Statewide Insurance Enrollment Assistance Program; establish within the Mississippi Department of Insurance.

S. B. No. 2722 *SS26/R908* ~ OFFICIAL ~ G1/2
26/SS26/R908
PAGE 1 (rdd\tb)

To: Insurance
MISSISSIPPI LEGISLATURE REGULAR SESSION 2026

By: Senator(s) Mumford, Frazier, Jackson

SENATE BILL NO. 2722

AN ACT TO AUTHORIZE THE MISSISSIPPI COMMISSIONER OF INSURANCE 1
TO ADOPT REASONABLE RULES AND REGULATIONS TO ESTABLISH A STATEWIDE 2
INSURANCE ENROLLMENT ASSISTANCE PROGRAM (SIEAP) WITHIN THE 3
MISSISSIPPI DEPARTMENT OF INSURANCE TO OFFER FREE, UNBIASED 4
ASSISTANCE WITH HEALTH INSURANCE CHOICES, APPLICATIONS, BENEFITS 5
AND COMPARING PLANS TO ENSURE ACCESS TO NECESSARY CARE THROUGH 6
PERSONALIZED GUIDANCE; TO DIRECT THE DIVISION OF MEDICAID TO 7
SIMPLIFY RENEWAL AND VERIFICATION PROCEDURES; TO DIRECT THE 8
MISSISSIPPI DEPARTMENT OF INSURANCE TO DEVELOP A COUNTY-BY-COUNTY 9
UNINSURED DATA REPORT TO IDENTIFY AREAS WITH THE GREATEST HEALTH 10
INSURANCE NEED; TO DIRECT THE MISSISSIPPI DEPARTMENT OF INSURANCE 11
TO DEVELOP A PROGRAM TO ENCOURAGE MISSISSIPPI EMPLOYERS TO 12
PARTICIPATE IN EXISTING INSURANCE PROGRAMS THROUGH INCENTIVES; TO 13
AMEND SECTION 43-13-116, MISSISSIPPI CODE OF 1972, IN CONFORMITY; 14
AND FOR RELATED PURPOSES. 15
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI: 16
SECTION 1. (1) The Mississippi Commissioner of Insurance is 17
empowered and directed to adopt reasonable rules necessary for the 18
implementation of the following enrollee assistance programs: 19
(a) Establish a Statewide Insurance Enrollment 20
Assistance Program (SIEAP) with community health centers, 21
hospitals, and local nonprofits to help residents complete 22
marketplace, Medicaid, Medicare and CHIP applications to assist 23
S. B. No. 2722 *SS26/R908* ~ OFFICIAL ~
26/SS26/R908
PAGE 2 (rdd\tb)

individuals seeking insurance enrollment without expanding 24
eligibility. 25
(b) In conjunction with the Division of Medicaid, 26
simplify renewal and verification procedures, reducing coverage 27
loss caused by administrative issues under applicable federal 28
rules. 29
(c) Require the creation of a county-by-county 30
uninsured data report to help legislators, providers, and local 31
governments clearly identify areas with the greatest need and 32
target resources more effectively. 33
(d) Develop a plan to encourage small employers to 34
participate in existing insurance programs by commissioning a 35
feasibility review for future incentives. 36
(2) The Statewide Insurance Enrollment Assistance Program, 37
in conjunction with the federal State Health Insurance Assistance 38
Program (SHIP) for Medicare shall offer free, unbiased help with 39
health coverage choices, applications, understanding benefits, and 40
comparing plans for different populations, from seniors to 41
low-income families, ensuring access to necessary care through 42
personalized guidance and community outreach. The SIEAP program 43
shall recruit and train both volunteer and in-kind team members to 44
provide program services. Team members shall be trained and 45
certified to assist people in obtaining coverage through options 46
such as Medicaid, original Medicare (Parts A & B), Medicare 47
Advantage (Part C), Medicare Prescription Drug Coverage (Part D), 48
S. B. No. 2722 *SS26/R908* ~ OFFICIAL ~
26/SS26/R908
PAGE 3 (rdd\tb)

and Medicare Supplement (Medigap). The SIEAP program shall also 49
assist beneficiaries with limited income to apply for programs, 50
such as Medicaid, Medicare Savings Program, and Extra 51
Help/Low-Income Subsidy, which help pay for or reduced health care 52
costs. SIEAP shall conduct outreach by providing presentations, 53
distributing information, conducting enrollment events, and 54
participating in health fairs, senior fairs, and other community 55
events, in order to inform groups and individuals about Medicaid 56
and Medicare benefits, coverage rules, written notices and forms, 57
appeal rights and procedures, and more. The SIEAP program shall 58
develop 'Conflict of Interest: Identification, Remedy, and 59
Removal' to provide technical assistance to the program and their 60
partner community-based organizations on how to avoid actual and 61
perceived conflicts of interest (COI) and mitigate risk. 62
SECTION 2. Section 43-13-116, Mississippi Code of 1972, is 63
amended as follows: 64
43-13-116. (1) It shall be the duty of the Division of 65
Medicaid to fully implement and carry out the administrative 66
functions of determining the eligibility of those persons who 67
qualify for medical assistance under Section 43-13-115. 68
(2) In determining Medicaid eligibility, the Division of 69
Medicaid is authorized to enter into an agreement with the 70
Secretary of the Department of Health and Human Services for the 71
purpose of securing the transfer of eligibility information from 72
the Social Security Administration on those individuals receiving 73
S. B. No. 2722 *SS26/R908* ~ OFFICIAL ~
26/SS26/R908
PAGE 4 (rdd\tb)

Supplemental Security Income (SSI) benefits under the federal 74
Social Security Act and any other information necessary in 75
determining Medicaid eligibility. The Division of Medicaid is 76
further empowered to enter into contractual arrangements with its 77
fiscal agent or with the State Department of Human Services in 78
securing electronic data processing support as may be necessary. 79
(3) Administrative hearings shall be available to any 80
applicant who requests it because his or her claim of eligibility 81
for services is denied or is not acted upon with reasonable 82
promptness or by any recipient who requests it because he or she 83
believes the agency has erroneously taken action to deny, reduce, 84
or terminate benefits. The agency need not grant a hearing if the 85
sole issue is a federal or state law requiring an automatic change 86
adversely affecting some or all recipients. Eligibility 87
determinations that are made by other agencies and certified to 88
the Division of Medicaid pursuant to Section 43-13-115 are not 89
subject to the administrative hearing procedures of the Division 90
of Medicaid but are subject to the administrative hearing 91
procedures of the agency that determined eligibility. 92
(a) A request may be made either for a local regional 93
office hearing or a state office hearing when the local regional 94
office has made the initial decision that the claimant seeks to 95
appeal or when the regional office has not acted with reasonable 96
promptness in making a decision on a claim for eligibility or 97
services. The only exception to requesting a local hearing is 98
S. B. No. 2722 *SS26/R908* ~ OFFICIAL ~
26/SS26/R908
PAGE 5 (rdd\tb)

when the issue under appeal involves either (i) a disability or 99
blindness denial, or termination, or (ii) a level of care denial 100
or termination for a disabled child living at home. An appeal 101
involving disability, blindness or level of care must be handled 102
as a state level hearing. The decision from the local hearing may 103
be appealed to the state office for a state hearing. A decision 104
to deny, reduce or terminate benefits that is initially made at 105
the state office may be appealed by requesting a state hearing. 106
(b) A request for a hearing, either state or local, 107
must be made in writing by the claimant or claimant's legal 108
representative. "Legal representative" includes the claimant's 109
authorized representative, an attorney retained by the claimant or 110
claimant's family to represent the claimant, a paralegal 111
representative with a legal aid services, a parent of a minor 112
child if the claimant is a child, a legal guardian or conservator 113
or an individual with power of attorney for the claimant. The 114
claimant may also be represented by anyone that he or she so 115
designates but must give the designation to the Medicaid regional 116
office or state office in writing, if the person is not the legal 117
representative, legal guardian, or authorized representative. 118
(c) The claimant may make a request for a hearing in 119
person at the regional office but an oral request must be put into 120
written form. Regional office staff will determine from the 121
claimant if a local or state hearing is requested and assist the 122
claimant in completing and signing the appropriate form. Regional 123
S. B. No. 2722 *SS26/R908* ~ OFFICIAL ~
26/SS26/R908
PAGE 6 (rdd\tb)

office staff may forward a state hearing request to the 124
appropriate division in the state office or the claimant may mail 125
the form to the address listed on the form. The claimant may make 126
a written request for a hearing by letter. A simple statement 127
requesting a hearing that is signed by the claimant or legal 128
representative is sufficient; however, if possible, the claimant 129
should state the reason for the request. The letter may be mailed 130
to the regional office or it may be mailed to the state office. 131
If the letter does not specify the type of hearing desired, local 132
or state, Medicaid staff will attempt to contact the claimant to 133
determine the level of hearing desired. If contact cannot be made 134
within three (3) days of receipt of the request, the request will 135
be assumed to be for a local hearing and scheduled accordingly. A 136
hearing will not be scheduled until either a letter or the 137
appropriate form is received by the regional or state office. 138
(d) When both members of a couple wish to appeal an 139
action or inaction by the agency that affects both applications or 140
cases similarly and arose from the same issue, one or both may 141
file the request for hearing, both may present evidence at the 142
hearing, and the agency's decision will be applicable to both. If 143
both file a request for hearing, two (2) hearings will be 144
registered but they will be conducted on the same day and in the 145
same place, either consecutively or jointly, as the couple wishes. 146
If they so desire, only one (1) of the couple need attend the 147
hearing. 148
S. B. No. 2722 *SS26/R908* ~ OFFICIAL ~
26/SS26/R908
PAGE 7 (rdd\tb)

(e) The procedure for administrative hearings shall be 149
as follows: 150
(i) The claimant has thirty (30) days from the 151
date the agency mails the appropriate notice to the claimant of 152
its decision regarding eligibility, services, or benefits to 153
request either a state or local hearing. This time period may be 154
extended if the claimant can show good cause for not filing within 155
thirty (30) days. Good cause includes, but may not be limited to, 156
illness, failure to receive the notice, being out of state, or 157
some other reasonable explanation. If good cause can be shown, a 158
late request may be accepted provided the facts in the case remain 159
the same. If a claimant's circumstances have changed or if good 160
cause for filing a request beyond thirty (30) days is not shown, a 161
hearing request will not be accepted. If the claimant wishes to 162
have eligibility reconsidered, he or she may reapply. 163
(ii) If a claimant or representative requests a 164
hearing in writing during the advance notice period before 165
benefits are reduced or terminated, benefits must be continued or 166
reinstated to the benefit level in effect before the effective 167
date of the adverse action. Benefits will continue at the 168
original level until the final hearing decision is rendered. Any 169
hearing requested after the advance notice period will not be 170
accepted as a timely request in order for continuation of benefits 171
to apply. 172
S. B. No. 2722 *SS26/R908* ~ OFFICIAL ~
26/SS26/R908
PAGE 8 (rdd\tb)

(iii) Upon receipt of a written request for a 173
hearing, the request will be acknowledged in writing within twenty 174
(20) days and a hearing scheduled. The claimant or representative 175
will be given at least five (5) days' advance notice of the 176
hearing date. The local and/or state level hearings will be held 177
by telephone unless, at the hearing officer's discretion, it is 178
determined that an in-person hearing is necessary. If a local 179
hearing is requested, the regional office will notify the claimant 180
or representative in writing of the time of the local hearing. If 181
a state hearing is requested, the state office will notify the 182
claimant or representative in writing of the time of the state 183
hearing. If an in-person hearing is necessary, local hearings 184
will be held at the regional office and state hearings will be 185
held at the state office unless other arrangements are 186
necessitated by the claimant's inability to travel. 187
(iv) All persons attending a hearing will attend 188
for the purpose of giving information on behalf of the claimant or 189
rendering the claimant assistance in some other way, or for the 190
purpose of representing the Division of Medicaid. 191
(v) A state or local hearing request may be 192
withdrawn at any time before the scheduled hearing, or after the 193
hearing is held but before a decision is rendered. The withdrawal 194
must be in writing and signed by the claimant or representative. 195
A hearing request will be considered abandoned if the claimant or 196
representative fails to appear at a scheduled hearing without good 197
S. B. No. 2722 *SS26/R908* ~ OFFICIAL ~
26/SS26/R908
PAGE 9 (rdd\tb)

cause. If no one appears for a hearing, the appropriate office 198
will notify the claimant in writing that the hearing is dismissed 199
unless good cause is shown for not attending. The proposed agency 200
action will be taken on the case following failure to appear for a 201
hearing if the action has not already been effected. 202
(vi) The claimant or his representative has the 203
following rights in connection with a local or state hearing: 204
(A) The right to examine at a reasonable time 205
before the date of the hearing and during the hearing the content 206
of the claimant's case record; 207
(B) The right to have legal representation at 208
the hearing and to bring witnesses; 209
(C) The right to produce documentary evidence 210
and establish all facts and circumstances concerning eligibility, 211
services, or benefits; 212
(D) The right to present an argument without 213
undue interference; 214
(E) The right to question or refute any 215
testimony or evidence including an opportunity to confront and 216
cross-examine adverse witnesses. 217
(vii) When a request for a local hearing is 218
received by the regional office or if the regional office is 219
notified by the state office that a local hearing has been 220
requested, the Medicaid specialist supervisor in the regional 221
office will review the case record, reexamine the action taken on 222
S. B. No. 2722 *SS26/R908* ~ OFFICIAL ~
26/SS26/R908
PAGE 10 (rdd\tb)

the case, and determine if policy and procedures have been 223
followed. If any adjustments or corrections should be made, the 224
Medicaid specialist supervisor will ensure that corrective action 225
is taken. If the request for hearing was timely made such that 226
continuation of benefits applies, the Medicaid specialist 227
supervisor will ensure that benefits continue at the level before 228
the proposed adverse action that is the subject of the appeal. 229
The Medicaid specialist supervisor will also ensure that all 230
needed information, verification, and evidence is in the case 231
record for the hearing. 232
(viii) When a state hearing is requested that 233
appeals the action or inaction of a regional office, the regional 234
office will prepare copies of the case record and forward it to 235
the appropriate division in the state office no later than five 236
(5) days after receipt of the request for a state hearing. The 237
original case record will remain in the regional office. Either 238
the original case record in the regional office or the copy 239
forwarded to the state office will be available for inspection by 240
the claimant or claimant's representative a reasonable time before 241
the date of the hearing. 242
(ix) The Medicaid specialist supervisor will serve 243
as the hearing officer for a local hearing unless the Medicaid 244
specialist supervisor actually participated in the eligibility, 245
benefits, or services decision under appeal, in which case the 246
Medicaid specialist supervisor must appoint a Medicaid specialist 247
S. B. No. 2722 *SS26/R908* ~ OFFICIAL ~
26/SS26/R908
PAGE 11 (rdd\tb)

in the regional office who did not actually participate in the 248
decision under appeal to serve as hearing officer. The local 249
hearing will be an informal proceeding in which the claimant or 250
representative may present new or additional information, may 251
question the action taken on the client's case, and will hear an 252
explanation from agency staff as to the regulations and 253
requirements that were applied to claimant's case in making the 254
decision. 255
(x) After the hearing, the hearing officer will 256
prepare a written summary of the hearing procedure and file it 257
with the case record. The hearing officer will consider the facts 258
presented at the local hearing in reaching a decision. The 259
claimant will be notified of the local hearing decision on the 260
appropriate form that will state clearly the reason for the 261
decision, the policy that governs the decision, the claimant's 262
right to appeal the decision to the state office, and, if the 263
original adverse action is upheld, the new effective date of the 264
reduction or termination of benefits or services if continuation 265
of benefits applied during the hearing process. The new effective 266
date of the reduction or termination of benefits or services must 267
be at the end of the fifteen-day advance notice period from the 268
mailing date of the notice of hearing decision. The notice to 269
claimant will be made part of the case record. 270
(xi) The claimant has the right to appeal a local 271
hearing decision by requesting a state hearing in writing within 272
S. B. No. 2722 *SS26/R908* ~ OFFICIAL ~
26/SS26/R908
PAGE 12 (rdd\tb)

fifteen (15) days of the mailing date of the notice of local 273
hearing decision. The state hearing request should be made to the 274
regional office. If benefits have been continued pending the 275
local hearing process, then benefits will continue throughout the 276
fifteen-day advance notice period for an adverse local hearing 277
decision. If a state hearing is timely requested within the 278
fifteen-day period, then benefits will continue pending the state 279
hearing process. State hearings requested after the fifteen-day 280
local hearing advance notice period will not be accepted unless 281
the initial thirty-day period for filing a hearing request has not 282
expired because the local hearing was held early, in which case a 283
state hearing request will be accepted as timely within the number 284
of days remaining of the unexpired initial thirty-day period in 285
addition to the fifteen-day time period. Continuation of benefits 286
during the state hearing process, however, will only apply if the 287
state hearing request is received within the fifteen-day advance 288
notice period. 289
(xii) When a request for a state hearing is 290
received in the regional office, the request will be made part of 291
the case record and the regional office will prepare the case 292
record and forward it to the appropriate division in the state 293
office within five (5) days of receipt of the state hearing 294
request. A request for a state hearing received in the state 295
office will be forwarded to the regional office for inclusion in 296
the case record and the regional office will prepare the case 297
S. B. No. 2722 *SS26/R908* ~ OFFICIAL ~
26/SS26/R908
PAGE 13 (rdd\tb)

record and forward it to the appropriate division in the state 298
office within five (5) days of receipt of the state hearing 299
request. 300
(xiii) Upon receipt of the hearing record, an 301
impartial hearing officer will be assigned to hear the case either 302
by the Executive Director of the Division of Medicaid or his or 303
her designee. Hearing officers will be individuals with 304
appropriate expertise employed by the division and who have not 305
been involved in any way with the action or decision on appeal in 306
the case. The hearing officer will review the case record and if 307
the review shows that an error was made in the action of the 308
agency or in the interpretation of policy, or that a change of 309
policy has been made, the hearing officer will discuss these 310
matters with the appropriate agency personnel and request that an 311
appropriate adjustment be made. Appropriate agency personnel will 312
discuss the matter with the claimant and if the claimant is 313
agreeable to the adjustment of the claim, then agency personnel 314
will request in writing dismissal of the hearing and the reason 315
therefor, to be placed in the case record. If the hearing is to 316
go forward, it shall be scheduled by the hearing officer in the 317
manner set forth in subparagraph (iii) of this paragraph (e). 318
(xiv) In conducting the hearing, the state hearing 319
officer will inform those present of the following: 320
S. B. No. 2722 *SS26/R908* ~ OFFICIAL ~
26/SS26/R908
PAGE 14 (rdd\tb)

(A) That the hearing will be recorded on tape 321
and that a transcript of the proceedings will be typed for the 322
record; 323
(B) The action taken by the agency which 324
prompted the appeal; 325
(C) An explanation of the claimant's rights 326
during the hearing as outlined in subparagraph (vi) of this 327
paragraph (e); 328
(D) That the purpose of the hearing is for 329
the claimant to express dissatisfaction and present additional 330
information or evidence; 331
(E) That the case record is available for 332
review by the claimant or representative during the hearing; 333
(F) That the final hearing decision will be 334
rendered by the Executive Director of the Division of Medicaid on 335
the basis of facts presented at the hearing and the case record 336
and that the claimant will be notified by letter of the final 337
decision. 338
(xv) During the hearing, the claimant and/or 339
representative will be allowed an opportunity to make a full 340
statement concerning the appeal and will be assisted, if 341
necessary, in disclosing all information on which the claim is 342
based. All persons representing the claimant and those 343
representing the Division of Medicaid will have the opportunity to 344
state all facts pertinent to the appeal. The hearing officer may 345
S. B. No. 2722 *SS26/R908* ~ OFFICIAL ~
26/SS26/R908
PAGE 15 (rdd\tb)

recess or continue the hearing for a reasonable time should 346
additional information or facts be required or if some change in 347
the claimant's circumstances occurs during the hearing process 348
which impacts the appeal. When all information has been 349
presented, the hearing officer will close the hearing and stop the 350
recorder. 351
(xvi) Immediately following the hearing the 352
hearing tape will be transcribed and a copy of the transcription 353
forwarded to the regional office for filing in the case record. 354
As soon as possible, the hearing officer shall review the evidence 355
and record of the proceedings, testimony, exhibits, and other 356
supporting documents, prepare a written summary of the facts as 357
the hearing officer finds them, and prepare a written 358
recommendation of action to be taken by the agency, citing 359
appropriate policy and regulations that govern the recommendation. 360
The decision cannot be based on any material, oral or written, not 361
available to the claimant before or during the hearing. The 362
hearing officer's recommendation will become part of the case 363
record which will be submitted to the Executive Director of the 364
Division of Medicaid for further review and decision. 365
(xvii) The Executive Director of the Division of 366
Medicaid, upon review of the recommendation, proceedings and the 367
record, may sustain the recommendation of the hearing officer, 368
reject the same, or remand the matter to the hearing officer to 369
take additional testimony and evidence, in which case, the hearing 370
S. B. No. 2722 *SS26/R908* ~ OFFICIAL ~
26/SS26/R908
PAGE 16 (rdd\tb)

officer thereafter shall submit to the executive director a new 371
recommendation. The executive director shall prepare a written 372
decision summarizing the facts and identifying policies and 373
regulations that support the decision, which shall be mailed to 374
the claimant and the representative, with a copy to the regional 375
office if appropriate, as soon as possible after submission of a 376
recommendation by the hearing officer. The decision notice will 377
specify any action to be taken by the agency, specify any revised 378
eligibility dates or, if continuation of benefits applies, will 379
notify the claimant of the new effective date of reduction or 380
termination of benefits or services, which will be fifteen (15) 381
days from the mailing date of the notice of decision. The 382
decision rendered by the Executive Director of the Division of 383
Medicaid is final and binding. The claimant is entitled to seek 384
judicial review in a court of proper jurisdiction. 385
(xviii) The Division of Medicaid must take final 386
administrative action on a hearing, whether state or local, within 387
ninety (90) days from the date of the initial request for a 388
hearing. 389
(xix) A group hearing may be held for a number of 390
claimants under the following circumstances: 391
(A) The Division of Medicaid may consolidate 392
the cases and conduct a single group hearing when the only issue 393
involved is one (1) of a single law or agency policy; 394
S. B. No. 2722 *SS26/R908* ~ OFFICIAL ~
26/SS26/R908
PAGE 17 (rdd\tb)

(B) The claimants may request a group hearing 395
when there is one (1) issue of agency policy common to all of 396
them. 397
In all group hearings, whether initiated by the Division of 398
Medicaid or by the claimants, the policies governing fair hearings 399
must be followed. Each claimant in a group hearing must be 400
permitted to present his or her own case and be represented by his 401
or her own representative, or to withdraw from the group hearing 402
and have his or her appeal heard individually. As in individual 403
hearings, the hearing will be conducted only on the issue being 404
appealed, and each claimant will be expected to keep individual 405
testimony within a reasonable time frame as a matter of 406
consideration to the other claimants involved. 407
(xx) Any specific matter necessitating an 408
administrative hearing not otherwise provided under this article 409
or agency policy shall be afforded under the hearing procedures as 410
outlined above. If the specific time frames of such a unique 411
matter relating to requesting, granting, and concluding of the 412
hearing is contrary to the time frames as set out in the hearing 413
procedures above, the specific time frames will govern over the 414
time frames as set out within these procedures. 415
(4) The Executive Director of the Division of Medicaid, with 416
the approval of the Governor, shall be authorized to employ 417
eligibility, technical, clerical and supportive staff as may be 418
required in carrying out and fully implementing the determination 419
S. B. No. 2722 *SS26/R908* ~ OFFICIAL ~
26/SS26/R908
PAGE 18 (rdd\tb)
ST: Statewide Insurance Enrollment Assistance
Program; establish within the Mississippi
Department of Insurance.
of Medicaid eligibility, including conducting quality control 420
reviews and the investigation of the improper receipt of medical 421
assistance. Staffing needs will be set forth in the annual 422
appropriation act for the division. Additional office space as 423
needed in performing eligibility, quality control and 424
investigative functions shall be obtained by the division. 425
(5) The division shall work with the Mississippi 426
Commissioner of Insurance in establishing and implementing the 427
Statewide Insurance Enrollment Assistance Program (SIEAP) provided 428
under Section 1 of this act. 429
SECTION 3. This act shall take effect and be in force from 430
and after July 1, 2026. 431