE COMMITTEE 8
CONSIDERS APPROPRIATE; TO AMEND SECTION 43-13-117, MISSISSIPPI 9
CODE OF 1972, TO PROVIDE THAT THE PEER COMMITTEE SHALL CONDUCT A 10
PERFORMANCE EVALUATION OF THE MEDICAID NONEMERGENCY TRANSPORTATION 11
PROGRAM ONCE EVERY THREE YEARS TO EVALUATE THE ADMINISTRATION OF 12
THE PROGRAM AND THE PROVIDERS OF TRANSPORTATION SERVICES TO 13
DETERMINE THE MOST COST-EFFECTIVE WAYS OF PROVIDING NONEMERGENCY 14
TRANSPORTATION SERVICES TO THE PATIENTS SERVED UNDER THE PROGRAM; 15
TO CREATE THE STATE BOARD OF HEALTH PROFESSIONS; TO PROVIDE THAT 16
THE MEMBERS OF THE BOARD SHALL BE ONE MEMBER FROM THE BOARDS OF 17
MEDICAL LICENSURE, PHARMACY, NURSING, CHIROPRACTIC EXAMINERS, 18
DENTAL EXAMINERS AND OPTOMETRY, AND FIVE ADDITIONAL MEMBERS; TO 19
PROVIDE THAT THE BOARD SHALL EVALUATE THE NEED FOR COORDINATION 20
AMONG THE HEALTH REGULATORY BOARDS AND THEIR STAFFS, EVALUATE ALL 21
HEALTH CARE PROFESSIONS AND OCCUPATIONS IN THE STATE AND CONSIDER 22
WHETHER EACH SUCH PROFESSION OR OCCUPATION SHOULD BE REGULATED AND 23
THE DEGREE OF REGULATION TO BE IMPOSED, SERVE AS A FORUM FOR 24
RESOLVING CONFLICTS AMONG THE HEALTH REGULATORY BOARDS, ADVISE THE 25
GOVERNOR AND THE LEGISLATURE ON MATTERS RELATING TO THE REGULATION 26
OR DEREGULATION OF HEALTH CARE PROFESSIONS AND OCCUPATIONS, AND 27
EXAMINE SCOPE OF PRACTICE CONFLICTS INVOLVING REGULATED AND 28
UNREGULATED HEALTH CARE PROFESSIONS AND OCCUPATIONS AND ADVISE THE 29
HEALTH REGULATORY BOARDS AND THE LEGISLATURE OF THE NATURE AND 30
DEGREE OF SUCH CONFLICTS; TO PROVIDE THAT THE STATE DEPARTMENT OF 31
HEALTH SHALL ANNUALLY REQUEST A BUDGET FOR THE STATE BOARD OF 32
HEALTH PROFESSIONS AND SHALL PROVIDE A MEETING SPACE AND 33
ADMINISTRATIVE SUPPORT FOR THE BOARD'S OPERATIONS; TO AMEND 34
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SECTION 47-5-579, MISSISSIPPI CODE OF 1972, TO CLARIFY THAT ALL 35
PROGRAM WITHHOLDINGS FROM PARTICIPANTS OF THE PRISON INDUSTRIES 36
CORPORATION'S WORK INITIATIVE PROGRAM SHALL BE CALCULATED BASED 37
UPON PARTICIPANT WAGES AFTER MANDATORY DEDUCTIONS; TO REQUIRE 38
ACCOUNTING OF ANY DEPENDENT SUPPORT PAYMENTS, FINES, RESTITUTIONS, 39
FEES OR COSTS, AS ORDERED BY THE COURT, BE REPORTED FOR EACH WORK 40
INITIATIVE PARTICIPANT; TO REQUIRE THAT THE REMAINING SENTENCE 41
LENGTH OF SUCH PARTICIPANT BE COLLECTED, MAINTAINED AND REPORTED; 42
TO REQUIRE THAT A FINANCIAL ACCOUNT CREATION DATE BE COLLECTED, 43
MAINTAINED AND REPORTED FOR EACH PARTICIPANT; TO AMEND SECTION 44
5-3-59, MISSISSIPPI CODE OF 1972, TO PROVIDE FOR CRIMINAL 45
PENALTIES FOR PERSONS WHO FAIL TO COMPLY WITH SUBPOENAS FROM THE 46
PEER COMMITTEE; TO CREATE NEW SECTION 5-3-60, MISSISSIPPI CODE OF 47
1972, TO PROVIDE FOR CIVIL ENFORCEMENT OF PEER COMMITTEE 48
SUBPOENAS; TO AMEND SECTIONS 5-1-23 AND 5-1-25, MISSISSIPPI CODE 49
OF 1972, TO PROVIDE THAT THESE PROVISIONS RELATING TO WITNESSES 50
BEFORE LEGISLATIVE COMMITTEES ARE NOT APPLICABLE TO SUBPOENAS 51
ISSUED BY THE PEER COMMITTEE; TO AMEND SECTION 5-1-35, MISSISSIPPI 52
CODE OF 1972, TO PROVIDE THAT THE SERGEANT-AT-ARMS OF THE SENATE 53
SHALL SERVE PEER COMMITTEE SUBPOENAS UPON REQUEST; AND FOR RELATED 54
PURPOSES. 55
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI: 56
SECTION 1. The provisions of this act may be known and cited 57
as the "Creating Logic for Efficiency and Accountability Reform 58
(CLEAR) Act". 59
SECTION 2. The following shall be codified as Section 60
5-3-77, Mississippi Code of 1972: 61
5-3-77. (1) In addition to other duties and 62
responsibilities set out in this chapter, the PEER Committee is 63
authorized to establish a program of reviewing selected newly 64
adopted state agency administrative rules. Such reviews shall 65
produce a report to the Legislature on newly adopted state agency 66
administrative rules and their conformity to the intent of the law 67
authorizing them, as well as any other matter the committee 68
considers appropriate. Such reports shall also contain a 69
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recommendation for legislative action in cases where the committee 70
believes that such is appropriate. 71
(2) From and after July 1, 2026, the committee may choose to 72
select fifteen (15) rules adopted during the previous fiscal year 73
for review. Reports on those rules shall be made to the 74
Legislature no later than December 15, 2026. Thereafter, the 75
committee may review up to thirty (30) newly adopted rules per 76
year, with reports on those rules being made to the Legislature no 77
later than December 15 of each year. 78
SECTION 3. Section 43-13-117, Mississippi Code of 1972, is 79
amended as follows: 80
43-13-117. (A) Medicaid as authorized by this article shall 81
include payment of part or all of the costs, at the discretion of 82
the division, with approval of the Governor and the Centers for 83
Medicare and Medicaid Services, of the following types of care and 84
services rendered to eligible applicants who have been determined 85
to be eligible for that care and services, within the limits of 86
state appropriations and federal matching funds: 87
(1) Inpatient hospital services. 88
(a) The division is authorized to implement an All 89
Patient Refined Diagnosis Related Groups (APR-DRG) reimbursement 90
methodology for inpatient hospital services. 91
(b) No service benefits or reimbursement 92
limitations in this subsection (A)(1) shall apply to payments 93
under an APR-DRG or Ambulatory Payment Classification (APC) model 94
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or a managed care program or similar model described in subsection 95
(H) of this section unless specifically authorized by the 96
division. 97
(2) Outpatient hospital services. 98
(a) Emergency services. 99
(b) Other outpatient hospital services. The 100
division shall allow benefits for other medically necessary 101
outpatient hospital services (such as chemotherapy, radiation, 102
surgery and therapy), including outpatient services in a clinic or 103
other facility that is not located inside the hospital, but that 104
has been designated as an outpatient facility by the hospital, and 105
that was in operation or under construction on July 1, 2009, 106
provided that the costs and charges associated with the operation 107
of the hospital clinic are included in the hospital's cost report. 108
In addition, the Medicare thirty-five-mile rule will apply to 109
those hospital clinics not located inside the hospital that are 110
constructed after July 1, 2009. Where the same services are 111
reimbursed as clinic services, the division may revise the rate or 112
methodology of outpatient reimbursement to maintain consistency, 113
efficiency, economy and quality of care. 114
(c) The division is authorized to implement an 115
Ambulatory Payment Classification (APC) methodology for outpatient 116
hospital services. The division shall give rural hospitals that 117
have fifty (50) or fewer licensed beds the option to not be 118
reimbursed for outpatient hospital services using the APC 119
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methodology, but reimbursement for outpatient hospital services 120
provided by those hospitals shall be based on one hundred one 121
percent (101%) of the rate established under Medicare for 122
outpatient hospital services. Those hospitals choosing to not be 123
reimbursed under the APC methodology shall remain under cost-based 124
reimbursement for a two-year period. 125
(d) No service benefits or reimbursement 126
limitations in this subsection (A)(2) shall apply to payments 127
under an APR-DRG or APC model or a managed care program or similar 128
model described in subsection (H) of this section unless 129
specifically authorized by the division. 130
(3) Laboratory and x-ray services. 131
(4) Nursing facility services. 132
(a) The division shall make full payment to 133
nursing facilities for each day, not exceeding forty-two (42) days 134
per year, that a patient is absent from the facility on home 135
leave. Payment may be made for the following home leave days in 136
addition to the forty-two-day limitation: Christmas, the day 137
before Christmas, the day after Christmas, Thanksgiving, the day 138
before Thanksgiving and the day after Thanksgiving. 139
(b) From and after July 1, 1997, the division 140
shall implement the integrated case-mix payment and quality 141
monitoring system, which includes the fair rental system for 142
property costs and in which recapture of depreciation is 143
eliminated. The division may reduce the payment for hospital 144
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leave and therapeutic home leave days to the lower of the case-mix 145
category as computed for the resident on leave using the 146
assessment being utilized for payment at that point in time, or a 147
case-mix score of 1.000 for nursing facilities, and shall compute 148
case-mix scores of residents so that only services provided at the 149
nursing facility are considered in calculating a facility's per 150
diem. 151
(c) From and after July 1, 1997, all state-owned 152
nursing facilities shall be reimbursed on a full reasonable cost 153
basis. 154
(d) On or after January 1, 2015, the division 155
shall update the case-mix payment system resource utilization 156
grouper and classifications and fair rental reimbursement system. 157
The division shall develop and implement a payment add-on to 158
reimburse nursing facilities for ventilator-dependent resident 159
services. 160
(e) The division shall develop and implement, not 161
later than January 1, 2001, a case-mix payment add-on determined 162
by time studies and other valid statistical data that will 163
reimburse a nursing facility for the additional cost of caring for 164
a resident who has a diagnosis of Alzheimer's or other related 165
dementia and exhibits symptoms that require special care. Any 166
such case-mix add-on payment shall be supported by a determination 167
of additional cost. The division shall also develop and implement 168
as part of the fair rental reimbursement system for nursing 169
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facility beds, an Alzheimer's resident bed depreciation enhanced 170
reimbursement system that will provide an incentive to encourage 171
nursing facilities to convert or construct beds for residents with 172
Alzheimer's or other related dementia. 173
(f) The division shall develop and implement an 174
assessment process for long-term care services. The division may 175
provide the assessment and related functions directly or through 176
contract with the area agencies on aging. 177
The division shall apply for necessary federal waivers to 178
assure that additional services providing alternatives to nursing 179
facility care are made available to applicants for nursing 180
facility care. 181
(5) Periodic screening and diagnostic services for 182
individuals under age twenty-one (21) years as are needed to 183
identify physical and mental defects and to provide health care 184
treatment and other measures designed to correct or ameliorate 185
defects and physical and mental illness and conditions discovered 186
by the screening services, regardless of whether these services 187
are included in the state plan. The division may include in its 188
periodic screening and diagnostic program those discretionary 189
services authorized under the federal regulations adopted to 190
implement Title XIX of the federal Social Security Act, as 191
amended. The division, in obtaining physical therapy services, 192
occupational therapy services, and services for individuals with 193
speech, hearing and language disorders, may enter into a 194
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cooperative agreement with the State Department of Education for 195
the provision of those services to handicapped students by public 196
school districts using state funds that are provided from the 197
appropriation to the Department of Education to obtain federal 198
matching funds through the division. The division, in obtaining 199
medical and mental health assessments, treatment, care and 200
services for children who are in, or at risk of being put in, the 201
custody of the Mississippi Department of Human Services may enter 202
into a cooperative agreement with the Mississippi Department of 203
Human Services for the provision of those services using state 204
funds that are provided from the appropriation to the Department 205
of Human Services to obtain federal matching funds through the 206
division. 207
(6) Physician services. Fees for physician's services 208
that are covered only by Medicaid shall be reimbursed at ninety 209
percent (90%) of the rate established on January 1, 2018, and as 210
may be adjusted each July thereafter, under Medicare. The 211
division may provide for a reimbursement rate for physician's 212
services of up to one hundred percent (100%) of the rate 213
established under Medicare for physician's services that are 214
provided after the normal working hours of the physician, as 215
determined in accordance with regulations of the division. The 216
division may reimburse eligible providers, as determined by the 217
division, for certain primary care services at one hundred percent 218
(100%) of the rate established under Medicare. The division shall 219
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reimburse obstetricians and gynecologists for certain primary care 220
services as defined by the division at one hundred percent (100%) 221
of the rate established under Medicare. 222
(7) (a) Home health services for eligible persons, not 223
to exceed in cost the prevailing cost of nursing facility 224
services. All home health visits must be precertified as required 225
by the division. In addition to physicians, certified registered 226
nurse practitioners, physician assistants and clinical nurse 227
specialists are authorized to prescribe or order home health 228
services and plans of care, sign home health plans of care, 229
certify and recertify eligibility for home health services and 230
conduct the required initial face-to-face visit with the recipient 231
of the services. 232
(b) [Repealed] 233
(8) Emergency medical transportation services as 234
determined by the division. 235
(9) Prescription drugs and other covered drugs and 236
services as determined by the division. 237
The division shall establish a mandatory preferred drug list. 238
Drugs not on the mandatory preferred drug list shall be made 239
available by utilizing prior authorization procedures established 240
by the division. 241
The division may seek to establish relationships with other 242
states in order to lower acquisition costs of prescription drugs 243
to include single-source and innovator multiple-source drugs or 244
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generic drugs. In addition, if allowed by federal law or 245
regulation, the division may seek to establish relationships with 246
and negotiate with other countries to facilitate the acquisition 247
of prescription drugs to include single-source and innovator 248
multiple-source drugs or generic drugs, if that will lower the 249
acquisition costs of those prescription drugs. 250
The division may allow for a combination of prescriptions for 251
single-source and innovator multiple-source drugs and generic 252
drugs to meet the needs of the beneficiaries. 253
The executive director may approve specific maintenance drugs 254
for beneficiaries with certain medical conditions, which may be 255
prescribed and dispensed in three-month supply increments. 256
Drugs prescribed for a resident of a psychiatric residential 257
treatment facility must be provided in true unit doses when 258
available. The division may require that drugs not covered by 259
Medicare Part D for a resident of a long-term care facility be 260
provided in true unit doses when available. Those drugs that were 261
originally billed to the division but are not used by a resident 262
in any of those facilities shall be returned to the billing 263
pharmacy for credit to the division, in accordance with the 264
guidelines of the State Board of Pharmacy and any requirements of 265
federal law and regulation. Drugs shall be dispensed to a 266
recipient and only one (1) dispensing fee per month may be 267
charged. The division shall develop a methodology for reimbursing 268
for restocked drugs, which shall include a restock fee as 269
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determined by the division not exceeding Seven Dollars and 270
Eighty-two Cents ($7.82). 271
Except for those specific maintenance drugs approved by the 272
executive director, the division shall not reimburse for any 273
portion of a prescription that exceeds a thirty-one-day supply of 274
the drug based on the daily dosage. 275
The division is authorized to develop and implement a program 276
of payment for additional pharmacist services as determined by the 277
division. 278
All claims for drugs for dually eligible Medicare/Medicaid 279
beneficiaries that are paid for by Medicare must be submitted to 280
Medicare for payment before they may be processed by the 281
division's online payment system. 282
The division shall develop a pharmacy policy in which drugs 283
in tamper-resistant packaging that are prescribed for a resident 284
of a nursing facility but are not dispensed to the resident shall 285
be returned to the pharmacy and not billed to Medicaid, in 286
accordance with guidelines of the State Board of Pharmacy. 287
The division shall develop and implement a method or methods 288
by which the division will provide on a regular basis to Medicaid 289
providers who are authorized to prescribe drugs, information about 290
the costs to the Medicaid program of single-source drugs and 291
innovator multiple-source drugs, and information about other drugs 292
that may be prescribed as alternatives to those single-source 293
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drugs and innovator multiple-source drugs and the costs to the 294
Medicaid program of those alternative drugs. 295
Notwithstanding any law or regulation, information obtained 296
or maintained by the division regarding the prescription drug 297
program, including trade secrets and manufacturer or labeler 298
pricing, is confidential and not subject to disclosure except to 299
other state agencies. 300
The dispensing fee for each new or refill prescription, 301
including nonlegend or over-the-counter drugs covered by the 302
division, shall be not less than Three Dollars and Ninety-one 303
Cents ($3.91), as determined by the division. 304
The division shall not reimburse for single-source or 305
innovator multiple-source drugs if there are equally effective 306
generic equivalents available and if the generic equivalents are 307
the least expensive. 308
It is the intent of the Legislature that the pharmacists 309
providers be reimbursed for the reasonable costs of filling and 310
dispensing prescriptions for Medicaid beneficiaries. 311
The division shall allow certain drugs, including 312
physician-administered drugs, and implantable drug system devices, 313
and medical supplies, with limited distribution or limited access 314
for beneficiaries and administered in an appropriate clinical 315
setting, to be reimbursed as either a medical claim or pharmacy 316
claim, as determined by the division. 317
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It is the intent of the Legislature that the division and any 318
managed care entity described in subsection (H) of this section 319
encourage the use of Alpha-Hydroxyprogesterone Caproate (17P) to 320
prevent recurrent preterm birth. 321
(10) Dental and orthodontic services to be determined 322
by the division. 323
The division shall increase the amount of the reimbursement 324
rate for diagnostic and preventative dental services for each of 325
the fiscal years 2022, 2023 and 2024 by five percent (5%) above 326
the amount of the reimbursement rate for the previous fiscal year. 327
The division shall increase the amount of the reimbursement rate 328
for restorative dental services for each of the fiscal years 2023, 329
2024 and 2025 by five percent (5%) above the amount of the 330
reimbursement rate for the previous fiscal year. It is the intent 331
of the Legislature that the reimbursement rate revision for 332
preventative dental services will be an incentive to increase the 333
number of dentists who actively provide Medicaid services. This 334
dental services reimbursement rate revision shall be known as the 335
"James Russell Dumas Medicaid Dental Services Incentive Program." 336
The Medical Care Advisory Committee, assisted by the Division 337
of Medicaid, shall annually determine the effect of this incentive 338
by evaluating the number of dentists who are Medicaid providers, 339
the number who and the degree to which they are actively billing 340
Medicaid, the geographic trends of where dentists are offering 341
what types of Medicaid services and other statistics pertinent to 342
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the goals of this legislative intent. This data shall annually be 343
presented to the Chair of the Senate Medicaid Committee and the 344
Chair of the House Medicaid Committee. 345
The division shall include dental services as a necessary 346
component of overall health services provided to children who are 347
eligible for services. 348
(11) Eyeglasses for all Medicaid beneficiaries who have 349
(a) had surgery on the eyeball or ocular muscle that results in a 350
vision change for which eyeglasses or a change in eyeglasses is 351
medically indicated within six (6) months of the surgery and is in 352
accordance with policies established by the division, or (b) one 353
(1) pair every five (5) years and in accordance with policies 354
established by the division. In either instance, the eyeglasses 355
must be prescribed by a physician skilled in diseases of the eye 356
or an optometrist, whichever the beneficiary may select. 357
(12) Intermediate care facility services. 358
(a) The division shall make full payment to all 359
intermediate care facilities for individuals with intellectual 360
disabilities for each day, not exceeding sixty-three (63) days per 361
year, that a patient is absent from the facility on home leave. 362
Payment may be made for the following home leave days in addition 363
to the sixty-three-day limitation: Christmas, the day before 364
Christmas, the day after Christmas, Thanksgiving, the day before 365
Thanksgiving and the day after Thanksgiving. 366
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(b) All state-owned intermediate care facilities 367
for individuals with intellectual disabilities shall be reimbursed 368
on a full reasonable cost basis. 369
(c) Effective January 1, 2015, the division shall 370
update the fair rental reimbursement system for intermediate care 371
facilities for individuals with intellectual disabilities. 372
(13) Family planning services, including drugs, 373
supplies and devices, when those services are under the 374
supervision of a physician or nurse practitioner. 375
(14) Clinic services. Preventive, diagnostic, 376
therapeutic, rehabilitative or palliative services that are 377
furnished by a facility that is not part of a hospital but is 378
organized and operated to provide medical care to outpatients. 379
Clinic services include, but are not limited to: 380
(a) Services provided by ambulatory surgical 381
centers (ASCs) as defined in Section 41-75-1(a); and 382
(b) Dialysis center services. 383
(15) Home- and community-based services for the elderly 384
and disabled, as provided under Title XIX of the federal Social 385
Security Act, as amended, under waivers, subject to the 386
availability of funds specifically appropriated for that purpose 387
by the Legislature. 388
(16) Mental health services. Certain services provided 389
by a psychiatrist shall be reimbursed at up to one hundred percent 390
(100%) of the Medicare rate. Approved therapeutic and case 391
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management services (a) provided by an approved regional mental 392
health/intellectual disability center established under Sections 393
41-19-31 through 41-19-39, or by another community mental health 394
service provider meeting the requirements of the Department of 395
Mental Health to be an approved mental health/intellectual 396
disability center if determined necessary by the Department of 397
Mental Health, using state funds that are provided in the 398
appropriation to the division to match federal funds, or (b) 399
provided by a facility that is certified by the State Department 400
of Mental Health to provide therapeutic and case management 401
services, to be reimbursed on a fee for service basis, or (c) 402
provided in the community by a facility or program operated by the 403
Department of Mental Health. Any such services provided by a 404
facility described in subparagraph (b) must have the prior 405
approval of the division to be reimbursable under this section. 406
(17) Durable medical equipment services and medical 407
supplies. Precertification of durable medical equipment and 408
medical supplies must be obtained as required by the division. 409
The Division of Medicaid may require durable medical equipment 410
providers to obtain a surety bond in the amount and to the 411
specifications as established by the Balanced Budget Act of 1997. 412
A maximum dollar amount of reimbursement for noninvasive 413
ventilators or ventilation treatments properly ordered and being 414
used in an appropriate care setting shall not be set by any health 415
maintenance organization, coordinated care organization, 416
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provider-sponsored health plan, or other organization paid for 417
services on a capitated basis by the division under any managed 418
care program or coordinated care program implemented by the 419
division under this section. Reimbursement by these organizations 420
to durable medical equipment suppliers for home use of noninvasive 421
and invasive ventilators shall be on a continuous monthly payment 422
basis for the duration of medical need throughout a patient's 423
valid prescription period. 424
(18) (a) Notwithstanding any other provision of this 425
section to the contrary, as provided in the Medicaid state plan 426
amendment or amendments as defined in Section 43-13-145(10), the 427
division shall make additional reimbursement to hospitals that 428
serve a disproportionate share of low-income patients and that 429
meet the federal requirements for those payments as provided in 430
Section 1923 of the federal Social Security Act and any applicable 431
regulations. It is the intent of the Legislature that the 432
division shall draw down all available federal funds allotted to 433
the state for disproportionate share hospitals. However, from and 434
after January 1, 1999, public hospitals participating in the 435
Medicaid disproportionate share program may be required to 436
participate in an intergovernmental transfer program as provided 437
in Section 1903 of the federal Social Security Act and any 438
applicable regulations. 439
(b) (i) 1. The division may establish a Medicare 440
Upper Payment Limits Program, as defined in Section 1902(a)(30) of 441
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the federal Social Security Act and any applicable federal 442
regulations, or an allowable delivery system or provider payment 443
initiative authorized under 42 CFR 438.6(c), for hospitals, 444
nursing facilities and physicians employed or contracted by 445
hospitals. 446
2. The division shall establish a 447
Medicaid Supplemental Payment Program, as permitted by the federal 448
Social Security Act and a comparable allowable delivery system or 449
provider payment initiative authorized under 42 CFR 438.6(c), for 450
emergency ambulance transportation providers in accordance with 451
this subsection (A)(18)(b). 452
(ii) The division shall assess each hospital, 453
nursing facility, and emergency ambulance transportation provider 454
for the sole purpose of financing the state portion of the 455
Medicare Upper Payment Limits Program or other program(s) 456
authorized under this subsection (A)(18)(b). The hospital 457
assessment shall be as provided in Section 43-13-145(4)(a), and 458
the nursing facility and the emergency ambulance transportation 459
assessments, if established, shall be based on Medicaid 460
utilization or other appropriate method, as determined by the 461
division, consistent with federal regulations. The assessments 462
will remain in effect as long as the state participates in the 463
Medicare Upper Payment Limits Program or other program(s) 464
authorized under this subsection (A)(18)(b). In addition to the 465
hospital assessment provided in Section 43-13-145(4)(a), hospitals 466
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with physicians participating in the Medicare Upper Payment Limits 467
Program or other program(s) authorized under this subsection 468
(A)(18)(b) shall be required to participate in an 469
intergovernmental transfer or assessment, as determined by the 470
division, for the purpose of financing the state portion of the 471
physician UPL payments or other payment(s) authorized under this 472
subsection (A)(18)(b). 473
(iii) Subject to approval by the Centers for 474
Medicare and Medicaid Services (CMS) and the provisions of this 475
subsection (A)(18)(b), the division shall make additional 476
reimbursement to hospitals, nursing facilities, and emergency 477
ambulance transportation providers for the Medicare Upper Payment 478
Limits Program or other program(s) authorized under this 479
subsection (A)(18)(b), and, if the program is established for 480
physicians, shall make additional reimbursement for physicians, as 481
defined in Section 1902(a)(30) of the federal Social Security Act 482
and any applicable federal regulations, provided the assessment in 483
this subsection (A)(18)(b) is in effect. 484
(iv) Notwithstanding any other provision of 485
this article to the contrary, effective upon implementation of the 486
Mississippi Hospital Access Program (MHAP) provided in 487
subparagraph (c)(i) below, the hospital portion of the inpatient 488
Upper Payment Limits Program shall transition into and be replaced 489
by the MHAP program. However, the division is authorized to 490
develop and implement an alternative fee-for-service Upper Payment 491
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Limits model in accordance with federal laws and regulations if 492
necessary to preserve supplemental funding. Further, the 493
division, in consultation with the hospital industry shall develop 494
alternative models for distribution of medical claims and 495
supplemental payments for inpatient and outpatient hospital 496
services, and such models may include, but shall not be limited to 497
the following: increasing rates for inpatient and outpatient 498
services; creating a low-income utilization pool of funds to 499
reimburse hospitals for the costs of uncompensated care, charity 500
care and bad debts as permitted and approved pursuant to federal 501
regulations and the Centers for Medicare and Medicaid Services; 502
supplemental payments based upon Medicaid utilization, quality, 503
service lines and/or costs of providing such services to Medicaid 504
beneficiaries and to uninsured patients. The goals of such 505
payment models shall be to ensure access to inpatient and 506
outpatient care and to maximize any federal funds that are 507
available to reimburse hospitals for services provided. Any such 508
documents required to achieve the goals described in this 509
paragraph shall be submitted to the Centers for Medicare and 510
Medicaid Services, with a proposed effective date of July 1, 2019, 511
to the extent possible, but in no event shall the effective date 512
of such payment models be later than July 1, 2020. The Chairmen 513
of the Senate and House Medicaid Committees shall be provided a 514
copy of the proposed payment model(s) prior to submission. 515
Effective July 1, 2018, and until such time as any payment 516
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model(s) as described above become effective, the division, in 517
consultation with the hospital industry, is authorized to 518
implement a transitional program for inpatient and outpatient 519
payments and/or supplemental payments (including, but not limited 520
to, MHAP and directed payments), to redistribute available 521
supplemental funds among hospital providers, provided that when 522
compared to a hospital's prior year supplemental payments, 523
supplemental payments made pursuant to any such transitional 524
program shall not result in a decrease of more than five percent 525
(5%) and shall not increase by more than the amount needed to 526
maximize the distribution of the available funds. 527
(v) 1. To preserve and improve access to 528
ambulance transportation provider services, the division shall 529
seek CMS approval to make ambulance service access payments as set 530
forth in this subsection (A)(18)(b) for all covered emergency 531
ambulance services rendered on or after July 1, 2022, and shall 532
make such ambulance service access payments for all covered 533
services rendered on or after the effective date of CMS approval. 534
2. The division shall calculate the 535
ambulance service access payment amount as the balance of the 536
portion of the Medical Care Fund related to ambulance 537
transportation service provider assessments plus any federal 538
matching funds earned on the balance, up to, but not to exceed, 539
the upper payment limit gap for all emergency ambulance service 540
providers. 541
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3. a. Except for ambulance services 542
exempt from the assessment provided in this paragraph (18)(b), all 543
ambulance transportation service providers shall be eligible for 544
ambulance service access payments each state fiscal year as set 545
forth in this paragraph (18)(b). 546
b. In addition to any other funds 547
paid to ambulance transportation service providers for emergency 548
medical services provided to Medicaid beneficiaries, each eligible 549
ambulance transportation service provider shall receive ambulance 550
service access payments each state fiscal year equal to the 551
ambulance transportation service provider's upper payment limit 552
gap. Subject to approval by the Centers for Medicare and Medicaid 553
Services, ambulance service access payments shall be made no less 554
than on a quarterly basis. 555
c. As used in this paragraph 556
(18)(b)(v), the term "upper payment limit gap" means the 557
difference between the total amount that the ambulance 558
transportation service provider received from Medicaid and the 559
average amount that the ambulance transportation service provider 560
would have received from commercial insurers for those services 561
reimbursed by Medicaid. 562
4. An ambulance service access payment 563
shall not be used to offset any other payment by the division for 564
emergency or nonemergency services to Medicaid beneficiaries. 565
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(c) (i) Not later than December l, 2015, the 566
division shall, subject to approval by the Centers for Medicare 567
and Medicaid Services (CMS), establish, implement and operate a 568
Mississippi Hospital Access Program (MHAP) for the purpose of 569
protecting patient access to hospital care through hospital 570
inpatient reimbursement programs provided in this section designed 571
to maintain total hospital reimbursement for inpatient services 572
rendered by in-state hospitals and the out-of-state hospital that 573
is authorized by federal law to submit intergovernmental transfers 574
(IGTs) to the State of Mississippi and is classified as Level I 575
trauma center located in a county contiguous to the state line at 576
the maximum levels permissible under applicable federal statutes 577
and regulations, at which time the current inpatient Medicare 578
Upper Payment Limits (UPL) Program for hospital inpatient services 579
shall transition to the MHAP. 580
(ii) Subject to approval by the Centers for 581
Medicare and Medicaid Services (CMS), the MHAP shall provide 582
increased inpatient capitation (PMPM) payments to managed care 583
entities contracting with the division pursuant to subsection (H) 584
of this section to support availability of hospital services or 585
such other payments permissible under federal law necessary to 586
accomplish the intent of this subsection. 587
(iii) The intent of this subparagraph (c) is 588
that effective for all inpatient hospital Medicaid services during 589
state fiscal year 2016, and so long as this provision shall remain 590
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in effect hereafter, the division shall to the fullest extent 591
feasible replace the additional reimbursement for hospital 592
inpatient services under the inpatient Medicare Upper Payment 593
Limits (UPL) Program with additional reimbursement under the MHAP 594
and other payment programs for inpatient and/or outpatient 595
payments which may be developed under the authority of this 596
paragraph. 597
(iv) The division shall assess each hospital 598
as provided in Section 43-13-145(4)(a) for the purpose of 599
financing the state portion of the MHAP, supplemental payments and 600
such other purposes as specified in Section 43-13-145. The 601
assessment will remain in effect as long as the MHAP and 602
supplemental payments are in effect. 603
(19) (a) Perinatal risk management services. The 604
division shall promulgate regulations to be effective from and 605
after October 1, 1988, to establish a comprehensive perinatal 606
system for risk assessment of all pregnant and infant Medicaid 607
recipients and for management, education and follow-up for those 608
who are determined to be at risk. Services to be performed 609
include case management, nutrition assessment/counseling, 610
psychosocial assessment/counseling and health education. The 611
division shall contract with the State Department of Health to 612
provide services within this paragraph (Perinatal High Risk 613
Management/Infant Services System (PHRM/ISS)). The State 614
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Department of Health shall be reimbursed on a full reasonable cost 615
basis for services provided under this subparagraph (a). 616
(b) Early intervention system services. The 617
division shall cooperate with the State Department of Health, 618
acting as lead agency, in the development and implementation of a 619
statewide system of delivery of early intervention services, under 620
Part C of the Individuals with Disabilities Education Act (IDEA). 621
The State Department of Health shall certify annually in writing 622
to the executive director of the division the dollar amount of 623
state early intervention funds available that will be utilized as 624
a certified match for Medicaid matching funds. Those funds then 625
shall be used to provide expanded targeted case management 626
services for Medicaid eligible children with special needs who are 627
eligible for the state's early intervention system. 628
Qualifications for persons providing service coordination shall be 629
determined by the State Department of Health and the Division of 630
Medicaid. 631
(20) Home- and community-based services for physically 632
disabled approved services as allowed by a waiver from the United 633
States Department of Health and Human Services for home- and 634
community-based services for physically disabled people using 635
state funds that are provided from the appropriation to the State 636
Department of Rehabilitation Services and used to match federal 637
funds under a cooperative agreement between the division and the 638
department, provided that funds for these services are 639
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specifically appropriated to the Department of Rehabilitation 640
Services. 641
(21) Nurse practitioner services. Services furnished 642
by a registered nurse who is licensed and certified by the 643
Mississippi Board of Nursing as a nurse practitioner, including, 644
but not limited to, nurse anesthetists, nurse midwives, family 645
nurse practitioners, family planning nurse practitioners, 646
pediatric nurse practitioners, obstetrics-gynecology nurse 647
practitioners and neonatal nurse practitioners, under regulations 648
adopted by the division. Reimbursement for those services shall 649
not exceed ninety percent (90%) of the reimbursement rate for 650
comparable services rendered by a physician. The division may 651
provide for a reimbursement rate for nurse practitioner services 652
of up to one hundred percent (100%) of the reimbursement rate for 653
comparable services rendered by a physician for nurse practitioner 654
services that are provided after the normal working hours of the 655
nurse practitioner, as determined in accordance with regulations 656
of the division. 657
(22) Ambulatory services delivered in federally 658
qualified health centers, rural health centers and clinics of the 659
local health departments of the State Department of Health for 660
individuals eligible for Medicaid under this article based on 661
reasonable costs as determined by the division. Federally 662
qualified health centers shall be reimbursed by the Medicaid 663
prospective payment system as approved by the Centers for Medicare 664
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and Medicaid Services. The division shall recognize federally 665
qualified health centers (FQHCs), rural health clinics (RHCs) and 666
community mental health centers (CMHCs) as both an originating and 667
distant site provider for the purposes of telehealth 668
reimbursement. The division is further authorized and directed to 669
reimburse FQHCs, RHCs and CMHCs for both distant site and 670
originating site services when such services are appropriately 671
provided by the same organization. 672
(23) Inpatient psychiatric services. 673
(a) Inpatient psychiatric services to be 674
determined by the division for recipients under age twenty-one 675
(21) that are provided under the direction of a physician in an 676
inpatient program in a licensed acute care psychiatric facility or 677
in a licensed psychiatric residential treatment facility, before 678
the recipient reaches age twenty-one (21) or, if the recipient was 679
receiving the services immediately before he or she reached age 680
twenty-one (21), before the earlier of the date he or she no 681
longer requires the services or the date he or she reaches age 682
twenty-two (22), as provided by federal regulations. From and 683
after January 1, 2015, the division shall update the fair rental 684
reimbursement system for psychiatric residential treatment 685
facilities. Precertification of inpatient days and residential 686
treatment days must be obtained as required by the division. From 687
and after July 1, 2009, all state-owned and state-operated 688
facilities that provide inpatient psychiatric services to persons 689
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under age twenty-one (21) who are eligible for Medicaid 690
reimbursement shall be reimbursed for those services on a full 691
reasonable cost basis. 692
(b) The division may reimburse for services 693
provided by a licensed freestanding psychiatric hospital to 694
Medicaid recipients over the age of twenty-one (21) in a method 695
and manner consistent with the provisions of Section 43-13-117.5. 696
(24) [Deleted] 697
(25) [Deleted] 698
(26) Hospice care. As used in this paragraph, the term 699
"hospice care" means a coordinated program of active professional 700
medical attention within the home and outpatient and inpatient 701
care that treats the terminally ill patient and family as a unit, 702
employing a medically directed interdisciplinary team. The 703
program provides relief of severe pain or other physical symptoms 704
and supportive care to meet the special needs arising out of 705
physical, psychological, spiritual, social and economic stresses 706
that are experienced during the final stages of illness and during 707
dying and bereavement and meets the Medicare requirements for 708
participation as a hospice as provided in federal regulations. 709
(27) Group health plan premiums and cost-sharing if it 710
is cost-effective as defined by the United States Secretary of 711
Health and Human Services. 712
(28) Other health insurance premiums that are 713
cost-effective as defined by the United States Secretary of Health 714
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and Human Services. Medicare eligible must have Medicare Part B 715
before other insurance premiums can be paid. 716
(29) The Division of Medicaid may apply for a waiver 717
from the United States Department of Health and Human Services for 718
home- and community-based services for developmentally disabled 719
people using state funds that are provided from the appropriation 720
to the State Department of Mental Health and/or funds transferred 721
to the department by a political subdivision or instrumentality of 722
the state and used to match federal funds under a cooperative 723
agreement between the division and the department, provided that 724
funds for these services are specifically appropriated to the 725
Department of Mental Health and/or transferred to the department 726
by a political subdivision or instrumentality of the state. 727
(30) Pediatric skilled nursing services as determined 728
by the division and in a manner consistent with regulations 729
promulgated by the Mississippi State Department of Health. 730
(31) Targeted case management services for children 731
with special needs, under waivers from the United States 732
Department of Health and Human Services, using state funds that 733
are provided from the appropriation to the Mississippi Department 734
of Human Services and used to match federal funds under a 735
cooperative agreement between the division and the department. 736
(32) Care and services provided in Christian Science 737
Sanatoria listed and certified by the Commission for Accreditation 738
of Christian Science Nursing Organizations/Facilities, Inc., 739
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rendered in connection with treatment by prayer or spiritual means 740
to the extent that those services are subject to reimbursement 741
under Section 1903 of the federal Social Security Act. 742
(33) Podiatrist services. 743
(34) Assisted living services as provided through 744
home- and community-based services under Title XIX of the federal 745
Social Security Act, as amended, subject to the availability of 746
funds specifically appropriated for that purpose by the 747
Legislature. 748
(35) Services and activities authorized in Sections 749
43-27-101 and 43-27-103, using state funds that are provided from 750
the appropriation to the Mississippi Department of Human Services 751
and used to match federal funds under a cooperative agreement 752
between the division and the department. 753
(36) Nonemergency transportation services for 754
Medicaid-eligible persons as determined by the division. The PEER 755
Committee shall conduct a performance evaluation of the 756
nonemergency transportation program to evaluate the administration 757
of the program and the providers of transportation services to 758
determine the most cost-effective ways of providing nonemergency 759
transportation services to the patients served under the program. 760
The performance evaluation shall be completed and provided to the 761
members of the Senate Medicaid Committee and the House Medicaid 762
Committee not later than January 1, * * * 2026, and every * * * 763
three (3) years thereafter. 764
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(37) [Deleted] 765
(38) Chiropractic services. A chiropractor's manual 766
manipulation of the spine to correct a subluxation, if x-ray 767
demonstrates that a subluxation exists and if the subluxation has 768
resulted in a neuromusculoskeletal condition for which 769
manipulation is appropriate treatment, and related spinal x-rays 770
performed to document these conditions. Reimbursement for 771
chiropractic services shall not exceed Seven Hundred Dollars 772
($700.00) per year per beneficiary. 773
(39) Dually eligible Medicare/Medicaid beneficiaries. 774
The division shall pay the Medicare deductible and coinsurance 775
amounts for services available under Medicare, as determined by 776
the division. From and after July 1, 2009, the division shall 777
reimburse crossover claims for inpatient hospital services and 778
crossover claims covered under Medicare Part B in the same manner 779
that was in effect on January 1, 2008, unless specifically 780
authorized by the Legislature to change this method. 781
(40) [Deleted] 782
(41) Services provided by the State Department of 783
Rehabilitation Services for the care and rehabilitation of persons 784
with spinal cord injuries or traumatic brain injuries, as allowed 785
under waivers from the United States Department of Health and 786
Human Services, using up to seventy-five percent (75%) of the 787
funds that are appropriated to the Department of Rehabilitation 788
Services from the Spinal Cord and Head Injury Trust Fund 789
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established under Section 37-33-261 and used to match federal 790
funds under a cooperative agreement between the division and the 791
department. 792
(42) [Deleted] 793
(43) The division shall provide reimbursement, 794
according to a payment schedule developed by the division, for 795
smoking cessation medications for pregnant women during their 796
pregnancy and other Medicaid-eligible women who are of 797
child-bearing age. 798
(44) Nursing facility services for the severely 799
disabled. 800
(a) Severe disabilities include, but are not 801
limited to, spinal cord injuries, closed-head injuries and 802
ventilator-dependent patients. 803
(b) Those services must be provided in a long-term 804
care nursing facility dedicated to the care and treatment of 805
persons with severe disabilities. 806
(45) Physician assistant services. Services furnished 807
by a physician assistant who is licensed by the State Board of 808
Medical Licensure and is practicing with physician supervision 809
under regulations adopted by the board, under regulations adopted 810
by the division. Reimbursement for those services shall not 811
exceed ninety percent (90%) of the reimbursement rate for 812
comparable services rendered by a physician. The division may 813
provide for a reimbursement rate for physician assistant services 814
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of up to one hundred percent (100%) or the reimbursement rate for 815
comparable services rendered by a physician for physician 816
assistant services that are provided after the normal working 817
hours of the physician assistant, as determined in accordance with 818
regulations of the division. 819
(46) The division shall make application to the federal 820
Centers for Medicare and Medicaid Services (CMS) for a waiver to 821
develop and provide services for children with serious emotional 822
disturbances as defined in Section 43-14-1(1), which may include 823
home- and community-based services, case management services or 824
managed care services through mental health providers certified by 825
the Department of Mental Health. The division may implement and 826
provide services under this waivered program only if funds for 827
these services are specifically appropriated for this purpose by 828
the Legislature, or if funds are voluntarily provided by affected 829
agencies. 830
(47) (a) The division may develop and implement 831
disease management programs for individuals with high-cost chronic 832
diseases and conditions, including the use of grants, waivers, 833
demonstrations or other projects as necessary. 834
(b) Participation in any disease management 835
program implemented under this paragraph (47) is optional with the 836
individual. An individual must affirmatively elect to participate 837
in the disease management program in order to participate, and may 838
elect to discontinue participation in the program at any time. 839
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(48) Pediatric long-term acute care hospital services. 840
(a) Pediatric long-term acute care hospital 841
services means services provided to eligible persons under 842
twenty-one (21) years of age by a freestanding Medicare-certified 843
hospital that has an average length of inpatient stay greater than 844
twenty-five (25) days and that is primarily engaged in providing 845
chronic or long-term medical care to persons under twenty-one (21) 846
years of age. 847
(b) The services under this paragraph (48) shall 848
be reimbursed as a separate category of hospital services. 849
(49) The division may establish copayments and/or 850
coinsurance for any Medicaid services for which copayments and/or 851
coinsurance are allowable under federal law or regulation. 852
(50) Services provided by the State Department of 853
Rehabilitation Services for the care and rehabilitation of persons 854
who are deaf and blind, as allowed under waivers from the United 855
States Department of Health and Human Services to provide home- 856
and community-based services using state funds that are provided 857
from the appropriation to the State Department of Rehabilitation 858
Services or if funds are voluntarily provided by another agency. 859
(51) Upon determination of Medicaid eligibility and in 860
association with annual redetermination of Medicaid eligibility, 861
beneficiaries shall be encouraged to undertake a physical 862
examination that will establish a base-line level of health and 863
identification of a usual and customary source of care (a medical 864
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home) to aid utilization of disease management tools. This 865
physical examination and utilization of these disease management 866
tools shall be consistent with current United States Preventive 867
Services Task Force or other recognized authority recommendations. 868
For persons who are determined ineligible for Medicaid, the 869
division will provide information and direction for accessing 870
medical care and services in the area of their residence. 871
(52) Notwithstanding any provisions of this article, 872
the division may pay enhanced reimbursement fees related to trauma 873
care, as determined by the division in conjunction with the State 874
Department of Health, using funds appropriated to the State 875
Department of Health for trauma care and services and used to 876
match federal funds under a cooperative agreement between the 877
division and the State Department of Health. The division, in 878
conjunction with the State Department of Health, may use grants, 879
waivers, demonstrations, enhanced reimbursements, Upper Payment 880
Limits Programs, supplemental payments, or other projects as 881
necessary in the development and implementation of this 882
reimbursement program. 883
(53) Targeted case management services for high-cost 884
beneficiaries may be developed by the division for all services 885
under this section. 886
(54) [Deleted] 887
(55) Therapy services. The plan of care for therapy 888
services may be developed to cover a period of treatment for up to 889
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six (6) months, but in no event shall the plan of care exceed a 890
six-month period of treatment. The projected period of treatment 891
must be indicated on the initial plan of care and must be updated 892
with each subsequent revised plan of care. Based on medical 893
necessity, the division shall approve certification periods for 894
less than or up to six (6) months, but in no event shall the 895
certification period exceed the period of treatment indicated on 896
the plan of care. The appeal process for any reduction in therapy 897
services shall be consistent with the appeal process in federal 898
regulations. 899
(56) Prescribed pediatric extended care centers 900
services for medically dependent or technologically dependent 901
children with complex medical conditions that require continual 902
care as prescribed by the child's attending physician, as 903
determined by the division. 904
(57) No Medicaid benefit shall restrict coverage for 905
medically appropriate treatment prescribed by a physician and 906
agreed to by a fully informed individual, or if the individual 907
lacks legal capacity to consent by a person who has legal 908
authority to consent on his or her behalf, based on an 909
individual's diagnosis with a terminal condition. As used in this 910
paragraph (57), "terminal condition" means any aggressive 911
malignancy, chronic end-stage cardiovascular or cerebral vascular 912
disease, or any other disease, illness or condition which a 913
physician diagnoses as terminal. 914
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(58) Treatment services for persons with opioid 915
dependency or other highly addictive substance use disorders. The 916
division is authorized to reimburse eligible providers for 917
treatment of opioid dependency and other highly addictive 918
substance use disorders, as determined by the division. Treatment 919
related to these conditions shall not count against any physician 920
visit limit imposed under this section. 921
(59) The division shall allow beneficiaries between the 922
ages of ten (10) and eighteen (18) years to receive vaccines 923
through a pharmacy venue. The division and the State Department 924
of Health shall coordinate and notify OB-GYN providers that the 925
Vaccines for Children program is available to providers free of 926
charge. 927
(60) Border city university-affiliated pediatric 928
teaching hospital. 929
(a) Payments may only be made to a border city 930
university-affiliated pediatric teaching hospital if the Centers 931
for Medicare and Medicaid Services (CMS) approve an increase in 932
the annual request for the provider payment initiative authorized 933
under 42 CFR Section 438.6(c) in an amount equal to or greater 934
than the estimated annual payment to be made to the border city 935
university-affiliated pediatric teaching hospital. The estimate 936
shall be based on the hospital's prior year Mississippi managed 937
care utilization. 938
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(b) As used in this paragraph (60), the term 939
"border city university-affiliated pediatric teaching hospital" 940
means an out-of-state hospital located within a city bordering the 941
eastern bank of the Mississippi River and the State of Mississippi 942
that submits to the division a copy of a current and effective 943
affiliation agreement with an accredited university and other 944
documentation establishing that the hospital is 945
university-affiliated, is licensed and designated as a pediatric 946
hospital or pediatric primary hospital within its home state, 947
maintains at least five (5) different pediatric specialty training 948
programs, and maintains at least one hundred (100) operated beds 949
dedicated exclusively for the treatment of patients under the age 950
of twenty-one (21) years. 951
(c) The cost of providing services to Mississippi 952
Medicaid beneficiaries under the age of twenty-one (21) years who 953
are treated by a border city university-affiliated pediatric 954
teaching hospital shall not exceed the cost of providing the same 955
services to individuals in hospitals in the state. 956
(d) It is the intent of the Legislature that 957
payments shall not result in any in-state hospital receiving 958
payments lower than they would otherwise receive if not for the 959
payments made to any border city university-affiliated pediatric 960
teaching hospital. 961
(e) This paragraph (60) shall stand repealed on 962
July 1, 2024. 963
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(61) Services described in Section 41-140-3 that are 964
provided by certified community health workers employed and 965
supervised by a Medicaid provider. Reimbursement for these 966
services shall be provided only if the division has received 967
approval from the Centers for Medicare and Medicaid Services for a 968
state plan amendment, waiver or alternative payment model for 969
services delivered by certified community health workers. 970
(B) Planning and development districts participating in the 971
home- and community-based services program for the elderly and 972
disabled as case management providers shall be reimbursed for case 973
management services at the maximum rate approved by the Centers 974
for Medicare and Medicaid Services (CMS). 975
(C) The division may pay to those providers who participate 976
in and accept patient referrals from the division's emergency room 977
redirection program a percentage, as determined by the division, 978
of savings achieved according to the performance measures and 979
reduction of costs required of that program. Federally qualified 980
health centers may participate in the emergency room redirection 981
program, and the division may pay those centers a percentage of 982
any savings to the Medicaid program achieved by the centers' 983
accepting patient referrals through the program, as provided in 984
this subsection (C). 985
(D) (1) As used in this subsection (D), the following terms 986
shall be defined as provided in this paragraph, except as 987
otherwise provided in this subsection: 988
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(a) "Committees" means the Medicaid Committees of 989
the House of Representatives and the Senate, and "committee" means 990
either one of those committees. 991
(b) "Rate change" means an increase, decrease or 992
other change in the payments or rates of reimbursement, or a 993
change in any payment methodology that results in an increase, 994
decrease or other change in the payments or rates of 995
reimbursement, to any Medicaid provider that renders any services 996
authorized to be provided to Medicaid recipients under this 997
article. 998
(2) Whenever the Division of Medicaid proposes a rate 999
change, the division shall give notice to the chairmen of the 1000
committees at least thirty (30) calendar days before the proposed 1001
rate change is scheduled to take effect. The division shall 1002
furnish the chairmen with a concise summary of each proposed rate 1003
change along with the notice, and shall furnish the chairmen with 1004
a copy of any proposed rate change upon request. The division 1005
also shall provide a summary and copy of any proposed rate change 1006
to any other member of the Legislature upon request. 1007
(3) If the chairman of either committee or both 1008
chairmen jointly object to the proposed rate change or any part 1009
thereof, the chairman or chairmen shall notify the division and 1010
provide the reasons for their objection in writing not later than 1011
seven (7) calendar days after receipt of the notice from the 1012
division. The chairman or chairmen may make written 1013
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recommendations to the division for changes to be made to a 1014
proposed rate change. 1015
(4) (a) The chairman of either committee or both 1016
chairmen jointly may hold a committee meeting to review a proposed 1017
rate change. If either chairman or both chairmen decide to hold a 1018
meeting, they shall notify the division of their intention in 1019
writing within seven (7) calendar days after receipt of the notice 1020
from the division, and shall set the date and time for the meeting 1021
in their notice to the division, which shall not be later than 1022
fourteen (14) calendar days after receipt of the notice from the 1023
division. 1024
(b) After the committee meeting, the committee or 1025
committees may object to the proposed rate change or any part 1026
thereof. The committee or committees shall notify the division 1027
and the reasons for their objection in writing not later than 1028
seven (7) calendar days after the meeting. The committee or 1029
committees may make written recommendations to the division for 1030
changes to be made to a proposed rate change. 1031
(5) If both chairmen notify the division in writing 1032
within seven (7) calendar days after receipt of the notice from 1033
the division that they do not object to the proposed rate change 1034
and will not be holding a meeting to review the proposed rate 1035
change, the proposed rate change will take effect on the original 1036
date as scheduled by the division or on such other date as 1037
specified by the division. 1038
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(6) (a) If there are any objections to a proposed rate 1039
change or any part thereof from either or both of the chairmen or 1040
the committees, the division may withdraw the proposed rate 1041
change, make any of the recommended changes to the proposed rate 1042
change, or not make any changes to the proposed rate change. 1043
(b) If the division does not make any changes to 1044
the proposed rate change, it shall notify the chairmen of that 1045
fact in writing, and the proposed rate change shall take effect on 1046
the original date as scheduled by the division or on such other 1047
date as specified by the division. 1048
(c) If the division makes any changes to the 1049
proposed rate change, the division shall notify the chairmen of 1050
its actions in writing, and the revised proposed rate change shall 1051
take effect on the date as specified by the division. 1052
(7) Nothing in this subsection (D) shall be construed 1053
as giving the chairmen or the committees any authority to veto, 1054
nullify or revise any rate change proposed by the division. The 1055
authority of the chairmen or the committees under this subsection 1056
shall be limited to reviewing, making objections to and making 1057
recommendations for changes to rate changes proposed by the 1058
division. 1059
(E) Notwithstanding any provision of this article, no new 1060
groups or categories of recipients and new types of care and 1061
services may be added without enabling legislation from the 1062
Mississippi Legislature, except that the division may authorize 1063
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those changes without enabling legislation when the addition of 1064
recipients or services is ordered by a court of proper authority. 1065
(F) The executive director shall keep the Governor advised 1066
on a timely basis of the funds available for expenditure and the 1067
projected expenditures. Notwithstanding any other provisions of 1068
this article, if current or projected expenditures of the division 1069
are reasonably anticipated to exceed the amount of funds 1070
appropriated to the division for any fiscal year, the Governor, 1071
after consultation with the executive director, shall take all 1072
appropriate measures to reduce costs, which may include, but are 1073
not limited to: 1074
(1) Reducing or discontinuing any or all services that 1075
are deemed to be optional under Title XIX of the Social Security 1076
Act; 1077
(2) Reducing reimbursement rates for any or all service 1078
types; 1079
(3) Imposing additional assessments on health care 1080
providers; or 1081
(4) Any additional cost-containment measures deemed 1082
appropriate by the Governor. 1083
To the extent allowed under federal law, any reduction to 1084
services or reimbursement rates under this subsection (F) shall be 1085
accompanied by a reduction, to the fullest allowable amount, to 1086
the profit margin and administrative fee portions of capitated 1087
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payments to organizations described in paragraph (1) of subsection 1088
(H). 1089
Beginning in fiscal year 2010 and in fiscal years thereafter, 1090
when Medicaid expenditures are projected to exceed funds available 1091
for the fiscal year, the division shall submit the expected 1092
shortfall information to the PEER Committee not later than 1093
December 1 of the year in which the shortfall is projected to 1094
occur. PEER shall review the computations of the division and 1095
report its findings to the Legislative Budget Office not later 1096
than January 7 in any year. 1097
(G) Notwithstanding any other provision of this article, it 1098
shall be the duty of each provider participating in the Medicaid 1099
program to keep and maintain books, documents and other records as 1100
prescribed by the Division of Medicaid in accordance with federal 1101
laws and regulations. 1102
(H) (1) Notwithstanding any other provision of this 1103
article, the division is authorized to implement (a) a managed 1104
care program, (b) a coordinated care program, (c) a coordinated 1105
care organization program, (d) a health maintenance organization 1106
program, (e) a patient-centered medical home program, (f) an 1107
accountable care organization program, (g) provider-sponsored 1108
health plan, or (h) any combination of the above programs. As a 1109
condition for the approval of any program under this subsection 1110
(H)(1), the division shall require that no managed care program, 1111
coordinated care program, coordinated care organization program, 1112
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health maintenance organization program, or provider-sponsored 1113
health plan may: 1114
(a) Pay providers at a rate that is less than the 1115
Medicaid All Patient Refined Diagnosis Related Groups (APR-DRG) 1116
reimbursement rate; 1117
(b) Override the medical decisions of hospital 1118
physicians or staff regarding patients admitted to a hospital for 1119
an emergency medical condition as defined by 42 US Code Section 1120
1395dd. This restriction (b) does not prohibit the retrospective 1121
review of the appropriateness of the determination that an 1122
emergency medical condition exists by chart review or coding 1123
algorithm, nor does it prohibit prior authorization for 1124
nonemergency hospital admissions; 1125
(c) Pay providers at a rate that is less than the 1126
normal Medicaid reimbursement rate. It is the intent of the 1127
Legislature that all managed care entities described in this 1128
subsection (H), in collaboration with the division, develop and 1129
implement innovative payment models that incentivize improvements 1130
in health care quality, outcomes, or value, as determined by the 1131
division. Participation in the provider network of any managed 1132
care, coordinated care, provider-sponsored health plan, or similar 1133
contractor shall not be conditioned on the provider's agreement to 1134
accept such alternative payment models; 1135
(d) Implement a prior authorization and 1136
utilization review program for medical services, transportation 1137
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services and prescription drugs that is more stringent than the 1138
prior authorization processes used by the division in its 1139
administration of the Medicaid program. Not later than December 1140
2, 2021, the contractors that are receiving capitated payments 1141
under a managed care delivery system established under this 1142
subsection (H) shall submit a report to the Chairmen of the House 1143
and Senate Medicaid Committees on the status of the prior 1144
authorization and utilization review program for medical services, 1145
transportation services and prescription drugs that is required to 1146
be implemented under this subparagraph (d); 1147
(e) [Deleted] 1148
(f) Implement a preferred drug list that is more 1149
stringent than the mandatory preferred drug list established by 1150
the division under subsection (A)(9) of this section; 1151
(g) Implement a policy which denies beneficiaries 1152
with hemophilia access to the federally funded hemophilia 1153
treatment centers as part of the Medicaid Managed Care network of 1154
providers. 1155
Each health maintenance organization, coordinated care 1156
organization, provider-sponsored health plan, or other 1157
organization paid for services on a capitated basis by the 1158
division under any managed care program or coordinated care 1159
program implemented by the division under this section shall use a 1160
clear set of level of care guidelines in the determination of 1161
medical necessity and in all utilization management practices, 1162
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including the prior authorization process, concurrent reviews, 1163
retrospective reviews and payments, that are consistent with 1164
widely accepted professional standards of care. Organizations 1165
participating in a managed care program or coordinated care 1166
program implemented by the division may not use any additional 1167
criteria that would result in denial of care that would be 1168
determined appropriate and, therefore, medically necessary under 1169
those levels of care guidelines. 1170
(2) Notwithstanding any provision of this section, the 1171
recipients eligible for enrollment into a Medicaid Managed Care 1172
Program authorized under this subsection (H) may include only 1173
those categories of recipients eligible for participation in the 1174
Medicaid Managed Care Program as of January 1, 2021, the 1175
Children's Health Insurance Program (CHIP), and the CMS-approved 1176
Section 1115 demonstration waivers in operation as of January 1, 1177
2021. No expansion of Medicaid Managed Care Program contracts may 1178
be implemented by the division without enabling legislation from 1179
the Mississippi Legislature. 1180
(3) (a) Any contractors receiving capitated payments 1181
under a managed care delivery system established in this section 1182
shall provide to the Legislature and the division statistical data 1183
to be shared with provider groups in order to improve patient 1184
access, appropriate utilization, cost savings and health outcomes 1185
not later than October 1 of each year. Additionally, each 1186
contractor shall disclose to the Chairmen of the Senate and House 1187
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Medicaid Committees the administrative expenses costs for the 1188
prior calendar year, and the number of full-equivalent employees 1189
located in the State of Mississippi dedicated to the Medicaid and 1190
CHIP lines of business as of June 30 of the current year. 1191
(b) The division and the contractors participating 1192
in the managed care program, a coordinated care program or a 1193
provider-sponsored health plan shall be subject to annual program 1194
reviews or audits performed by the Office of the State Auditor, 1195
the PEER Committee, the Department of Insurance and/or independent 1196
third parties. 1197
(c) Those reviews shall include, but not be 1198
limited to, at least two (2) of the following items: 1199
(i) The financial benefit to the State of 1200
Mississippi of the managed care program, 1201
(ii) The difference between the premiums paid 1202
to the managed care contractors and the payments made by those 1203
contractors to health care providers, 1204
(iii) Compliance with performance measures 1205
required under the contracts, 1206
(iv) Administrative expense allocation 1207
methodologies, 1208
(v) Whether nonprovider payments assigned as 1209
medical expenses are appropriate, 1210
(vi) Capitated arrangements with related 1211
party subcontractors, 1212
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(vii) Reasonableness of corporate 1213
allocations, 1214
(viii) Value-added benefits and the extent to 1215
which they are used, 1216
(ix) The effectiveness of subcontractor 1217
oversight, including subcontractor review, 1218
(x) Whether health care outcomes have been 1219
improved, and 1220
(xi) The most common claim denial codes to 1221
determine the reasons for the denials. 1222
The audit reports shall be considered public documents and 1223
shall be posted in their entirety on the division's website. 1224
(4) All health maintenance organizations, coordinated 1225
care organizations, provider-sponsored health plans, or other 1226
organizations paid for services on a capitated basis by the 1227
division under any managed care program or coordinated care 1228
program implemented by the division under this section shall 1229
reimburse all providers in those organizations at rates no lower 1230
than those provided under this section for beneficiaries who are 1231
not participating in those programs. 1232
(5) No health maintenance organization, coordinated 1233
care organization, provider-sponsored health plan, or other 1234
organization paid for services on a capitated basis by the 1235
division under any managed care program or coordinated care 1236
program implemented by the division under this section shall 1237
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require its providers or beneficiaries to use any pharmacy that 1238
ships, mails or delivers prescription drugs or legend drugs or 1239
devices. 1240
(6) (a) Not later than December 1, 2021, the 1241
contractors who are receiving capitated payments under a managed 1242
care delivery system established under this subsection (H) shall 1243
develop and implement a uniform credentialing process for 1244
providers. Under that uniform credentialing process, a provider 1245
who meets the criteria for credentialing will be credentialed with 1246
all of those contractors and no such provider will have to be 1247
separately credentialed by any individual contractor in order to 1248
receive reimbursement from the contractor. Not later than 1249
December 2, 2021, those contractors shall submit a report to the 1250
Chairmen of the House and Senate Medicaid Committees on the status 1251
of the uniform credentialing process for providers that is 1252
required under this subparagraph (a). 1253
(b) If those contractors have not implemented a 1254
uniform credentialing process as described in subparagraph (a) by 1255
December 1, 2021, the division shall develop and implement, not 1256
later than July 1, 2022, a single, consolidated credentialing 1257
process by which all providers will be credentialed. Under the 1258
division's single, consolidated credentialing process, no such 1259
contractor shall require its providers to be separately 1260
credentialed by the contractor in order to receive reimbursement 1261
from the contractor, but those contractors shall recognize the 1262
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credentialing of the providers by the division's credentialing 1263
process. 1264
(c) The division shall require a uniform provider 1265
credentialing application that shall be used in the credentialing 1266
process that is established under subparagraph (a) or (b). If the 1267
contractor or division, as applicable, has not approved or denied 1268
the provider credentialing application within sixty (60) days of 1269
receipt of the completed application that includes all required 1270
information necessary for credentialing, then the contractor or 1271
division, upon receipt of a written request from the applicant and 1272
within five (5) business days of its receipt, shall issue a 1273
temporary provider credential/enrollment to the applicant if the 1274
applicant has a valid Mississippi professional or occupational 1275
license to provide the health care services to which the 1276
credential/enrollment would apply. The contractor or the division 1277
shall not issue a temporary credential/enrollment if the applicant 1278
has reported on the application a history of medical or other 1279
professional or occupational malpractice claims, a history of 1280
substance abuse or mental health issues, a criminal record, or a 1281
history of medical or other licensing board, state or federal 1282
disciplinary action, including any suspension from participation 1283
in a federal or state program. The temporary 1284
credential/enrollment shall be effective upon issuance and shall 1285
remain in effect until the provider's credentialing/enrollment 1286
application is approved or denied by the contractor or division. 1287
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The contractor or division shall render a final decision regarding 1288
credentialing/enrollment of the provider within sixty (60) days 1289
from the date that the temporary provider credential/enrollment is 1290
issued to the applicant. 1291
(d) If the contractor or division does not render 1292
a final decision regarding credentialing/enrollment of the 1293
provider within the time required in subparagraph (c), the 1294
provider shall be deemed to be credentialed by and enrolled with 1295
all of the contractors and eligible to receive reimbursement from 1296
the contractors. 1297
(7) (a) Each contractor that is receiving capitated 1298
payments under a managed care delivery system established under 1299
this subsection (H) shall provide to each provider for whom the 1300
contractor has denied the coverage of a procedure that was ordered 1301
or requested by the provider for or on behalf of a patient, a 1302
letter that provides a detailed explanation of the reasons for the 1303
denial of coverage of the procedure and the name and the 1304
credentials of the person who denied the coverage. The letter 1305
shall be sent to the provider in electronic format. 1306
(b) After a contractor that is receiving capitated 1307
payments under a managed care delivery system established under 1308
this subsection (H) has denied coverage for a claim submitted by a 1309
provider, the contractor shall issue to the provider within sixty 1310
(60) days a final ruling of denial of the claim that allows the 1311
provider to have a state fair hearing and/or agency appeal with 1312
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the division. If a contractor does not issue a final ruling of 1313
denial within sixty (60) days as required by this subparagraph 1314
(b), the provider's claim shall be deemed to be automatically 1315
approved and the contractor shall pay the amount of the claim to 1316
the provider. 1317
(c) After a contractor has issued a final ruling 1318
of denial of a claim submitted by a provider, the division shall 1319
conduct a state fair hearing and/or agency appeal on the matter of 1320
the disputed claim between the contractor and the provider within 1321
sixty (60) days, and shall render a decision on the matter within 1322
thirty (30) days after the date of the hearing and/or appeal. 1323
(8) It is the intention of the Legislature that the 1324
division evaluate the feasibility of using a single vendor to 1325
administer pharmacy benefits provided under a managed care 1326
delivery system established under this subsection (H). Providers 1327
of pharmacy benefits shall cooperate with the division in any 1328
transition to a carve-out of pharmacy benefits under managed care. 1329
(9) The division shall evaluate the feasibility of 1330
using a single vendor to administer dental benefits provided under 1331
a managed care delivery system established in this subsection (H). 1332
Providers of dental benefits shall cooperate with the division in 1333
any transition to a carve-out of dental benefits under managed 1334
care. 1335
(10) It is the intent of the Legislature that any 1336
contractor receiving capitated payments under a managed care 1337
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delivery system established in this section shall implement 1338
innovative programs to improve the health and well-being of 1339
members diagnosed with prediabetes and diabetes. 1340
(11) It is the intent of the Legislature that any 1341
contractors receiving capitated payments under a managed care 1342
delivery system established under this subsection (H) shall work 1343
with providers of Medicaid services to improve the utilization of 1344
long-acting reversible contraceptives (LARCs). Not later than 1345
December 1, 2021, any contractors receiving capitated payments 1346
under a managed care delivery system established under this 1347
subsection (H) shall provide to the Chairmen of the House and 1348
Senate Medicaid Committees and House and Senate Public Health 1349
Committees a report of LARC utilization for State Fiscal Years 1350
2018 through 2020 as well as any programs, initiatives, or efforts 1351
made by the contractors and providers to increase LARC 1352
utilization. This report shall be updated annually to include 1353
information for subsequent state fiscal years. 1354
(12) The division is authorized to make not more than 1355
one (1) emergency extension of the contracts that are in effect on 1356
July 1, 2021, with contractors who are receiving capitated 1357
payments under a managed care delivery system established under 1358
this subsection (H), as provided in this paragraph (12). The 1359
maximum period of any such extension shall be one (1) year, and 1360
under any such extensions, the contractors shall be subject to all 1361
of the provisions of this subsection (H). The extended contracts 1362
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shall be revised to incorporate any provisions of this subsection 1363
(H). 1364
(I) [Deleted] 1365
(J) There shall be no cuts in inpatient and outpatient 1366
hospital payments, or allowable days or volumes, as long as the 1367
hospital assessment provided in Section 43-13-145 is in effect. 1368
This subsection (J) shall not apply to decreases in payments that 1369
are a result of: reduced hospital admissions, audits or payments 1370
under the APR-DRG or APC models, or a managed care program or 1371
similar model described in subsection (H) of this section. 1372
(K) In the negotiation and execution of such contracts 1373
involving services performed by actuarial firms, the Executive 1374
Director of the Division of Medicaid may negotiate a limitation on 1375
liability to the state of prospective contractors. 1376
(L) The Division of Medicaid shall reimburse for services 1377
provided to eligible Medicaid beneficiaries by a licensed birthing 1378
center in a method and manner to be determined by the division in 1379
accordance with federal laws and federal regulations. The 1380
division shall seek any necessary waivers, make any required 1381
amendments to its State Plan or revise any contracts authorized 1382
under subsection (H) of this section as necessary to provide the 1383
services authorized under this subsection. As used in this 1384
subsection, the term "birthing centers" shall have the meaning as 1385
defined in Section 41-77-1(a), which is a publicly or privately 1386
owned facility, place or institution constructed, renovated, 1387
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leased or otherwise established where nonemergency births are 1388
planned to occur away from the mother's usual residence following 1389
a documented period of prenatal care for a normal uncomplicated 1390
pregnancy which has been determined to be low risk through a 1391
formal risk-scoring examination. 1392
(M) This section shall stand repealed on July 1, 2028. 1393
SECTION 4. The Legislature finds that: 1394
(a) There is a growing complexity in health professions 1395
that can lead to the overlapping of existing licensed professions; 1396
(b) The Legislature is often called upon to make 1397
decisions about issues related to the scope of professional 1398
practice for multiple regulated health professions; and 1399
(c) A source of sound policy guidance could provide the 1400
Legislature with meaningful assistance in addressing these issues. 1401
SECTION 5. (1) There is created the State Board of Health 1402
Professions, which shall consist of one (1) member from each of 1403
the following health regulatory boards: 1404
(a) The State Board of Medical Licensure; 1405
(b) The State Board of Pharmacy; 1406
(c) The Mississippi Board of Nursing; 1407
(d) The State Board of Chiropractic Examiners; 1408
(e) The State Board of Dental Examiners; and 1409
(f) The State Board of Optometry. 1410
(2) The members described in subsection (1) of this section 1411
shall be appointed by the Governor for terms of four (4) years and 1412
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until their successor is duly qualified. Terms shall begin on 1413
July 1 and end on June 30. 1414
(3) In addition to the members provided for in subsection 1415
(1) of this section, there shall be five (5) members to be 1416
appointed by the Governor from the state at large, with the advice 1417
and consent of the Senate. The term for members appointed under 1418
this subsection (3) shall be for four (4) years and until their 1419
successor is duly qualified. Terms shall begin on July 1 and end 1420
on June 30. These members shall not hold a license to practice 1421
any of the professions regulated by the boards listed in 1422
subsection (1) of this section. 1423
(4) No member of the State Board of Health Professions who 1424
represents a health regulatory board shall continue serving as a 1425
member of the State Board of Health Professions after he or she 1426
ceases to be a member of the health regulatory board from which he 1427
or she was appointed. 1428
SECTION 6. The Chairman of the State Board of Health 1429
Professions shall be elected by the board from its members. The 1430
board shall meet at least annually and may hold additional 1431
meetings as necessary to perform its duties. Six (6) members of 1432
the board shall constitute a quorum for the conduct of business. 1433
Members of the board shall be entitled to actual travel expenses 1434
including mileage as provided in Section 25-3-41 and a per diem 1435
for attending meetings of the board in the amount provided in 1436
Section 25-3-69. 1437
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SECTION 7. The State Board of Health Professions shall have 1438
the following powers and duties: 1439
(a) To evaluate the need for coordination among the 1440
health regulatory boards and their staffs and report its findings 1441
and recommendations to the boards; 1442
(b) To evaluate all health care professions and 1443
occupations in the state, including those regulated and those not 1444
regulated by other provisions of Title 73, Mississippi Code of 1445
1972, and to consider whether each such profession or occupation 1446
should be regulated and the degree of regulation to be imposed. 1447
Whenever the board determines that the public interest requires 1448
that a health care profession or occupation that is not regulated 1449
by law should be regulated, the board shall recommend to the 1450
Legislature a regulatory system to establish the appropriate 1451
degree of regulation; 1452
(c) To serve as a forum for resolving conflicts among 1453
the health regulatory boards; 1454
(d) To advise the Governor and the Legislature on 1455
matters relating to the regulation or deregulation of health care 1456
professions and occupations; 1457
(e) To make bylaws for the governing of the board and 1458
the proper fulfillment of its duties under this chapter; 1459
(f) To promote the development of standards to evaluate 1460
the competency of the professions and occupations represented on 1461
the board; 1462
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(g) To review periodically the investigatory, 1463
disciplinary and enforcement processes of the individual health 1464
regulatory boards to ensure the protection of the public and the 1465
fair and equitable treatment of health professionals; and 1466
(h) To examine scope of practice conflicts involving 1467
regulated and unregulated health care professions and occupations 1468
and advise the health regulatory boards and the Legislature of the 1469
nature and degree of such conflicts. 1470
SECTION 8. The State Department of Health shall annually 1471
request a budget for the State Board of Health Professions and 1472
shall provide a meeting space and administrative support for the 1473
board's operations. 1474
SECTION 9. Sections 4 through 8 of this act shall be 1475
codified as a new Chapter 44 in Title 73, Mississippi Code of 1476
1972. 1477
SECTION 10. Section 47-5-579, Mississippi Code of 1972, is 1478
amended as follows: 1479
47-5-579. (1) (a) The corporation shall operate a work 1480
initiative at the Central Mississippi Correctional Facility, South 1481
Mississippi Correctional Institution, Mississippi State 1482
Penitentiary and the Mississippi Correctional Institute for Women, 1483
and is authorized, in its discretion, to create a work initiative 1484
at any other correctional facility listed in Section 47-5-539(d). 1485
In lieu of a work initiative created by the corporation, the 1486
warden or superintendent or sheriff at any regional and private 1487
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facility listed in Section 47-5-539 is authorized to create a work 1488
initiative at their respective facility consistent with the 1489
provisions and requirements of this section. Each initiative 1490
shall be limited to no more than twenty-five (25) inmates in the 1491
state, regional or private facility at any given time. 1492
(b) The department, with regard to a work initiative in 1493
an MDOC facility, shall: 1494
(i) Have the ultimate authority for oversight of 1495
the administration of the initiative; 1496
(ii) Delegate the administration of the initiative 1497
to the corporation; and 1498
(iii) Oversee the selection of inmates for 1499
admission to the initiative. 1500
(c) The sheriff, with regard to a work initiative at a 1501
regional facility, shall: 1502
(i) Have the ultimate authority for oversight of 1503
the administration of the initiative; 1504
(ii) Oversee the selection of inmates for 1505
admission to the initiative; and 1506
(iii) Work with the department and the corporation 1507
to establish guidelines for the initiative and develop a report 1508
thereon. 1509
(2) (a) An inmate is eligible for participation in the 1510
initiative if the inmate has: 1511
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(i) No more than two (2) years remaining on the 1512
inmate's sentence; 1513
(ii) Not been convicted under Section 97-9-49 1514
within the last five (5) years; and 1515
(iii) Not been sentenced for a sex offense as 1516
defined in Section 45-33-23(h). 1517
(b) Any inmate who meets the eligibility requirements 1518
of paragraph (a) may request assignment to a work initiative 1519
established under this section. 1520
(3) (a) The commissioner, in the case of MDOC facilities, 1521
or the warden, superintendent, sheriff or similar leader in the 1522
case of regional and private facilities, shall select inmates for 1523
admission to the program. 1524
(b) An inmate currently participating in vocational 1525
training or a soft skills training program at a facility 1526
authorized to operate a work initiative shall have priority in 1527
admission to the program. 1528
(4) (a) The chief executive officer, in the case of MDOC 1529
facilities, or the warden, superintendent, sheriff or similar 1530
leader in the case of regional and private facilities, may 1531
authorize the inmate to participate in educational or other 1532
rehabilitative programs designed to supplement his work initiative 1533
employment or to prepare the person for successful reentry. 1534
(b) Before accepting any participants to the program, 1535
the corporation, in consultation with the department, shall adopt 1536
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and publish rules and regulations to effectuate this section no 1537
later than six (6) months after the effective date of this 1538
section. These rules and regulations shall include all protection 1539
requirements for work release programs established pursuant to 1540
Sections 47-5-451 through 47-5-471. 1541
(5) Participating employers shall pay no less than the 1542
prevailing wage for the position and shall under no circumstance 1543
pay less than the federal minimum wage. 1544
(6) Any inmate assigned to the initiative who, without 1545
proper authority or just cause, leaves the area to which he has 1546
been assigned to work or attend educational or other 1547
rehabilitative programs, or leaves the vehicle or route of travel 1548
involved in his or her going to or returning from such place, will 1549
be guilty of escape as provided in Section 97-9-49. An offender 1550
who is convicted under Section 97-9-49 shall be ineligible for 1551
further participation in the work initiative during his or her 1552
current term of confinement. 1553
(7) (a) The inmate shall maintain an account through a 1554
local financial institution and shall provide a copy of a check 1555
stub to the chief executive officer, the warden, the 1556
superintendent or the sheriff at a regional facility, as the case 1557
may be. 1558
(b) The inmate shall be required: 1559
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(i) To pay twenty-five percent (25%) of the 1560
inmate's wages after mandatory deductions for the following 1561
purposes: 1562
1. To pay support of dependents or to the 1563
Mississippi Department of Human Services on behalf of dependents 1564
as may be ordered by a judge of competent jurisdiction; and 1565
2. To pay any fines, restitution, or costs as 1566
ordered by the court to include any fines and fees associated with 1567
obtaining a valid driver's license upon release. 1568
(ii) To pay fifteen percent (15%) of the inmate's 1569
wages after mandatory deductions to the corporation for 1570
administrative expenses to include transportation costs to be 1571
remitted to the state, regional or private facility where the 1572
inmate is housed. In the case of state facilities, the 1573
administrative expense reimbursement shall be paid to the 1574
corporation; in the case of regional facilities, the 1575
administrative expense reimbursement shall be paid to the 1576
sheriff's department; in the case of private facilities the 1577
administrative expense reimbursement shall be paid to the 1578
contractor overseeing the facility. 1579
(iii) To save fifty percent (50%) of the inmate's 1580
wages after mandatory reductions in the account required under 1581
paragraph (a) of this subsection. Monies under this subparagraph 1582
shall be made available to the inmate upon parole or release. 1583
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(c) The inmate shall have access to the remaining ten 1584
percent (10%) of the monies in the inmate's account to purchase 1585
incidental expenses. 1586
(d) Any monies remaining under paragraph (a) of this 1587
subsection after all mandatory deductions are paid, shall be 1588
deposited in the inmate's account established under this 1589
subsection. Any monies remaining upon release in paragraph (c) of 1590
this subsection shall be released to the inmate. 1591
(8) The chief executive officer of the corporation shall 1592
collect and maintain data which shall be shared semiannually with 1593
the Joint Legislative Committee on Performance Evaluation and 1594
Expenditure Review (PEER) and the Corrections and Criminal Justice 1595
Oversight Task Force in sortable electronic format. The first 1596
report shall be made on January 15, 2023, and in six-month 1597
intervals thereafter unless PEER establishes a different schedule. 1598
The data shall include: 1599
(a) Total number of participants at the end of each 1600
month by race, gender, and offenses charged; 1601
(b) Total number of participants who began the program 1602
in each month by race, gender, and offenses charged; 1603
(c) Total number of participants who successfully 1604
completed the program in each month by race, gender, and offenses 1605
charged; 1606
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(d) Total number of participants who left the program 1607
in each month and reason for leaving by race, gender, and offenses 1608
charged; 1609
(e) Total number of participants who were arrested for 1610
a new criminal offense while in the program in each month by race, 1611
gender and offenses charged; 1612
(f) Total number of participants who were convicted of 1613
a new crime while in the program in each month by race, gender and 1614
offenses charged; 1615
(g) Total number of participants who completed the 1616
program and were convicted of a new crime within three (3) years 1617
of completing the program; 1618
(h) Total amount earned by participants and how the 1619
earnings were distributed in each month; 1620
(i) Results of any initial risk and needs assessments 1621
conducted on each participant by race, gender, and offenses 1622
charged; 1623
(j) List of participating employers; 1624
(k) List of jobs acquired by participants; 1625
(l) List of the hourly wage paid to each participant; 1626
(m) Accounting of the manner and use of the * * * 1627
fifteen percent (15%) of the wages paid to the corporation by the 1628
inmate for administrative expenses; 1629
(n) Total costs associated with program operations; 1630
(o) List of participating financial institutions; 1631
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(p) * * * Participating financial institutions, which 1632
must collect, maintain and report the create date for financial 1633
accounts opened by work initiative participants; 1634
(q) The average hourly wage earned in the 1635
program; * * * 1636
(r) The accounting of any dependent support payments, 1637
fines, restitutions, fees or costs as ordered by the court for 1638
each work initiative participant; 1639
(s) The collection, maintenance and reporting of the 1640
remaining sentence length of work initiative participants; and 1641
( * * *t) Any other data or information as requested by 1642
the task force. 1643
(9) The Joint Legislative Committee on Performance 1644
Evaluation and Expenditure Review (PEER) shall conduct a review of 1645
the initiative, including any expansion of the initiative 1646
authorized under this section, and produce an annual report to the 1647
Legislature on their effectiveness by January 1 of each year. The 1648
PEER Committee shall seek the assistance of the Corrections and 1649
Criminal Justice Task Force and may seek assistance from any other 1650
criminal justice experts it deems necessary during its review. 1651
SECTION 11. Section 5-3-59, Mississippi Code of 1972, is 1652
amended as follows: 1653
5-3-59. (1) The committee, while in the discharge of 1654
official duties, shall have the following additional powers: 1655
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(a) To subpoena and examine witnesses; to require the 1656
appearance of any person and the production of any paper or 1657
document; to order the appearance of any person for the purpose of 1658
producing any paper or document; and to issue all process 1659
necessary to compel such appearance or production. When such 1660
process has been served, the committee may compel obedience 1661
thereto by the attachment of the person, papers or records 1662
subpoenaed; and if any person shall willfully refuse to appear 1663
before such committee or to produce any paper or record in 1664
obedience to any process issued by the committee and served on 1665
that person, he or she shall be guilty of contempt of the * * * 1666
committee and shall, upon conviction thereof, be * * * punished by 1667
a fine of not more than One Thousand Dollars ($1,000.00), by 1668
imprisonment in the county jail for not more than six (6) months, 1669
or both. 1670
(b) To administer oaths to witnesses appearing before 1671
the committee when, by a majority vote, the committee deems the 1672
administration of an oath necessary and advisable as provided by 1673
law. 1674
(c) To determine that a witness has perjured himself or 1675
herself by testifying falsely before the committee, and to 1676
institute penal proceedings as provided by law. 1677
(2) (a) Whenever facts alleged to constitute contempt under 1678
subsection (1)(a) of this section arise, the chairman of the 1679
committee shall certify a statement to this effect to the Attorney 1680
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General or to the appropriate county prosecuting attorney, who 1681
shall institute and prosecute a criminal proceeding against the 1682
accused for contempt under the provisions of this section. 1683
(b) Any offense described in subsection (1)(a) of this 1684
section shall be deemed to have been committed in any of the 1685
following counties, and the trial for the offense may take place 1686
in any of those counties: 1687
(i) The county where the subpoena was issued; 1688
(ii) The county where the offender was served with 1689
the subpoena; or 1690
(iii) The county where the subpoena ordered the 1691
offender to give testimony or to produce papers or other evidence. 1692
SECTION 12. The following shall be codified as Section 1693
5-3-60, Mississippi Code of 1972: 1694
5-3-60. (1) (a) As an alternative to a criminal proceeding 1695
as provided in Section 5-3-59, in any instance in which a witness 1696
fails to respond to the lawful subpoena of the committee at any 1697
time or, having responded, fails to answer all lawful inquiries or 1698
to turn over evidence that has been subpoenaed, the committee may 1699
seek judicial enforcement of the process as provided in paragraph 1700
(b) of this subsection. 1701
(b) The chairman, in the name of the committee, may 1702
file a complaint before any chancery court of the state setting up 1703
such failure on the part of the witness. Upon the filing of such 1704
a complaint, the court shall take jurisdiction of the witness and 1705
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the subject matter of the complaint and shall direct the witness 1706
to respond to all lawful questions and to produce all documentary 1707
evidence in the possession of the witness that is lawfully 1708
demanded. The failure of a witness to comply with the order of 1709
the court constitutes contempt of court, and the court shall 1710
punish the witness as provided in Section 9-1-17. 1711
(c) The committee may use the Office of the Attorney 1712
General to bring a civil enforcement action or may use contract 1713
counsel to bring an enforcement action authorized in this 1714
subsection. 1715
(2) The provisions of this section are supplemental to the 1716
powers of the Legislature and of the Senate and of the House of 1717
Representatives to punish for contempt, and the Legislature 1718
reserves to itself and to the Senate and to the House of 1719
Representatives all inherent and all constitutional powers to 1720
punish for contempt. 1721
SECTION 13. Section 5-1-23, Mississippi Code of 1972, is 1722
amended as follows: 1723
5-1-23. (1) If any witness neglects or refuses to obey a 1724
subpoena, or, appearing, refuses to testify, the Senate or House 1725
may, by a resolution entered on its journal, commit him or her for 1726
contempt, the commitment not to extend beyond the final 1727
adjournment of the session; and any witness neglecting and 1728
refusing to attend in obedience to a subpoena may be arrested by 1729
the Sergeant-at-Arms and brought before the Senate or House; and a 1730
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copy of the resolution of the Senate or House, signed by the 1731
presiding officer thereof, and attested by the secretary or clerk, 1732
shall be sufficient authority to authorize such arrest. 1733
(2) The provisions of this section shall not apply to any 1734
subpoena or other process issued by the Joint Legislative 1735
Committee on Performance Evaluation and Expenditure Review (PEER) 1736
as provided for in Sections 24 and 25 of this act. 1737
SECTION 14. Section 5-1-25, Mississippi Code of 1972, is 1738
amended as follows: 1739
5-1-25. (1) A person sworn and examined as a witness before 1740
either house, without procurement or contrivance, on his or her 1741
part, shall not be held to answer criminally, or be subject to any 1742
penalty or forfeiture for any fact or act touching which he or she 1743
is required to testify; nor shall any statement made, or book, 1744
document, or paper produced by any such witness be competent 1745
evidence in any criminal proceeding against such witness other 1746
than for perjury in delivering his or her evidence; nor shall such 1747
witness refuse to testify to any fact or to produce any book, 1748
document, or paper touching which he or she is examined, on the 1749
ground that he or she thereby will criminate himself, or that it 1750
will tend to disgrace him or her or render him or her infamous. 1751
(2) The immunity conferred by subsection (1) of this section 1752
shall not apply to any person who testifies or produces any book, 1753
document or paper required to comply with a subpoena of the Joint 1754
Legislative Committee on Performance Evaluation and Expenditure 1755
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Review (PEER). The committee may, by a majority vote of the 1756
members of both houses, offer a person or persons such immunity. 1757
SECTION 15. Section 5-1-35, Mississippi Code of 1972, is 1758
amended as follows: 1759
5-1-35. (1) The Sergeant-at-Arms of the Senate shall give a 1760
general supervision, under the direction of the presiding officer. 1761
He or she shall attend the sittings thereof, preserve order, 1762
execute its commands and all process issued by its authority, and 1763
shall have control of the doorkeeper. He or she shall see that 1764
the hall of the Senate and the committee rooms and the room of its 1765
presiding officer, the anterooms, lobbies and galleries thereof, 1766
are clean, comfortable and lighted at night during the sitting of 1767
the Senate, and that all necessary conveniences are supplied to 1768
the members, officers and committees. 1769
(2) The Sergeant-at-Arms shall, upon request of the Joint 1770
Legislative Committee on Performance Evaluation and Expenditure 1771
Review (PEER), serve any committee process provided for in Section 1772
24 of this act. 1773
SECTION 16. This act shall take effect and be in force from 1774
and after July 1, 2026. 1775