reglab/statecodes huggingface dataset:
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 79 - HEALTH PROBLEMS OF SCHOOL CHILDREN (§§ 41-79-1 — 41-79-55) › SCHOOL NURSE INTERVENTION PROGRAM (§§ 41-79-1 — 41-79-5) › Section 41-79-1 - Legislative findings

The Legislature finds that health problems often are not prevented or detected in early stages because so many of the state's children are not in a health-care system. A school nurse can provide the preventive health services needed to facilitate the student's optimal physical, mental, emotional and social growth and development, as well as to help prevent serious health problems which would be more difficult and costly to address later.
Laws, 1987, ch. 505 § 1; reenacted, Laws, 1988, ch. 512, § 1, eff. 6/30/1988.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 79 - HEALTH PROBLEMS OF SCHOOL CHILDREN (§§ 41-79-1 — 41-79-55) › SCHOOL NURSE INTERVENTION PROGRAM (§§ 41-79-1 — 41-79-5) › Section 41-79-3 - Authorization to implement regulations

The State Board of Health, after consultation with the State Board of Education, is authorized to issue regulations to implement the provisions of this chapter.
Laws, 1987, ch. 505 § 2; reenacted, Laws, 1988, ch. 512, § 2, eff. 6/30/1988.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 79 - HEALTH PROBLEMS OF SCHOOL CHILDREN (§§ 41-79-1 — 41-79-55) › HEAD LICE (§ 41-79-21) › Section 41-79-21 - Notification by school officials of recurrent head lice

If a student in any public elementary or secondary school has had head lice on three (3) occasions during one (1) school year while attending school, or if the parent of the student has been notified by school officials that the student has had head lice on three (3) occasions in one (1) school year, as determined by the school nurse, public health nurse or a physician, the principal or administrator shall notify the county health department of the recurring problem of head lice with that student. The county health department then shall instruct the child's parents or guardians on how to treat head lice, eliminate head lice from household items, and prevent the recurrence of head lice. The county health department shall charge the child's parents or guardians a fee to recover its costs of providing treatment and counseling for the head lice. The school principal or administrator shall not allow the child to attend school until proof of treatment is obtained.
Laws, 1997, ch. 510, § 1; Laws, 1999, ch. 348, § 1, eff. 7/1/1999.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 79 - HEALTH PROBLEMS OF SCHOOL CHILDREN (§§ 41-79-1 — 41-79-55) › SELF-ADMINISTRATION OF ASTHMA MEDICATION AT SCHOOL [Repealed] (§ 41-79-31) › Section 41-79-31 - [Repealed]

Laws, 2003, ch. 493, § 1; Laws, 2010, ch. 512, § 1, eff. 7/1/2010.
Repealed by Laws, 2014, ch. 464, SB 2218, 3, eff. 7/1/2014.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 79 - HEALTH PROBLEMS OF SCHOOL CHILDREN (§§ 41-79-1 — 41-79-55) › PREVENTION OF UNINTENDED TEEN PREGNANCY AND SEXUALLY TRANSMITTED INFECTIONS (§§ 41-79-51 — 41-79-55) › Section 41-79-51 - [Repealed]

Laws, 2009, ch. 507, § 2; Laws, 2011, ch. 430, § 4, eff. 7/1/2011.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 79 - HEALTH PROBLEMS OF SCHOOL CHILDREN (§§ 41-79-1 — 41-79-55) › PREVENTION OF UNINTENDED TEEN PREGNANCY AND SEXUALLY TRANSMITTED INFECTIONS (§§ 41-79-51 — 41-79-55) › Section 41-79-53 - Programs to provide education, counseling, support and training to prevent unintended teen pregnancies and sexually transmitted infections; implementation by school nurses

(1)
The Mississippi Department of Human Services shall develop programs to accomplish the purpose of one or more of the following strategies:
(a)
Promoting effective communication among families about preventing teen pregnancy, particularly communication among parents or guardians and their children;
(b)
Educating community members about the consequences of unprotected, uninformed and underage sexual activity and teen pregnancy;
(c)
Encouraging young people to postpone sexual activity and prepare for a healthy, successful adulthood, including teaching them skills to avoid making or receiving unwanted verbal, physical, and sexual advances;
(d)
Providing medically accurate information about the health benefits and side effects of all contraceptives and barrier methods as a means to prevent pregnancy and reduce the risk of contracting sexually transmitted infections, including HIV/AIDS; or
(e)
Providing educational information, including medically accurate information about the health benefits and side effects of all contraceptives and barrier methods, for young people in those communities who are already sexually active or are at risk of becoming sexually active and inform young people in those communities about the responsibilities and consequences of being a parent, and how early pregnancy and parenthood can interfere with educational and other goals.
(2)
The State Department of Health shall develop programs with the following strategies:
(a)
To carry out activities, including counseling, to prevent unintended pregnancy and sexually transmitted infections, including HIV/AIDS, among teens;
(b)
To provide necessary social and cultural support services regarding teen pregnancy;
(c)
To provide health and educational services related to the prevention of unintended pregnancy and sexually transmitted infections, including HIV/AIDS, among teens;
(d)
To promote better health and educational outcomes among pregnant teens; and
(e)
To provide training for individuals who plan to work in school-based support programs regarding the prevention of unintended pregnancy and sexually transmitted infections, including HIV/AIDS, among teens.
(3)
It shall be the responsibility of school nurses employed by local school districts implementing the program developed by the State Department of Health under subsection (2) of this section to carry out the functions of those strategies to promote consistency in the administration of the program.
Laws, 2011, ch. 430, § 2, eff. 7/1/2011.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 79 - HEALTH PROBLEMS OF SCHOOL CHILDREN (§§ 41-79-1 — 41-79-55) › PREVENTION OF UNINTENDED TEEN PREGNANCY AND SEXUALLY TRANSMITTED INFECTIONS (§§ 41-79-51 — 41-79-55) › Section 41-79-55 - Pilot programs to be established in each health care district and located in a school district in the county having highest number of teen pregnancies

(1)
Beginning with the 2012-2013 school year, to the extent that federal or state funds are available and appropriated by the Legislature for the purposes of establishing and implementing the Prevention of Teen Pregnancy Pilot Program authorized by Section
41-79-5
, the State Department of Health in conjunction with the State Department of Education shall establish a pilot program in each of the nine (9) health districts as defined by the State Department of Health, to be located in a school district in a county in that district having the highest number of teen pregnancies.
(2)
The State Department of Health and the State Department of Education shall jointly provide education services through qualified personnel to increase awareness of the health, social and economic risks associated with teen pregnancy. The services and curriculum provided shall have a primary emphasis on reducing the teenage pregnancy rate in those pilot districts.
Laws, 2011, ch. 430, § 5, eff. 7/1/2011.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 81 - PERINATAL HEALTH CARE (§§ 41-81-1 — 41-81-3) › Section 41-81-1 - Authorization for regionalized service system

The State Department of Health is authorized to coordinate the development and implementation of a regionalized system of perinatal health-care services.
Laws, 1987, ch. 514, § 1, eff. 7/1/1987.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 81 - PERINATAL HEALTH CARE (§§ 41-81-1 — 41-81-3) › Section 41-81-3 - Contracts with and grants to health-care providers

The State Department of Health is authorized to enter into contracts with and provide grants to health-care providers in order to implement a statewide regionalization program.
Laws, 1987, ch. 514, § 2, eff. 7/1/1987.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 83 - UTILIZATION REVIEW OF AVAILABILITY OF HOSPITAL RESOURCES AND MEDICAL SERVICES (§§ 41-83-1 — 41-83-31) › Section 41-83-1 - Definitions

As used in this chapter, the following terms shall be defined as follows:
(a)
"Utilization review" means a system for reviewing the appropriate and efficient allocation of hospital resources and medical services given or proposed to be given, including, but not limited to, any prior authorization as defined in Section 4 of this act, to a patient or group of patients as to necessity for the purpose of determining whether such service should be covered or provided by an insurer, plan or other entity.
(b)
"Private review agent" means a nonhospital-affiliated person or entity performing utilization review on behalf of:
(i)
An employer or employees in the State of Mississippi; or
(ii)
A third party that provides or administers hospital and medical benefits to citizens of this state, including: a health maintenance organization issued a certificate of authority under and by virtue of the laws of the State of Mississippi; or a health insurer, nonprofit health service plan, health insurance service organization, or preferred provider organization or other entity offering health insurance policies, contracts or benefits in this state.
(c)
"Utilization review plan" means a description of the utilization review procedures of a private review agent.
(d)
"Department" means the Mississippi State Department of Insurance.
(e)
"Certificate" means a certificate of registration granted by the Mississippi State Department of Insurance to a private review agent.
Laws, 1990, ch. 347, § 1, eff. 7/1/1990.
Amended by Laws, 2024, ch. 302, SB 2140,§ 20, eff. 7/1/2024.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 83 - UTILIZATION REVIEW OF AVAILABILITY OF HOSPITAL RESOURCES AND MEDICAL SERVICES (§§ 41-83-1 — 41-83-31) › Section 41-83-3 - Certificate requirement for utilization review; nontransferability; disclosure to public

(1)
A private review agent who approves or denies payment or who recommends approval or denial of payment for hospital or medical services or whose review results in approval or denial of payment for hospital or medical services on a case by case basis, may not conduct utilization review in this state unless the Mississippi State Department of Insurance has granted the private review agent a certificate.
(2)
The Mississippi State Department of Insurance shall issue a certificate to an applicant that has met all the requirements of this chapter and all applicable regulations of the department.
(3)
A certificate issued under this chapter is not transferable.
(4)
The State Department of Insurance shall adopt regulations to implement the provisions of this chapter. Any personal information required by the department with respect to customers or patients shall be held in confidence and not disclosed to the public.
Laws, 1990, ch. 347, § 2; Laws, 1994, ch. 378, § 1, eff. 7/1/1994.
Amended by Laws, 2024, ch. 302, SB 2140,§ 21, eff. 7/1/2024.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 83 - UTILIZATION REVIEW OF AVAILABILITY OF HOSPITAL RESOURCES AND MEDICAL SERVICES (§§ 41-83-1 — 41-83-31) › Section 41-83-5 - Certificate requirement for general in-house utilization review; exemptions

No certificate is required for those private review agents conducting general in-house utilization review for hospitals, home health agencies, preferred provider organizations or other managed care entities, clinics, private physician offices or any other health facility or entity, so long as the review does not result in the approval or denial of payment for hospital or medical services for a particular case. Such general in-house utilization review is completely exempt from the provisions of this chapter.
Laws, 1990, ch. 347, § 3, eff. 7/1/1990.
Amended without change by Laws, 2024, ch. 302, SB 2140,§ 27, eff. 7/1/2024.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 83 - UTILIZATION REVIEW OF AVAILABILITY OF HOSPITAL RESOURCES AND MEDICAL SERVICES (§§ 41-83-1 — 41-83-31) › Section 41-83-7 - Application for certificate; fees

(1)
An applicant for a certificate shall:
(a)
Submit an application to the department; and
(b)
Pay to the department the application fee established by the department through regulation.
(2)
The application shall:
(a)
Be on a form and accompanied by any supporting documentation that the department requires; and
(b)
Be signed and verified by the applicant.
(3)
The application fee required under this section shall be sufficient to pay for the administrative cost of the certification program and any other cost associated with carrying out the provisions of this chapter.
Laws, 1990, ch. 347, § 4, eff. 7/1/1990.
Amended without change by Laws, 2024, ch. 302, SB 2140,§ 28, eff. 7/1/2024.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 83 - UTILIZATION REVIEW OF AVAILABILITY OF HOSPITAL RESOURCES AND MEDICAL SERVICES (§§ 41-83-1 — 41-83-31) › Section 41-83-9 - Submission of information in conjunction with application

In conjunction with the application, the private review agent shall submit information that the department requires including:
(a)
A utilization review plan that includes a description of review criteria, standards and procedures to be used in evaluating proposed or delivered hospital and medical care and the provisions by which patients, physicians or hospitals may seek reconsideration or appeal of adverse decisions by the private review agent;
(b)
The type and qualifications of the personnel either employed or under contract to perform the utilization review;
(c)
The procedures and policies to insure that a representative of the private review agent is reasonably accessible to patients and providers at all times in this state;
(d)
The policies and procedures to insure that all applicable state and federal laws to protect the confidentiality of individual medical records are followed;
(e)
A copy of the materials designed to inform applicable patients and providers of the requirements of the utilization review plan; and
(f)
A list of the third party payors for which the private review agent is performing utilization review in this state.
Laws, 1990, ch. 347, § 5, eff. 7/1/1990.
Amended without change by Laws, 2024, ch. 302, SB 2140,§ 29, eff. 7/1/2024.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 83 - UTILIZATION REVIEW OF AVAILABILITY OF HOSPITAL RESOURCES AND MEDICAL SERVICES (§§ 41-83-1 — 41-83-31) › Section 41-83-11 - Expiration date of certificate; renewal; fees

(1)
A certificate expires on the second anniversary of its effective date unless the certificate is renewed for a two-year term as provided in this section.
(2)
Before the certificate expires, a certificate may be renewed for an additional two-year term if the applicant:
(a)
Otherwise is entitled to the certificate;
(b)
Pays the department the renewal fee set by the department through regulation; and
(c)
Submits to the department a renewal application on the form that the department requires and satisfactory evidence of compliance with any requirement of this chapter for certificate renewal.
Laws, 1990, ch. 347, § 6, eff. 7/1/1990.
Amended without change by Laws, 2024, ch. 302, SB 2140,§ 30, eff. 7/1/2024.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 83 - UTILIZATION REVIEW OF AVAILABILITY OF HOSPITAL RESOURCES AND MEDICAL SERVICES (§§ 41-83-1 — 41-83-31) › Section 41-83-13 - Grounds for denial or revocation of certificate; time to supply additional information; hearing

(1)
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:
(a)
Have available the services of a physician to carry out its utilization review activities;
(b)
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
(c)
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.
(2)
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.
(3)
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 .
Laws, 1990, ch. 347, § 7, eff. 7/1/1990.
Amended by Laws, 2024, ch. 302, SB 2140,§ 22, eff. 7/1/2024.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 83 - UTILIZATION REVIEW OF AVAILABILITY OF HOSPITAL RESOURCES AND MEDICAL SERVICES (§§ 41-83-1 — 41-83-31) › Section 41-83-15 - Reporting requirements to evaluate and determine compliance

The department shall establish reporting requirements to:
(a)
Evaluate the effectiveness of private review agents; and
(b)
Determine if the utilization review programs are in compliance with the provisions of this section and applicable regulations.
Laws, 1990, ch. 347, § 8, eff. 7/1/1990.
Amended without change by Laws, 2024, ch. 302, SB 2140,§ 31, eff. 7/1/2024.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 83 - UTILIZATION REVIEW OF AVAILABILITY OF HOSPITAL RESOURCES AND MEDICAL SERVICES (§§ 41-83-1 — 41-83-31) › Section 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.
Laws, 1990, ch. 347, § 9, eff. 7/1/1990.
Amended without change by Laws, 2024, ch. 302, SB 2140,§ 32, eff. 7/1/2024.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 83 - UTILIZATION REVIEW OF AVAILABILITY OF HOSPITAL RESOURCES AND MEDICAL SERVICES (§§ 41-83-1 — 41-83-31) › Section 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).
Laws, 1990, ch. 347, § 10, eff. 7/1/1990.
Amended without change by Laws, 2024, ch. 302, SB 2140,§ 33, eff. 7/1/2024.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 83 - UTILIZATION REVIEW OF AVAILABILITY OF HOSPITAL RESOURCES AND MEDICAL SERVICES (§§ 41-83-1 — 41-83-31) › Section 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 for emergency services, 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.
Laws, 1990, ch. 347, § 11, eff. 7/1/1990.
Amended by Laws, 2024, ch. 302, SB 2140,§ 23, eff. 7/1/2024.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 83 - UTILIZATION REVIEW OF AVAILABILITY OF HOSPITAL RESOURCES AND MEDICAL SERVICES (§§ 41-83-1 — 41-83-31) › Section 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.
Laws, 1990, ch. 347, § 12, eff. 7/1/1990.
Amended without change by Laws, 2024, ch. 302, SB 2140,§ 34, eff. 7/1/2024.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 83 - UTILIZATION REVIEW OF AVAILABILITY OF HOSPITAL RESOURCES AND MEDICAL SERVICES (§§ 41-83-1 — 41-83-31) › Section 41-83-25 - Health insurance plans; certificate requirement; contract with private review agent; reimbursement under policy where medical necessity in dispute

(1)
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:
(a)
Have a certificate in accordance with this chapter; or
(b)
Contract with a private review agent who has a certificate in accordance with this chapter.
(2)
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.
Laws, 1990, ch. 347, § 13, eff. 7/1/1990.
Amended without change by Laws, 2024, ch. 302, SB 2140,§ 35, eff. 7/1/2024.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 83 - UTILIZATION REVIEW OF AVAILABILITY OF HOSPITAL RESOURCES AND MEDICAL SERVICES (§§ 41-83-1 — 41-83-31) › Section 41-83-27 - Other health insurance policies; certificate requirement; contract with private review agent; reimbursement under policy where medical necessity in dispute

(1)
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:
(a)
Have a certificate in accordance with this chapter; or
(b)
Contract with a private review agent that has a certificate in accordance with this chapter.
(2)
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.
Laws, 1990, ch. 347, § 14, eff. 7/1/1990.
Amended without change by Laws, 2024, ch. 302, SB 2140,§ 36, eff. 7/1/2024.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 83 - UTILIZATION REVIEW OF AVAILABILITY OF HOSPITAL RESOURCES AND MEDICAL SERVICES (§§ 41-83-1 — 41-83-31) › Section 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:
(a)
Have a certificate in accordance with this chapter; or
(b)
Contract with a private review agent that has a certificate in accordance with this chapter.
Laws, 1990, ch. 347, § 15, eff. 7/1/1990.
Amended without change by Laws, 2024, ch. 302, SB 2140,§ 37, eff. 7/1/2024.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 83 - UTILIZATION REVIEW OF AVAILABILITY OF HOSPITAL RESOURCES AND MEDICAL SERVICES (§§ 41-83-1 — 41-83-31) › Section 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, including, but not limited to, any prior authorization as defined in Section 4 of this act, shall comply with the following:
(a)
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 seven (7) 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.
(b)
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.
(c)
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.
Laws, 1990, ch. 347, § 16; Laws, 1998, ch. 508, § 1; Laws, 2000, ch. 443, § 1, eff. 7/1/2000.
Amended by Laws, 2024, ch. 302, SB 2140,§ 24, eff. 7/1/2024.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 85 - MISSISSIPPI HOSPICE LAW OF 1995 (§§ 41-85-1 — 41-85-25) › Section 41-85-1 - Short title

This chapter shall be known and may be cited as the "Mississippi Hospice Law of 1995."
Laws, 1995, ch. 325, § 1, eff. 7/1/1995.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 85 - MISSISSIPPI HOSPICE LAW OF 1995 (§§ 41-85-1 — 41-85-25) › Section 41-85-3 - Definitions

When used in this chapter, unless the context otherwise requires:
(a)
"Autonomous" means a separate and distinct operational entity which functions under its own administration and bylaws, either within or independently of a parent organization.
(b)
"Department" means the Mississippi Department of Health.
(c)
"Freestanding hospice" means a hospice that is not a part of any other type of health-care provider.
(d)
"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.
(e)
"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.
(f)
"Hospice services" means items and services furnished to an individual by a hospice, or by others under arrangements with such a hospice program.
(g)
"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.
(h)
"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.
(i)
"Patient" means the terminally ill individual receiving hospice services.
(j)
"Person" means an individual, a trust or estate, partnership, corporation, association, the state, or a political subdivision or agency of the state.
(k)
"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.
Laws, 1995, ch. 325, § 2; Laws, 1996, ch. 369, § 1; Laws, 2006, ch. 322, § 1, eff. 7/1/2006.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 85 - MISSISSIPPI HOSPICE LAW OF 1995 (§§ 41-85-1 — 41-85-25) › Section 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

(1)
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.
(2)
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.
(3)
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.
(4)
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.
(5)
The Department of Corrections may provide hospice care services to inmates confined in facilities under the jurisdiction of the department as authorized under Section
47-5-178
without a license issued under this chapter.
Laws, 1995, ch. 325, § 3, eff. 7/1/1995.
Amended by Laws, 2022, ch. 496, HB 936,§ 2, eff. 7/1/2022.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 85 - MISSISSIPPI HOSPICE LAW OF 1995 (§§ 41-85-1 — 41-85-25) › Section 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.
Laws, 1995, ch. 325, § 5, eff. 7/1/1995.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 85 - MISSISSIPPI HOSPICE LAW OF 1995 (§§ 41-85-1 — 41-85-25) › Section 41-85-11 - Application for license; plan for delivery of hospice care; duration of license; renewal of license; conditional license

(1)
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:
(a)
The estimated average number of terminally ill persons to be served monthly;
(b)
The geographic area in which hospice services will be available;
(c)
A listing of services which are or will be provided, either directly by the applicant or through contractual arrangements with existing providers;
(d)
Provisions for the implementation of hospice home care within three (3) months of licensure;
(e)
Provisions for the implementation of hospice outpatient and homelike inpatient care within twelve (12) months of licensure;
(f)
The qualifications of any existing or potential contractee;
(g)
The projected annual operating cost of the hospice; and
(h)
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.
(2)
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.
(3)
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.
Laws, 1995, ch. 325, § 6, eff. 7/1/1995.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 85 - MISSISSIPPI HOSPICE LAW OF 1995 (§§ 41-85-1 — 41-85-25) › Section 41-85-13 - Denial, revocation or suspension of license

(1)
The department may deny, revoke or suspend a license.
(2)
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)
A violation of the provisions of this chapter or of any standard or rule promulgated hereunder.
(b)
An intentional or negligent act materially affecting the health or safety of a patient.
(3)
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.
(4)
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.
Laws, 1995, ch. 325, § 7, eff. 7/1/1995.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 85 - MISSISSIPPI HOSPICE LAW OF 1995 (§§ 41-85-1 — 41-85-25) › Section 41-85-19 - Government and administration of hospice program

(1)
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.
(2)
The hospice program shall have a director, administrator or manager who shall be responsible for the overall coordination and administration of the hospice program.
Laws, 1995, ch. 325, § 10; Laws, 2009, ch. 365, § 1, eff. 7/1/2009.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 85 - MISSISSIPPI HOSPICE LAW OF 1995 (§§ 41-85-1 — 41-85-25) › Section 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.
Laws, 1995, ch. 325, § 11, eff. 7/1/1995.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 85 - MISSISSIPPI HOSPICE LAW OF 1995 (§§ 41-85-1 — 41-85-25) › Section 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.
Laws, 1995, ch. 325, § 12, eff. 7/1/1995.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 85 - MISSISSIPPI HOSPICE LAW OF 1995 (§§ 41-85-1 — 41-85-25) › Section 41-85-25 - Advertisement of hospice program; penalties

(1)
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.
(2)
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.
Laws, 1995, ch. 325, § 13, eff. 7/1/1995.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 86 - MISSISSIPPI CHILDREN'S HEALTH CARE INSURANCE PROGRAM ACT (§§ 41-86-1 — 41-86-17) › Section 41-86-1 - Short title

This chapter shall be known as and may be cited as the Mississippi Children's Health Insurance Program Act.
Laws, 1998, ch. 572, § 1; reenacted without change, Laws, 2001, ch. 532, § 1; Laws, 2012, ch. 334, § 1, eff. 1/1/2013.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 86 - MISSISSIPPI CHILDREN'S HEALTH CARE INSURANCE PROGRAM ACT (§§ 41-86-1 — 41-86-17) › Section 41-86-3 - [Repealed]

Laws, 1998, ch. 572, § 2; reenacted without change, Laws, 2001, ch. 532, § 2, eff. 6/30/2001.
Laws, 2012, ch. 334, § 8, eff. 1/1/2013.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 86 - MISSISSIPPI CHILDREN'S HEALTH CARE INSURANCE PROGRAM ACT (§§ 41-86-1 — 41-86-17) › Section 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:
(a)
"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.
(b)
"Covered benefits" means the types of health care benefits and services provided to eligible recipients under the program.
(c)
"Division" means the Division of Medicaid in the Office of the Governor.
(d)
"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.
(e)
"Plan" means the State Child Health Plan.
(f)
"Program" means the Mississippi Children's Health Insurance Program established by this chapter.
(g)
"Recipient" means a person who is eligible for assistance under the program.
(h)
"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.
Laws, 1998, ch. 572, § 3; Laws, 1999, ch. 546, § 1; reenacted without change, Laws, 2001, ch. 532, § 3; Laws, 2012, ch. 334, § 2, eff. 1/1/2013.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 86 - MISSISSIPPI CHILDREN'S HEALTH CARE INSURANCE PROGRAM ACT (§§ 41-86-1 — 41-86-17) › Section 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.
Laws, 1998, ch. 572, § 4; reenacted without change, Laws, 2001, ch. 532, § 4; Laws, 2012, ch. 334, § 3, eff. 1/1/2013.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 86 - MISSISSIPPI CHILDREN'S HEALTH CARE INSURANCE PROGRAM ACT (§§ 41-86-1 — 41-86-17) › Section 41-86-9 - Transfer of health insurance program from State and School Employees Health Insurance Management Board to the Division of Medicaid

On January 1, 2013, the Mississippi Children's Health Insurance Program and the current contract for insurance services shall be transferred from the State and School Employees Health Insurance Management Board to the Division of Medicaid, and the division shall be responsible for the implementation and administration of the Mississippi Children's Health Insurance Program in accordance with federal law and regulations and this chapter from and after January 1, 2013. The Health Insurance Management Board shall be responsible for any audit or claims processing issues for the period during which the board administered the program. Effective January 1, 2015, and notwithstanding any other provision of law to the contrary, the division is authorized to operate the program as described under Section
43-13-117(H)
.
Laws, 1998, ch. 572, § 5; reenacted without change, Laws, 2001, ch. 532, § 5; Laws, 2012, ch. 334, § 4, eff. 1/1/2013.
Amended by Laws, 2014, ch. 488, HB 1275, 6, eff. 7/1/2014.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 86 - MISSISSIPPI CHILDREN'S HEALTH CARE INSURANCE PROGRAM ACT (§§ 41-86-1 — 41-86-17) › Section 41-86-11 - Implementation of program by Division of Medicaid; reports; contracting

(1)
The division shall adopt, in accordance with Section
25-43-1.101
et seq., rules and regulations for the implementation of the program, and for the coordination of the program with the state's other medical assistance programs.
(2)
The division shall have all of the authority set forth in Section
43-13-101
et seq. in administering the program.
(3)
The division shall make reports to the federal government and to the Legislature on the providing of benefits to those children under the program.
(4)
The division shall execute a contract or contracts to provide the health care coverage and services under the program in a manner that is consistent with all federal and state procurement regulations.
Laws, 1998, ch. 572, § 6; reenacted without change, Laws, 2001, ch. 532, § 6; Laws, 2012, ch. 334, § 5, eff. 1/1/2013.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 86 - MISSISSIPPI CHILDREN'S HEALTH CARE INSURANCE PROGRAM ACT (§§ 41-86-1 — 41-86-17) › Section 41-86-13 - Funding; source; effect on program

(1)
The division shall receive state appropriations for the program and federal matching funds under the Children's Health Insurance Program established by Title XXI of the federal Social Security Act, as amended, for the administration of the program. The Legislature shall include those funds as a line item in the appropriation to the division.
(2)
The program is subject to the availability of state funds specifically appropriated by the Legislature for the purpose of the program and federal matching funds under the Children's Health Insurance Program established by Title XXI of the federal Social Security Act, as amended. The division may limit enrollment as necessary to ensure that the costs of the program do not exceed the total amount of state and federal funds appropriated by the Legislature for that purpose.
Laws, 1998, ch. 572, § 7; reenacted without change, Laws, 2001, ch. 532, § 7; Laws, 2012, ch. 334, § 6, eff. 1/1/2013.
Mississippi Code 1972 (2023) › Title 41 - PUBLIC HEALTH (§§ 41-1-1 — 41-149-NEW-003) › Chapter 86 - MISSISSIPPI CHILDREN'S HEALTH CARE INSURANCE PROGRAM ACT (§§ 41-86-1 — 41-86-17) › Section 41-86-15 - Eligibility for benefits

Persons eligible to receive covered benefits under this chapter shall be low-income children who meet the eligibility standards set forth in the State Child Health Plan. Any person who is eligible for benefits under the Mississippi Medicaid Law, Section
43-13-101
et seq., shall not be eligible to receive benefits under this chapter. A person who is without insurance coverage at the time of application for the program and who meets the other eligibility criteria in the plan shall be eligible to receive covered benefits under the program.
Laws, 1998, ch. 572, § 8; Laws, 2000, ch. 625, § 1; reenacted and amended, Laws, 2001, ch. 532, § 8; Laws, 2003, ch. 543, § 8; Laws, 2012, ch. 334, § 7, eff. 1/1/2013.