reglab/housing_qa huggingface dataset:
MS Code § 41-83-13 (2020)
2020 Mississippi Code|Title 41 - Public Health|Chapter 83 - Utilization Review of Availability of Hospital Resources and Medical Services|§ 41-83-13. Grounds for denial or revocation of certificate; time to supply additional information; hearing

  The department shall deny a certificate to any applicant if, upon review of the application, the department finds that the applicant proposing to conduct utilization review does not:   Have available the services of a physician to carry out its utilization review activities;   Meet any applicable regulations the department adopted under this chapter relating to the qualifications of private review agents or the performance of utilization review; and   Provide assurances satisfactory to the department that the procedure and policies of the private review agent will protect the confidentiality of medical records and the private review agent will be reasonably accessible to patients and providers for five (5) working days a week during normal business hours in this state.     The department may revoke or deny a certificate if the holder does not comply with the performance assurances under this section, violates any provision of this chapter, or violates any regulation adopted pursuant to this chapter.   Before denying or revoking a certificate under this section, the department shall provide the applicant or certificate holder with reasonable time to supply additional information demonstrating compliance with the requirements of this chapter and the opportunity to request a hearing. If an applicant or certificate holder requests a hearing, the department shall send a hearing notice and conduct a hearing in accordance with the Mississippi Administrative Procedure Law, Section 25-43-17, Mississippi Code of 1972.
MS Code § 41-83-15 (2020)
2020 Mississippi Code|Title 41 - Public Health|Chapter 83 - Utilization Review of Availability of Hospital Resources and Medical Services|§ 41-83-15. Reporting requirements to evaluate and determine compliance

 The department shall establish reporting requirements to:   Evaluate the effectiveness of private review agents; and   Determine if the utilization review programs are in compliance with the provisions of this section and applicable regulations.
MS Code § 41-83-17 (2020)
2020 Mississippi Code|Title 41 - Public Health|Chapter 83 - Utilization Review of Availability of Hospital Resources and Medical Services|§ 41-83-17. Disclosure or publication of information; consent or authorization; court order

 A private review agent may not disclose or publish individual medical records or any other confidential medical information obtained in the performance of utilization review activities without the patient's authorization or an order of a county, circuit or chancery court of Mississippi or a U.S. district court. Provided, however, that nothing in this chapter shall prohibit private review agents from providing information to a third party with whom the private review agent is under contract or acting on behalf of.
MS Code § 41-83-19 (2020)
2020 Mississippi Code|Title 41 - Public Health|Chapter 83 - Utilization Review of Availability of Hospital Resources and Medical Services|§ 41-83-19. Penalties for violations

 A person who violates any provision of this chapter or any regulation adopted under this chapter is guilty of a misdemeanor and on conviction is subject to a penalty not exceeding One Thousand Dollars ($1,000.00).
MS Code § 41-83-21 (2020)
2020 Mississippi Code|Title 41 - Public Health|Chapter 83 - Utilization Review of Availability of Hospital Resources and Medical Services|§ 41-83-21. Certification of need of immediate hospital care; prima facie evidence

 Notwithstanding language to the contrary elsewhere contained herein, if a licensed physician certifies in writing to an insurer within seventy-two (72) hours of an admission that the insured person admitted was in need of immediate hospital care, such shall constitute a prima facie case of the medical necessity of the admission. To overcome this, the entity requesting the utilization review and/or the private review agent must show by clear and convincing evidence that the admitted person was not in need of immediate hospital care.
MS Code § 41-83-23 (2020)
2020 Mississippi Code|Title 41 - Public Health|Chapter 83 - Utilization Review of Availability of Hospital Resources and Medical Services|§ 41-83-23. Judicial review; other remedies

 Any person aggrieved by a final decision of the department or a private review agent in a contested case under this chapter shall have the right of judicial appeal to the chancery court of the county of the residence of the aggrieved person.   Notwithstanding any provision of this chapter, the insured shall have the express right to pursue any legal remedies he may have in a court of competent jurisdiction.
MS Code § 41-83-25 (2020)
2020 Mississippi Code|Title 41 - Public Health|Chapter 83 - Utilization Review of Availability of Hospital Resources and Medical Services|§ 41-83-25. Health insurance plans; certificate requirement; contract with private review agent; reimbursement under policy where medical necessity in dispute

  Every health insurance plan proposing to issue or deliver a health insurance policy or contract or administer a health benefit program which provides for the coverage of hospital and medical benefits and the utilization review of those benefits shall:   Have a certificate in accordance with this chapter; or   Contract with a private review agent who has a certificate in accordance with this chapter.     Notwithstanding any other provisions of this chapter, for claims where the medical necessity of the provision of a covered benefit is disputed, a health service plan that does not meet the requirements of subsection (1) of this section shall pay any person or hospital entitled to reimbursement under the policy or contract.
MS Code § 41-83-27 (2020)
2020 Mississippi Code|Title 41 - Public Health|Chapter 83 - Utilization Review of Availability of Hospital Resources and Medical Services|§ 41-83-27. Other health insurance policies; certificate requirement; contract with private review agent; reimbursement under policy where medical necessity in dispute

  Every insurer proposing to issue or deliver a health insurance policy or contract or administer a health benefit program which provides for the coverage of hospital and medical benefits and the utilization review of such benefits shall:   Have a certificate in accordance with this chapter; or   Contract with a private review agent that has a certificate in accordance with this chapter.     Notwithstanding any provision of this chapter, for claims where the medical necessity of the provision of a covered benefit is disputed, an insurer that does not meet the requirements of subsection (1) of this section shall pay any person or hospital entitled to reimbursement under the policy or contract.
MS Code § 41-83-29 (2020)
2020 Mississippi Code|Title 41 - Public Health|Chapter 83 - Utilization Review of Availability of Hospital Resources and Medical Services|§ 41-83-29. Group or blanket health insurance policies; certificate requirement; contract with private review agent

 Any health insurer proposing to issue or deliver in this state a group or blanket health insurance policy or administer a health benefit program which provides for the coverage of hospital and medical benefits and the utilization review of such benefits shall:   Have a certificate in accordance with this chapter; or   Contract with a private review agent that has a certificate in accordance with this chapter.
MS Code § 41-83-31 (2020)
2020 Mississippi Code|Title 41 - Public Health|Chapter 83 - Utilization Review of Availability of Hospital Resources and Medical Services|§ 41-83-31. Adverse determination to patient or health-care provider; discussion of reasons; denial of third party reimbursement or precertification; evaluation by trained specialist

 Any program of utilization review with regard to hospital, medical or other health-care services provided in this state shall comply with the following:   No determination adverse to a patient or to any affected health-care provider shall be made on any question relating to the necessity or justification for any form of hospital, medical or other health-care services without prior evaluation and concurrence in the adverse determination by a physician licensed to practice in Mississippi. The physician who made the adverse determination shall discuss the reasons for any adverse determination with the affected health-care provider, if the provider so requests. The physician shall comply with this request within fourteen (14) calendar days of being notified of a request. Adverse determination by a physician shall not be grounds for any disciplinary action against the physician by the State Board of Medical Licensure.   Any determination regarding hospital, medical or other health-care services rendered or to be rendered to a patient which may result in a denial of third-party reimbursement or a denial of precertification for that service shall include the evaluation, findings and concurrence of a physician trained in the relevant specialty or subspecialty, if requested by the patient's physician, to make a final determination that care rendered or to be rendered was, is, or may be medically inappropriate.   The requirement in this section that the physician who makes the evaluation and concurrence in the adverse determination must be licensed to practice in Mississippi shall not apply to the Comprehensive Health Insurance Risk Pool Association or its policyholders and shall not apply to any utilization review company which reviews fewer than ten (10) persons residing in the State of Mississippi.
MS Code § 41-85-1 (2020)
2020 Mississippi Code|Title 41 - Public Health|Chapter 85 - Mississippi Hospice Law of 1995|§ 41-85-1. Short title

 This chapter shall be known and may be cited as the "Mississippi Hospice Law of 1995."
MS Code § 41-85-3 (2020)
2020 Mississippi Code|Title 41 - Public Health|Chapter 85 - Mississippi Hospice Law of 1995|§ 41-85-3. Definitions

 When used in this chapter, unless the context otherwise requires:   "Autonomous" means a separate and distinct operational entity which functions under its own administration and bylaws, either within or independently of a parent organization.   "Department" means the Mississippi Department of Health.   "Freestanding hospice" means a hospice that is not a part of any other type of health-care provider.   "Hospice" means an autonomous, centrally administered, nonprofit or profit, medically directed, nurse-coordinated program providing a continuum of home, outpatient and homelike inpatient care for not less than four (4) terminally ill patients and their families. It employs a hospice care team to assist in providing palliative and supportive care to meet the special needs arising out of the physical, emotional, spiritual, social and economic stresses which are experienced during the final stages of illness and during dying and bereavement. This care is available twenty-four (24) hours a day, seven (7) days a week, and is provided on the basis of need regardless of inability to pay.   "Hospice care team" means an interdisciplinary team which is a working unit composed by the integration of the various helping professions and lay persons providing hospice care. Such team shall, as a minimum, consist of a licensed physician, a registered nurse, a social worker, a member of the clergy or a counselor and volunteers.   "Hospice services" means items and services furnished to an individual by a hospice, or by others under arrangements with such a hospice program.   "Medically directed" means that the delivery of medical care is directed by a licensed physician who is employed by the hospice for the purpose of providing ongoing palliative care as a participating care giver on the hospice care team.   "Palliative care" means the reduction or abatement of pain and other troubling symptoms by appropriate coordination of all elements of the hospice care team needed to achieve needed relief of distress.   "Patient" means the terminally ill individual receiving hospice services.   "Person" means an individual, a trust or estate, partnership, corporation, association, the state, or a political subdivision or agency of the state.   "Terminally ill" refers to a medical prognosis of limited expected survival, of six (6) months or less at the time of referral to a hospice, of an individual who is experiencing an illness for which therapeutic strategies directed toward cure and control of the disease alone outside the context of symptom control are no longer appropriate.
MS Code § 41-85-5 (2020)
2020 Mississippi Code|Title 41 - Public Health|Chapter 85 - Mississippi Hospice Law of 1995|§ 41-85-5. Operation of hospice without license; display of license; transfer of license; services constituting hospice program of care; effect of local zoning laws upon location of hospice

  It is unlawful for a person to operate or maintain a hospice, use the title "hospice", or represent that the person provides a hospice program of care, without first obtaining a license therefor from the department.   The license shall be displayed in a conspicuous place inside the hospice program office; shall be valid only in the possession of the person to which it is issued; shall not be subject to sale, assignment or other transfer, voluntary or involuntary; and shall not be valid for any hospice other than the hospice for which originally issued.   Services provided by a hospital, nursing home or other health-care facility or health-care provider shall not be considered to constitute a hospice program of care unless such facility, provider or care giver establishes a freestanding or distinct hospice unit, staff, facility and services to provide hospice home care, homelike inpatient hospice care, or outpatient hospice care under the separate and distinct administrative authority of a hospice program.   A license for a hospice program shall not be issued if the hospice is to be located in an area in violation of any local zoning ordinances or regulations.
MS Code § 41-85-9 (2020)
2020 Mississippi Code|Title 41 - Public Health|Chapter 85 - Mississippi Hospice Law of 1995|§ 41-85-9. Inspections and investigations

 Any duly authorized officer or employee of the department shall have the right to make such inspections and investigations as are necessary in order to determine the state of compliance with the provisions of this chapter and of rules or standards in force pursuant hereto. The right of inspection shall also extend to any program which the department has reason to believe is offering or advertising itself as a hospice without a license, but no inspection of any such program may be made without the permission of the owner or person in charge thereof unless a warrant is first obtained authorizing such inspection. Any application for a license or renewal thereof made pursuant to this chapter shall constitute permission for any inspection of the hospice for which the license is sought in order to facilitate verification of the information submitted on or in connection with the application.
MS Code § 41-85-11 (2020)
2020 Mississippi Code|Title 41 - Public Health|Chapter 85 - Mississippi Hospice Law of 1995|§ 41-85-11. Application for license; plan for delivery of hospice care; duration of license; renewal of license; conditional license

  An application shall be filed on a form prescribed by the department and shall be accompanied by the appropriate license fee as well as satisfactory proof that the hospice is in compliance with this chapter and any rules and minimum standards promulgated hereunder and proof of financial ability to operate and conduct the hospice in accordance with the requirements of this chapter. The initial application shall be accompanied by a plan for the delivery of home, outpatient and inpatient hospice care to terminally ill persons and their families. Such plan shall contain, but not be limited to:   The estimated average number of terminally ill persons to be served monthly;   The geographic area in which hospice services will be available;   A listing of services which are or will be provided, either directly by the applicant or through contractual arrangements with existing providers;   Provisions for the implementation of hospice home care within three (3) months of licensure;   Provisions for the implementation of hospice outpatient and homelike inpatient care within twelve (12) months of licensure;   The qualifications of any existing or potential contractee;   The projected annual operating cost of the hospice; and   A statement of financial resources and personnel available to the applicant to deliver hospice care. If the applicant is an existing health-care provider, the application shall be accompanied by a copy of the most recent profit-loss statement and, if applicable, the most recent licensure inspection report.     A license issued for the operation of a hospice program, unless sooner suspended or revoked, shall expire automatically one (1) year from the date of issuance. Sixty (60) days prior to the expiration date, an application for renewal shall be submitted to the department on forms furnished by the department; and the license shall be renewed if the applicant has first met the requirements established under this chapter and all rules promulgated hereunder and has provided the information described in subsection (1) in addition to the application. However, the application for license renewal shall be accompanied by an update of the plan for delivery of hospice care only if information contained in the plan submitted pursuant to subsection (1) is no longer applicable.   A hospice program against which a revocation or suspension proceeding is pending at the time of license renewal may be issued a conditional license effective until final disposition by the department of such proceeding. If judicial relief is sought from the final disposition, the court having jurisdiction may issue a conditional permit for the duration of the judicial proceeding.
MS Code § 41-85-13 (2020)
2020 Mississippi Code|Title 41 - Public Health|Chapter 85 - Mississippi Hospice Law of 1995|§ 41-85-13. Denial, revocation or suspension of license

  The department may deny, revoke or suspend a license.   Any of the following actions by a hospice program or any of its employees shall be grounds for action by the department against a hospice program:   A violation of the provisions of this chapter or of any standard or rule promulgated hereunder.   An intentional or negligent act materially affecting the health or safety of a patient.     If, three (3) months after the date of obtaining a license, or at any time thereafter, a hospice does not have in operation the home-care component of hospice care, the department shall immediately revoke the license of such hospice.   If, twelve (12) months after the date of obtaining a license, or at any time thereafter, a hospice does not have in operation the outpatient and homelike inpatient components of hospice care, the department shall immediately revoke the license of such hospice.
MS Code § 41-85-19 (2020)
2020 Mississippi Code|Title 41 - Public Health|Chapter 85 - Mississippi Hospice Law of 1995|§ 41-85-19. Government and administration of hospice program

  A hospice program shall have a clearly defined organized governing body that has autonomous authority for the conduct of the hospice program. This body is not required to meet more often than quarterly.   The hospice program shall have a director, administrator or manager who shall be responsible for the overall coordination and administration of the hospice program.
MS Code § 41-85-21 (2020)
2020 Mississippi Code|Title 41 - Public Health|Chapter 85 - Mississippi Hospice Law of 1995|§ 41-85-21. Recordkeeping requirements

 An up-to-date, interdisciplinary record of care being given and patient and family status shall be kept. Records shall contain pertinent past and current medical, nursing, social and other therapeutic information and such other information that is necessary for the safe and adequate care of the patient and the family. Notations regarding all aspects of care for the patient and family shall be made in the record. When services are terminated, the record shall show the date and reason for termination.
MS Code § 41-85-23 (2020)
2020 Mississippi Code|Title 41 - Public Health|Chapter 85 - Mississippi Hospice Law of 1995|§ 41-85-23. Disclosure of information received through hospice program

 Information received by persons employed by, or providing services to, a hospice or received by the licensing agency through reports or inspection shall be deemed privileged and confidential information and shall not be disclosed to any person other than the patient or the family without the written consent of that patient, the patient's guardian or the patient's family.
MS Code § 41-85-25 (2020)
2020 Mississippi Code|Title 41 - Public Health|Chapter 85 - Mississippi Hospice Law of 1995|§ 41-85-25. Advertisement of hospice program; penalties

  It is unlawful for any person or public body to offer or advertise to the public in any way by any medium whatever to be a hospice as defined in this chapter without obtaining a valid current license. It is unlawful for any holder of a license issued pursuant to the provisions of this chapter to advertise or hold out to the public that it holds a license for a hospice program other than that for which it actually holds a license.   Any person found guilty of violating subsection (1) is guilty of a misdemeanor, punishable, upon conviction, by a fine of not more than Ten Thousand Dollars ($10,000.00) or by imprisonment in the county jail for not greater than six (6) months, or both. Each day of a continuing violation shall be considered a separate offense.
MS Code § 41-86-1 (2020)
2020 Mississippi Code|Title 41 - Public Health|Chapter 86 - Mississippi Children's Health Care Insurance Program Act|§ 41-86-1. Short title

 This chapter shall be known as and may be cited as the Mississippi Children's Health Insurance Program Act.
MS Code § 41-86-5 (2020)
2020 Mississippi Code|Title 41 - Public Health|Chapter 86 - Mississippi Children's Health Care Insurance Program Act|§ 41-86-5. Definitions

 As used in this chapter, the following definitions shall have the meanings ascribed in this section, unless the context indicates otherwise:   "Child" means an individual who is under nineteen (19) years of age who is not eligible for Medicaid benefits and is not covered by other health insurance.   "Covered benefits" means the types of health care benefits and services provided to eligible recipients under the program.   "Division" means the Division of Medicaid in the Office of the Governor.   "Low-income child" means a child whose family income does not exceed two hundred percent (200%) of the poverty level for a family of the size involved.   "Plan" means the State Child Health Plan.   "Program" means the Mississippi Children's Health Insurance Program established by this chapter.   "Recipient" means a person who is eligible for assistance under the program.   "State Child Health Plan" means the permanent plan that sets forth the manner and means by which the State of Mississippi will provide health care assistance to eligible uninsured, low-income children consistent with the provisions of Title XXI of the federal Social Security Act, as amended.
MS Code § 41-86-7 (2020)
2020 Mississippi Code|Title 41 - Public Health|Chapter 86 - Mississippi Children's Health Care Insurance Program Act|§ 41-86-7. Establishment of insurance program; funding

 There is established a Children's Health Insurance Program in Mississippi, which shall be financed by state appropriations and federal matching funds received by the state under the Children's Health Insurance Program established by Title XXI of the federal Social Security Act, as amended.