reglab/statecodes huggingface dataset:
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 12 - MEDICAID AND HUMAN SERVICES TRANSPARENCY AND FRAUD PREVENTION ACT (§§ 43-12-1 — 43-12-71) › MEDICAID AND HUMAN SERVICES TRANSPARENCY AND FRAUD PREVENTION (§§ 43-12-1 — 43-12-47) › Section 43-12-37 - [Repealed] Noncompliance with Supplemental Nutrition Assistance Program rules

(1)
The Department of Human Services shall set disqualification periods for all instances of noncompliance with any SNAP requirement, unless expressly prohibited by federal law.
(2)
The department shall institute a three-month, full-household disqualification period for the first instance of noncompliance, unless expressly prohibited by federal law.
(3)
The department shall institute a six-month, full-household disqualification period for the second instance of noncompliance, unless expressly prohibited by federal law.
(4)
The department shall institute a permanent disqualification period for the third instance of noncompliance, unless expressly prohibited by federal law.
(5)
If a recipient is subject to a disqualification period under subsection (4) of this section, the department shall institute a six-month disqualification period for the recipient's entire household, unless expressly prohibited by federal law.
(6)
Unless expressly prohibited by federal law, recipients shall be subject to disqualification for failure to perform actions required by other federal, state, or local means-tested public assistance programs.
Added by Laws, 2017, ch. 421, HB 1090, 19, eff. 7/1/2019.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 12 - MEDICAID AND HUMAN SERVICES TRANSPARENCY AND FRAUD PREVENTION ACT (§§ 43-12-1 — 43-12-71) › MEDICAID AND HUMAN SERVICES TRANSPARENCY AND FRAUD PREVENTION (§§ 43-12-1 — 43-12-47) › Section 43-12-39 - [Repealed] Out-of-state spending

(1)
The Department of Human Services shall post on its website and make available on an annual basis to the chairmen of the House and Senate Appropriations Committees, the House Public Health and Human Services Committee and the Senate Public Health and Welfare Committee a report of SNAP and TANF benefit spending. The report also shall be provided to the other members of the Legislature upon request.
(2)
The report required under subsection (1) of this section shall include:
(a)
The dollar amount and number of transactions of SNAP benefits that are accessed or spent out-of-state, disaggregated by state;
(b)
The dollar amount and number of transactions of TANF benefits that are accessed or spent out-of-state, disaggregated by state;
(c)
The dollar amount, number of transactions, and times of transactions of SNAP benefits that are accessed or spent in-state, disaggregated by retailer, institution, or location, unless expressly prohibited by federal law; and
(d)
The dollar amount, number of transactions, and time of transactions of TANF benefits that are accessed or spent in-state, disaggregated by retailer, institution, or location.
(3)
The report required under subsection (1) of this section shall be de-identified to prevent identification of individual recipients.
Added by Laws, 2017, ch. 421, HB 1090, 20, eff. 7/1/2019.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 12 - MEDICAID AND HUMAN SERVICES TRANSPARENCY AND FRAUD PREVENTION ACT (§§ 43-12-1 — 43-12-71) › MEDICAID AND HUMAN SERVICES TRANSPARENCY AND FRAUD PREVENTION (§§ 43-12-1 — 43-12-47) › Section 43-12-41 - Public reporting

(1)
The Division of Medicaid and the Department of Human Services shall provide on an annual basis to the chairmen of the House and Senate Appropriations Committees, the House Public Health and Human Services Committee and the Senate Public Health and Welfare Committee, and the House and Senate Medicaid Committees, a report of characteristics of recipients of Medicaid, SNAP and TANF benefits. The report also shall be provided to the other members of the Legislature upon request.
(2)
The report required under subsection (1) of this section shall include:
(a)
The length of enrollment, disaggregated by program and eligibility group;
(b)
The share of recipients concurrently enrolled in one or more additional means-tested programs, disaggregated by program and eligibility group;
(c)
The number of means-tested programs recipients are concurrently enrolled in, disaggregated by program and eligibility group;
(d)
The demographics and characteristics of recipients, disaggregated by program and eligibility group; and
(e)
The dollar amount spent on advertising and marketing for TANF, SNAP, Medicaid, and other means-tested programs, including both state and federal funds, disaggregated by program.
(3)
The report required under subsection (1) of this section shall be de-identified to prevent identification of individual recipients.
Added by Laws, 2017, ch. 421, HB 1090, 21, eff. 7/1/2017.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 12 - MEDICAID AND HUMAN SERVICES TRANSPARENCY AND FRAUD PREVENTION ACT (§§ 43-12-1 — 43-12-71) › MEDICAID AND HUMAN SERVICES TRANSPARENCY AND FRAUD PREVENTION (§§ 43-12-1 — 43-12-47) › Section 43-12-43 - [Repealed] Pilot program for photos on EBT cards

(1)
The Department of Human Services may establish a pilot program in which a photograph of the recipient is included on any electronic benefits transfer card issued by the department to the recipient, unless the recipient declines to have the photograph included. When a recipient is a minor or otherwise incapacitated individual, a parent or legal guardian of such recipient may have a photograph of such parent or legal guardian placed on the card.
(2)
The Department of Human Services shall explore opportunities with other state agencies, departments, or divisions, including the Department of Public Safety, to share photographs when available. The Department of Human Services may sign one or more memorandum of understanding with such agencies, departments, or divisions as necessary to implement this section.
Added by Laws, 2017, ch. 421, HB 1090, 22, eff. 7/1/2019.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 12 - MEDICAID AND HUMAN SERVICES TRANSPARENCY AND FRAUD PREVENTION ACT (§§ 43-12-1 — 43-12-71) › MEDICAID AND HUMAN SERVICES TRANSPARENCY AND FRAUD PREVENTION (§§ 43-12-1 — 43-12-47) › Section 43-12-45 - [Repealed] Limits on spending locations

(1)
Funds available on electronic benefit transfer cards shall not be used to purchase alcohol, liquor or imitation liquor, cigarettes, tobacco products, bail, gambling activities, lottery tickets, tattoos, travel services provided by a travel agent, money transmission to locations abroad, sexually oriented adult materials, concert tickets, professional or collegiate sporting event tickets, or tickets for other entertainment events intended for the general public.
(2)
Electronic benefit transfer card transactions shall be prohibited at all retail liquor stores, casinos, gaming establishments, jewelry stores, tattoo parlors, massage parlors, body piercing parlors, spas, nail salons, lingerie shops, tobacco paraphernalia stores, vapor cigarette stores, psychic or fortune telling businesses, bail bond companies, video arcades, movie theaters, cruise ships, theme parks, dog or horse racing facilities, pari-mutuel facilities, sexually oriented businesses, retail establishments that provide adult-oriented entertainment in which performers disrobe or perform in an unclothed state for entertainment, and businesses or retail establishments where minors under eighteen (18) years of age are not permitted.
(3)
Upon enrollment, the Department of Human Services shall provide new applicants an itemized list of prohibited purchases, including those specified in subsection (1) of this section, and make such a list available on the department's website.
(4)
The department shall prohibit establishments identified under subsection (2) of this section from operating ATMs that accept electronic benefit transfer cards. Businesses found in violation of this subsection shall be subject to appropriate licensing sanctions.
(5)
If a recipient is found to have violated subsection (1) of this section, the department shall issue a warning in writing to the recipient. The recipient shall be subject to disqualification of benefits for up to three (3) months following the first offense and a permanent termination of benefits following the second offense, unless expressly prohibited by federal law.
Added by Laws, 2017, ch. 421, HB 1090, 23, eff. 7/1/2019.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 12 - MEDICAID AND HUMAN SERVICES TRANSPARENCY AND FRAUD PREVENTION ACT (§§ 43-12-1 — 43-12-71) › MEDICAID AND HUMAN SERVICES TRANSPARENCY AND FRAUD PREVENTION (§§ 43-12-1 — 43-12-47) › Section 43-12-47 - [Repealed] Excessive EBT card loss

(1)
The Department of Human Services shall send all recipients that have requested four (4) replacement cards within a twelve-month-period a letter informing them that another request shall require participation in a face-to-face interview with a fraud investigator and eligibility expert.
(2)
If a third-party vendor is administering replacement cards directly to recipients, it shall notify the department after the request for a fourth replacement card in a twelve-month-period, and any subsequent request thereafter.
(3)
Upon a recipient's request of a fifth replacement card within any twelve-month-period, and any subsequent request thereafter, the department shall schedule an interview, within thirty (30) business days, with a fraud investigator and eligibility expert before another new card is issued.
(4)
Unless expressly prohibited by federal law, if a recipient fails to appear at an interview scheduled under subsection (3) of this section, the department shall terminate the recipient's benefits within ten (10) business days, or the minimum required by federal law.
Added by Laws, 2017, ch. 421, HB 1090, 24, eff. 7/1/2019.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 12 - MEDICAID AND HUMAN SERVICES TRANSPARENCY AND FRAUD PREVENTION ACT (§§ 43-12-1 — 43-12-71) › MISCELLANEOUS PROVISIONS (§ 43-12-71) › Section 43-12-71 - Eligibility for TANF or SNAP benefits following certain criminal convictions

As provided in
21 USC Section 862a(d)(1)
, Mississippi opts out of the application of
21 USC Section 862a(a)
to all individuals domiciled in the state.
Added by Laws, 2019, ch. 466, HB 1352,§ 38, eff. 7/1/2019.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 13 - MEDICAL ASSISTANCE FOR THE AGED; MEDICAID (§§ 43-13-1 — 43-13-607) › Article 1 - MEDICAL ASSISTANCE FOR THE AGED (§§ 43-13-1 — 43-13-13) › Section 43-13-1 - Citation of article

This article shall be known as and may be cited as the "Medical Assistance for the Aged Law."
Codes, 1942, § 7290-01; Laws, 1964, ch. 446, § 1, eff. 6/11/1964.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 13 - MEDICAL ASSISTANCE FOR THE AGED; MEDICAID (§§ 43-13-1 — 43-13-607) › Article 1 - MEDICAL ASSISTANCE FOR THE AGED (§§ 43-13-1 — 43-13-13) › Section 43-13-3 - Definitions

Unless the context clearly requires a different meaning as used in this article:
(1)
"Medical assistance for the aged" means payment of part or all of the cost of the following care and services provided for persons sixty-five (65) years of age or older who are not recipients of old age assistance but whose income and resources are insufficient to meet all of such cost:
(a)
Inpatient hospital services;
(b)
Skilled nursing-home services;
(c)
Physicians' services;
(d)
Outpatient hospital or clinic services;
(e)
Home health care services;
(f)
Private duty nursing service;
(g)
Physical therapy and related services;
(h)
Dental and optometric services;
(i)
Laboratory and X-ray services;
(j)
Prescribed drugs, eyeglasses, dentures, and prosthetic devices;
(k)
Diagnostic, screening, and preventive services; and
(l)
Any other medical care or remedial care recognized under state law.
(2)
The definitions of the care and services listed above shall be in keeping with Title I or Title XVI of the federal Social Security Act as amended, the rules and regulations promulgated by the secretary of health, education, and welfare, and the state licensing laws governing such care and services when licensing is required.
(3)
"Administering agency" means the state department of public welfare, the state board of public welfare of which shall have the duty of making and publishing rules and regulations, not inconsistent with the terms of this article, as may be necessary for its efficient administration.
(4)
"A vendor payment" is a payment made directly to a supplier or provider of medical and remedial care or service on behalf of an eligible recipient of medical assistance to the aged.
Codes, 1942, § 7290-02; Laws, 1964, ch. 446, § 2, eff. 6/11/1964.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 13 - MEDICAL ASSISTANCE FOR THE AGED; MEDICAID (§§ 43-13-1 — 43-13-607) › Article 1 - MEDICAL ASSISTANCE FOR THE AGED (§§ 43-13-1 — 43-13-13) › Section 43-13-5 - Medical assistance for the aged

The State Department of Public Welfare, after having made a determination with respect to eligibility with due regard to the resources and income of the applicant, may make vendor payments on behalf of eligible individuals for such care as may be authorized within the limits of available funds, provided that such medical or remedial care is rendered by or under the supervision of a licensed practitioner, and provided further that no regulation shall be promulgated which limits or abridges the recipient's free choice of the provider of medical and remedial care or service. Such recipients of medical assistance for the aged shall only be persons:
(1)
Who shall have attained the age of sixty-five (65) years;
(2)
Who are not receiving old age assistance;
(3)
Who have net income and resources not exceeding amounts as may be set forth from time to time by the administering agency of the state; and
(4)
Who have not made a voluntary assignment or transfer of property for the purpose of qualifying for such assistance at any time within two (2) years immediately prior to the filing of an application for medical assistance for the aged.
Medical assistance for the aged shall be payable under this article on behalf of any person who is a patient of an institution, public or private, where such payments are matchable under the provisions of the federal Social Security Act as amended and where such institution conforms to the requirements of the federal Social Security Act as amended and the applicable statutes of Mississippi.
Codes, 1942, § 7290-03; Laws, 1964, ch. 446, § 3, eff. 6/11/1964.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 13 - MEDICAL ASSISTANCE FOR THE AGED; MEDICAID (§§ 43-13-1 — 43-13-607) › Article 1 - MEDICAL ASSISTANCE FOR THE AGED (§§ 43-13-1 — 43-13-13) › Section 43-13-7 - Obligations upon the administering agency

The administering agency, in providing medical assistance for the aged, shall:
(1)
Include some institutional and some noninstitutional medical care;
(2)
Provide an opportunity for hearing before an appeals and review body within the agency for any applicant whose application is denied upon request by such applicant, who has been denied the opportunity to apply for such assistance, whose application has not been acted upon with reasonable promptness, whose benefit hereunder has not been forthcoming with reasonable promptness after a determination of eligibility and approval of the application has been made, whose benefit authorization has been revoked, and/or whose benefit authorization is reduced;
(3)
Provide that, in the issuance of regulations, no enrollment fee, premium, or similar charge may be imposed as a condition of the individual's eligibility for such assistance;
(4)
Provide for the furnishing of such assistance to residents of the state who are temporarily absent therefrom;
(5)
Publish and make available a description of services to be provided to help recipients attain self-care including utilization of other agencies providing similar or related services;
(6)
Provide safeguards which restrict the use or disclosure of information concerning applicants and recipients to purposes directly connected with the administration of the state program;
(7)
Establish reasonable standards for determining eligibility for and the extent of such assistance;
(8)
Provide that no lien will be imposed on the property of the recipient prior to his death and that there will be no recovery until after death from such a recipient and the surviving spouse, if any, for any medical assistance correctly paid on behalf of such recipient; and
(9)
Promulgate no citizenship requirement for eligibility which excludes a citizen of the United States.
Codes, 1942, § 7290-04; Laws, 1964, ch. 446, § 4, eff. 6/11/1964.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 13 - MEDICAL ASSISTANCE FOR THE AGED; MEDICAID (§§ 43-13-1 — 43-13-607) › Article 1 - MEDICAL ASSISTANCE FOR THE AGED (§§ 43-13-1 — 43-13-13) › Section 43-13-9 - Medical advisory committee

The state board of public welfare shall appoint a medical advisory committee consisting of not less than nine (9) nor more than twenty (20) physicians from among nominees made by the Mississippi State Medical Association whose respective tenures of service shall be not less than two (2) nor more than four (4) years. Members of this committee shall serve without compensation, but expenses to defray actual expenses incurred in the performance of travel, lodging, and subsistence may be authorized, shall meet not less than twice annually, and shall be furnished written notice of meetings called at least ten (10) days prior to the date of the meeting. The state board of public welfare may also appoint one (1) person from each of the other medical or remedial care professions to serve as members of the medical advisory committee if, in the opinion of the board, their service on said committee would be helpful to the state department of public welfare in administering the provisions of this article. The committee, among its duties and responsibilities prescribed and agreed to, shall:
(1)
Advise the administering agency and personnel thereof with respect to determining the quantity and extent of medical care provided under this article;
(2)
Communicate the views of the medical care professions in these respects to the administering agency;
(3)
Communicate the views of the administering agency in these respects to the medical care professions; and
(4)
Encourage physicians and other medical care personnel to participate in medical care programs herein authorized and prescribed, although such participation shall not be mandatory upon any such personnel.
Codes, 1942, § 7290-05; Laws, 1964, ch. 446, § 5, eff. 6/11/1964.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 13 - MEDICAL ASSISTANCE FOR THE AGED; MEDICAID (§§ 43-13-1 — 43-13-607) › Article 1 - MEDICAL ASSISTANCE FOR THE AGED (§§ 43-13-1 — 43-13-13) › Section 43-13-11 - Program administration and vendor payments

The administering agency is authorized to contract with other state government and nongovernment agencies and organizations in the State of Mississippi for purposes of performing all or part of the administrative aspects of medical or remedial care programs herein authorized, paying a reasonable fee for such service.
Codes, 1942, § 7290-06; Laws, 1964, ch. 446, § 6, eff. 6/11/1964.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 13 - MEDICAL ASSISTANCE FOR THE AGED; MEDICAID (§§ 43-13-1 — 43-13-607) › Article 1 - MEDICAL ASSISTANCE FOR THE AGED (§§ 43-13-1 — 43-13-13) › Section 43-13-13 - Penalties

Any person, making application for benefits under this article for himself or for another person, and any vendor, who knowingly makes a false statement or false representation or fails to disclose a material fact to obtain or increase any benefit or payment under this article shall be guilty of a misdemeanor, and upon conviction therefor shall be punished by a fine not to exceed one hundred dollars ($100.00), or imprisoned not to exceed thirty (30) days, or both such fine and imprisonment. Each subsequent false statement or false representation or failure to disclose a material fact shall constitute a separate offense.
Codes, 1942, § 7290-07; Laws, 1964, ch. 446, § 7, eff. 6/11/1964.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 13 - MEDICAL ASSISTANCE FOR THE AGED; MEDICAID (§§ 43-13-1 — 43-13-607) › Article 3 - MEDICAID (§§ 43-13-101 — 43-13-149) › Section 43-13-101 - Title of article

This article shall be entitled and cited as the "Mississippi Medicaid Law."
Codes, 1942, § 7290-31; Laws, 1969, Ex Sess, ch. 37, § 1, eff. 10/10/1969.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 13 - MEDICAL ASSISTANCE FOR THE AGED; MEDICAID (§§ 43-13-1 — 43-13-607) › Article 3 - MEDICAID (§§ 43-13-101 — 43-13-149) › Section 43-13-103 - Purpose

For the purpose of affording health care and remedial and institutional services in accordance with the requirements for federal grants and other assistance under Titles XVIII, XIX and XXI of the Social Security Act, as amended, a statewide system of medical assistance is established and shall be in effect in all political subdivisions of the state, to be financed by state appropriations and federal matching funds therefor, and to be administered by the Office of the Governor as hereinafter provided.
Codes, 1942, § 7290-32; Laws, 1969, Ex Sess, ch. 37, § 2; Laws, 1984, ch. 488, § 39; Laws, 2000, ch. 301, § 1, eff. 7/1/1999.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 13 - MEDICAL ASSISTANCE FOR THE AGED; MEDICAID (§§ 43-13-1 — 43-13-607) › Article 3 - MEDICAID (§§ 43-13-101 — 43-13-149) › Section 43-13-105 - Definitions

When used in this article, the following definitions shall apply, unless the context requires otherwise:
(a)
"Administering agency" means the Division of Medicaid in the Office of the Governor as created by this article.
(b)
"Division" or "Division of Medicaid" means the Division of Medicaid in the Office of the Governor.
(c)
"Medical assistance" means payment of part or all of the costs of medical and remedial care provided under the terms of this article and in accordance with provisions of Titles XIX and XXI of the Social Security Act, as amended.
(d)
"Applicant" means a person who applies for assistance under Titles IV, XVI, XIX or XXI of the Social Security Act, as amended, and under the terms of this article.
(e)
"Recipient" means a person who is eligible for assistance under Title XIX or XXI of the Social Security Act, as amended and under the terms of this article.
(f)
"State health agency" means any agency, department, institution, board or commission of the State of Mississippi, except the University of Mississippi Medical School, which is supported in whole or in part by any public funds, including funds directly appropriated from the State Treasury, funds derived by taxes, fees levied or collected by statutory authority, or any other funds used by "state health agencies" derived from federal sources, when any funds available to such agency are expended either directly or indirectly in connection with, or in support of, any public health, hospital, hospitalization or other public programs for the preventive treatment or actual medical treatment of persons with a physical disability, mental illness or an intellectual disability.
(g)
"Mississippi Medicaid Commission" or "Medicaid Commission," wherever they appear in the laws of the State of Mississippi, means the Division of Medicaid in the Office of the Governor.
Codes, 1942, § 7290-33; Laws, 1969, Ex Sess, ch. 37, § 3; Laws, 1980, ch. 508, § 4; Laws, 1984, ch. 488, § 40; Laws, 2000, ch. 301, § 2; Laws, 2010, ch. 476, § 70, eff. 4/1/2010.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 13 - MEDICAL ASSISTANCE FOR THE AGED; MEDICAID (§§ 43-13-1 — 43-13-607) › Article 3 - MEDICAID (§§ 43-13-101 — 43-13-149) › Section 43-13-109 - Rules and regulations for procurement of employees

The director, with the approval of the governor and pursuant to the rules and regulations of the state personnel board, may adopt reasonable rules and regulations to provide for an open, competitive or qualifying examination for all employees of the division other than the director, part-time consultants and professional staff members.
Codes, 1942, § 7290-35; Laws, 1969, Ex Sess, ch. 37, § 5; Laws, 1984, ch. 488, § 42, eff. 7/1/1984.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 13 - MEDICAL ASSISTANCE FOR THE AGED; MEDICAID (§§ 43-13-1 — 43-13-607) › Article 3 - MEDICAID (§§ 43-13-101 — 43-13-149) › Section 43-13-111 - Budgets of state health agencies

Every state health agency, as defined in Section
43-13-105
, shall obtain an appropriation of state funds from the state Legislature for all medical assistance programs rendered by the agency and shall organize its programs and budgets in such a manner as to secure maximum federal funding through the Division of Medicaid under Title XIX or Title XXI of the federal Social Security Act, as amended.
Codes, 1942, § 7290-36; Laws, 1969, Ex Sess, ch. 37, § 6; Laws, 1984, ch. 488, § 44; Laws, 2000, ch. 301, § 4, eff. 7/1/1999.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 13 - MEDICAL ASSISTANCE FOR THE AGED; MEDICAID (§§ 43-13-1 — 43-13-607) › Article 3 - MEDICAID (§§ 43-13-101 — 43-13-149) › Section 43-13-117.1 - Nursing facility services funds for certain nursing facility residents may be transferred to cover costs of services available through home- and community-based waiver programs

It is the intent of the Legislature to expand access to Medicaid-funded home- and community-based services for eligible nursing facility residents who choose those services. The Executive Director of the Division of Medicaid is authorized to transfer funds allocated for nursing facility services for eligible residents to cover the cost of services available through the Independent Living Waiver, the Traumatic Brain Injury/Spinal Cord Injury Waiver, the Elderly and Disabled Waiver, and the Assisted Living Waiver programs when eligible residents choose those community services. The amount of funding transferred by the division shall be sufficient to cover the cost of home- and community-based waiver services for each eligible nursing facility residents who choose those services. The number of nursing facility residents who return to the community and home- and community-based waiver services shall not count against the total number of waiver slots for which the Legislature appropriates funding each year. Any funds remaining in the program when a former nursing facility resident ceases to participate in a home- and community-based waiver program under this provision shall be returned to nursing facility funding.
Laws, 2007, ch. 553, § 4, eff. 7/1/2007.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 13 - MEDICAL ASSISTANCE FOR THE AGED; MEDICAID (§§ 43-13-1 — 43-13-607) › Article 3 - MEDICAID (§§ 43-13-101 — 43-13-149) › Section 43-13-117.2 - Study on implementation of pilot program to provide chronic disease management of chronic obstructive pulmonary disease

The Division of Medicaid is authorized and directed to study the feasibility of implementing a pilot program to provide chronic disease management of chronic obstructive pulmonary disease (COPD) using private sources of funding in an effort to reduce the financial and clinical burden of COPD illness upon the Medicaid program and the citizens of Mississippi. If a pilot program is deemed feasible, such a program shall be implemented and a report of findings and recommendations be prepared and provided to the Office of the Governor and the Chairmen of the House and Senate Public Health and Welfare Committees and the Chairman of the House Medicaid Committee in order to evaluate the effectiveness of the pilot program in reducing costs within the Medicaid program and in providing improved health and well-being of the affected patients.
Laws, 2007, ch. 553, § 5, eff. 7/1/2007.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 13 - MEDICAL ASSISTANCE FOR THE AGED; MEDICAID (§§ 43-13-1 — 43-13-607) › Article 3 - MEDICAID (§§ 43-13-101 — 43-13-149) › Section 43-13-117.3 - [Repealed]

Laws, 2007, ch. 553, § 6, eff. 7/1/2007.
Repealed by Laws, 2015, ch. 473, HB 545, 3, eff. 7/1/2015.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 13 - MEDICAL ASSISTANCE FOR THE AGED; MEDICAID (§§ 43-13-1 — 43-13-607) › Article 3 - MEDICAID (§§ 43-13-101 — 43-13-149) › Section 43-13-117.4 - Payment by Division of Medicaid of costs of care and services rendered by an entity that performs nontherapeutic abortions or maintains or operates or is affiliated with an entity that maintains or operates a facility where nontherapeutic abortions are performed prohibited

Notwithstanding any other provision of Section
43-13-117
, the division shall not authorize payment of part or all of the costs of care and services rendered by any entity that performs nontherapeutic abortions, maintains or operates a facility where nontherapeutic abortions are performed, or is affiliated with such an entity. For purposes of this provision, "nontherapeutic abortions" means abortions that are not qualified for federal matching funds under the Medicaid program,
42 USC Section 1396
et seq., and as amended hereafter, and "affiliated with" means having a legal relationship with another entity created or governed by one or more written instruments that demonstrates common control, ownership, franchisee status or management, or that grants a license or other authority to utilize the other entity's brand name, trademark, service mark or other registered identification mark.
Added by Laws, 2016, ch. 469, SB 2238, 1, eff. 7/1/2016.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 13 - MEDICAL ASSISTANCE FOR THE AGED; MEDICAID (§§ 43-13-1 — 43-13-607) › Article 3 - MEDICAID (§§ 43-13-101 — 43-13-149) › Section 43-13-117.5 - Reimbursement for services provided eligible beneficiaries by licensed freestanding psychiatric hospital authorized

The Division of Medicaid is authorized to reimburse for services provided to eligible Medicaid beneficiaries by a licensed freestanding psychiatric hospital in a method and manner to be determined by the division in accordance with federal law and federal regulations. The division may seek any necessary waivers, make any required amendments to its State Plan, or revise any contracts authorized under Section
43-13-117(H)
as necessary to provide the services authorized under this section. As used in this section, the term "psychiatric hospital" shall have the meaning as defined in Section
41-7-173(h)(ii)
, which is an institution that is primarily engaged in providing to inpatients, by or under the supervision of a physician, psychiatric services for the diagnosis and treatment of persons with mental illness. It is the intent of the Legislature that the cost of providing services to individuals in a psychiatric hospital shall not exceed the cost of providing the same services to individuals in a hospital as defined by Section
41-7-173(h)(i)
.
Added by Laws, 2019, ch. 426, SB 2268,§ 1, eff. 3/28/2019.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 13 - MEDICAL ASSISTANCE FOR THE AGED; MEDICAID (§§ 43-13-1 — 43-13-607) › Article 3 - MEDICAID (§§ 43-13-101 — 43-13-149) › Section 43-13-117.6 - Reimbursement for authorized services to qualifying medically frail inmates

(1)
The Division of Medicaid may apply to the federal Center for Medicaid Services (CMS) for necessary waivers to provide federal funding under the Medicaid program for providing reimbursement for authorized services to medically frail inmates who qualify for nursing home-level care and who the state deems are not public safety risks, provided through a Special Care Facility for Paroled Inmates licensed by the State Department of Health under contract with the Mississippi Department of Corrections, as specifically authorized under Chapter 496, Laws of 2022.
(2)
Subject to CMS approval, the program for paroled inmates shall be funded from monies that are appropriated or otherwise made available to the division specifically to cover the cost of the paroled inmate program. This program shall be a separate program within the Division of Medicaid as the administering agent.
Added by Laws, 2022, ch. 496, HB 936,§ 7, eff. 7/1/2022.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 13 - MEDICAL ASSISTANCE FOR THE AGED; MEDICAID (§§ 43-13-1 — 43-13-607) › Article 3 - MEDICAID (§§ 43-13-101 — 43-13-149) › Section 43-13-117.7 - Reimbursement or provision of coverage by Division of Medicaid for gender transition procedures for persons under the age of eighteen prohibited

Notwithstanding any other provisions of Section
43-13-117
, the division shall not reimburse or provide coverage for gender transition procedures for a person under eighteen (18) years of age. As used in this section, the term "gender transition procedures" means the same as defined in Section
41-141-3
.
Added by Laws, 2023, ch. 303, HB 1125,§ 7, eff. 2/28/2023.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 13 - MEDICAL ASSISTANCE FOR THE AGED; MEDICAID (§§ 43-13-1 — 43-13-607) › Article 3 - MEDICAID (§§ 43-13-101 — 43-13-149) › Section 43-13-118 - Records of provider participating in Medicaid program

It shall be the duty of each provider participating in the medical assistance program to keep and maintain books, documents, and other records as prescribed by the division of Medicaid in substantiation of its claim for services rendered Medicaid recipients, and such books, documents, and other records shall be kept and maintained for a period of five (5) years or for whatever longer period as may be required or prescribed under federal or state statutes and shall be subject to audit by the division. The division shall be entitled to full recoupment of the amount it has paid any provider of medical service who has failed to keep or maintain records as required herein.
Laws, 1983, ch. 336, § 2; Laws, 1984, ch. 488, § 49; Laws, 1994, ch. 649, § 3, eff. 7/1/1994.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 13 - MEDICAL ASSISTANCE FOR THE AGED; MEDICAID (§§ 43-13-1 — 43-13-607) › Article 3 - MEDICAID (§§ 43-13-101 — 43-13-149) › Section 43-13-119 - [Repealed]

Laws, 2006, ch. 303, § 1; Laws, 2007, ch. 412, § 1; Laws, 2008, ch. 422, § 1; Laws, 2010, ch. 498, § 3, eff. 7/1/2010.
Repealed internally, eff.7/1/2016.
Amended by Laws, 2014, ch. 488, HB 1275, 2, eff. 7/1/2014.
Amended by Laws, 2013EX2, ch. 1, HB 1,§ 3, eff. 7/1/2013.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 13 - MEDICAL ASSISTANCE FOR THE AGED; MEDICAID (§§ 43-13-1 — 43-13-607) › Article 3 - MEDICAID (§§ 43-13-101 — 43-13-149) › Section 43-13-122 - Division authorized to apply for federal, private and public waivers, grants and contributions; implementation of integrated case-mix payment and quality monitoring system

(1)
The division is authorize to apply to the Center for Medicare and Medicaid Services of the United States Department of Health and Human Services for waivers and research and demonstration grants.
(2)
The division is further authorized to accept and expend any grants, donations or contributions from any public or private organization together with any additional federal matching funds that may accrue and including, but not limited to, one hundred percent (100%) federal grant funds or funds from any governmental entity or instrumentality thereof in furthering the purposes and objectives of the Mississippi Medicaid program, provided that such receipts and expenditures are reported and otherwise handled in accordance with the General Fund Stabilization Act. The Department of Finance and Administration is authorized to transfer monies to the division from special funds in the State Treasury in amounts not exceeding the amounts authorized in the appropriation to the division.
Laws, 1989, ch. 527, § 6; Laws, 1990, ch. 548, § 3; Laws, 1991, ch. 612, § 3; Laws, 1993, ch. 609, § 5; Laws, 1994, ch. 649, § 5; Laws, 1995, ch. 614, § 4; Laws, 1996, ch. 518, § 2; Laws, 2000, ch. 301, § 10; Laws, 2003, ch. 543, § 5, eff. 4/21/2003.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 13 - MEDICAL ASSISTANCE FOR THE AGED; MEDICAID (§§ 43-13-1 — 43-13-607) › Article 3 - MEDICAID (§§ 43-13-101 — 43-13-149) › Section 43-13-123 - Methods of providing for payment of claims

The determination of the method of providing payment of claims under this article shall be made by the division, with approval of the Governor, which methods may be:
(a)
By contract with insurance companies licensed to do business in the State of Mississippi or with nonprofit hospital service corporations, medical or dental service corporations, authorized to do business in Mississippi to underwrite on an insured premium approach, such medical assistance benefits as may be available, and any carrier selected under the provisions of this article is expressly authorized and empowered to undertake the performance of the requirements of that contract.
(b)
By contract with an insurance company licensed to do business in the State of Mississippi or with nonprofit hospital service, medical or dental service organizations, or other organizations including data processing companies, authorized to do business in Mississippi to act as fiscal agent.
The division shall obtain services to be provided under either of the above-described provisions in accordance with the Personal Service Contract Review Board Procurement Regulations.
The authorization of the foregoing methods shall not preclude other methods of providing payment of claims through direct operation of the program by the state or its agencies.
Codes, 1942, 7290-42; Laws, 1969, Ex Sess, ch. 37, 12; Laws, 1978, ch. 489, 3; Laws, 1984, ch. 488, 51;Laws, 2002, ch. 636B, 3, eff. 4/12/2002.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 13 - MEDICAL ASSISTANCE FOR THE AGED; MEDICAID (§§ 43-13-1 — 43-13-607) › Article 3 - MEDICAID (§§ 43-13-101 — 43-13-149) › Section 43-13-126 - Health insurers required to provide certain information to Division of Medicaid, accept Division's right of recovery and not deny claims submitted by Division on the basis of certain errors as condition of doing business in Mississippi

As a condition of doing business in the state, health insurers, including self-insured plans, group health plans (as defined in Section 607(1) of the Employee Retirement Income Security Act of 1974), service benefit plans, managed care organizations, pharmacy benefit managers, or other parties that are by statute, contract, or agreement, legally responsible for payment of a claim for a health care item or service, are required to:
(a)
Provide, with respect to individuals who are eligible for, or are provided, medical assistance under the state plan, upon the request of the Division of Medicaid, information to determine during what period the individual or their spouses or their dependents may be (or may have been) covered by a health insurer and the nature of the coverage that is or was provided by the health insurer (including the name, address and identifying number of the plan) in a manner prescribed by the Secretary of the Department of Health and Human Services;
(b)
Accept the Division of Medicaid's right of recovery and the assignment to the division of any right of an individual or other entity to payment from the party for an item or service for which payment has been made under the state plan;
(c)
Respond to any inquiry by the Division of Medicaid regarding a claim for payment for any health care item or service that is submitted not later than three (3) years after the date of the provision of that health care item or service; and
(d)
Agree not to deny a claim submitted by the Division of Medicaid solely on the basis of the date of submission of the claim, the type or format of the claim form, or a failure to present proper documentation at the point-of-sale that is the basis of the claim, if:
(i)
The claim is submitted by the division within the three-year period beginning on the date on which the item or service was furnished; and
(ii)
Any action by the division to enforce its rights with respect to the claim is begun within six (6) years of the division's submission of the claim.
Laws, 2007, ch. 553, § 3, eff. 7/1/2007.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 13 - MEDICAL ASSISTANCE FOR THE AGED; MEDICAID (§§ 43-13-1 — 43-13-607) › Article 3 - MEDICAID (§§ 43-13-101 — 43-13-149) › Section 43-13-127 - Reports and recommendations required of Division of Medicaid

(1)
Within sixty (60) days after the end of each fiscal year and at each regular session of the Legislature, the division shall make and publish a report to the Governor and to the Legislature, showing for the period of time covered the following:
(a)
The total number of recipients;
(b)
The total amount paid for medical assistance and care under this article;
(c)
The total number of applications;
(d)
The number of applications approved;
(e)
The number of applications denied;
(f)
The amount expended for administration of the provisions of this article;
(g)
The amount of money received from the federal government, if any;
(h)
The amount of money recovered by reason of collections from third persons by reason of assignment or subrogation, and the disposition of the same;
(i)
The actions and activities of the division in detecting and investigating suspected or alleged fraudulent practices, violations and abuses of the program; and
(j)
Any recommendations it may have as to expanding, enlarging, limiting or restricting the eligibility of persons covered by this article or services provided by this article, to make more effective the basic purposes of this article; to eliminate or curtail fraudulent practices and inequities in the plan or administration thereof; and to continue to participate in receiving federal funds for the furnishing of medical assistance under Title XIX of the Social Security Act or other federal law.
(2)
In addition to the reports required by subsection (1) of this section, the division shall submit a report each month to the Chairmen of the Public Health and Welfare Committees of the Senate and the House of Representatives and to the Joint Legislative Budget Committee that contains the information specified in each paragraph of subsection (1) for the preceding month.
Codes, 1942, 7290-44; Laws, 1969, Ex Sess, ch. 37, 14; Laws, 1972, ch. 306, 1; Laws, 1984, ch. 488, 53; Laws, 1990, ch. 548, 4;Laws, 2002, ch. 636B, 4, eff. 4/12/2002.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 13 - MEDICAL ASSISTANCE FOR THE AGED; MEDICAID (§§ 43-13-1 — 43-13-607) › Article 3 - MEDICAID (§§ 43-13-101 — 43-13-149) › Section 43-13-129 - Misrepresentation by applicant for benefits or by provider of services; penalty

Any person making application for benefits under this article for himself or for another person, and any provider of services, who knowingly makes a false statement or false representation or fails to disclose a material fact to obtain or increase any benefit or payment under this article shall be guilty of a misdemeanor and, upon conviction thereof, shall be punished by a fine not to exceed five hundred dollars ($500.00) or imprisoned not to exceed one (1) year, or by both such fine and imprisonment. Each false statement or false representation or failure to disclose a material fact shall constitute a separate offense. This section shall not prohibit prosecution under any other criminal statutes of this state or the United States.
Codes, 1942, § 7290-45; Laws, 1969, Ex Sess, ch. 37, § 15, eff. 10/10/1969.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 13 - MEDICAL ASSISTANCE FOR THE AGED; MEDICAID (§§ 43-13-1 — 43-13-607) › Article 3 - MEDICAID (§§ 43-13-101 — 43-13-149) › Section 43-13-131 - Influencing recipient to elect particular provider or type of services for purpose of obtaining increase in benefits or payments; penalties

Any person who shall, through intentional misrepresentation, fraud, deceit or unlawful design, either acting individually or in concert with others, influence any recipient to elect any particular provider of services, or any particular type of services, for the purposes and with the intent to obtain or increase any benefit or payment under this article shall be guilty of a misdemeanor and, upon conviction thereof, shall be punished by a fine not exceeding five hundred dollars ($500.00) or imprisonment not exceeding one (1) year, or by both such fine and imprisonment. This section shall not prohibit prosecution under any other criminal statutes of this state or the United States.
Codes, 1942, § 7290-46; Laws, 1969, Ex Sess, ch. 37, § 16, eff. 10/10/1969.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 13 - MEDICAL ASSISTANCE FOR THE AGED; MEDICAID (§§ 43-13-1 — 43-13-607) › Article 3 - MEDICAID (§§ 43-13-101 — 43-13-149) › Section 43-13-133 - Intent as to use of federal matching funds

It is the intent of the Legislature that all federal matching funds for medical assistance under Titles V, XVIII and XIX of the federal Social Security Act paid into any state health agency after October 10, 1969, shall be used exclusively to defray the cost of medical assistance expended under the terms of this article.
Codes, 1942, § 7290-47; Laws, 1969, Ex Sess, ch. 37, § 17, eff. 10/10/1969.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 13 - MEDICAL ASSISTANCE FOR THE AGED; MEDICAID (§§ 43-13-1 — 43-13-607) › Article 3 - MEDICAID (§§ 43-13-101 — 43-13-149) › Section 43-13-135 - [Repealed]

Repealed by Laws, 1994, ch. 649, § 14, eff. 7/1/1994.
Codes, 1942, § 7290-48; Laws, 1969, Ex Sess, ch. 37, § 19; Laws, 1972, ch. 320, § 1; Laws, 1973, ch. 455, § 1; Laws, 1974, ch. 346; Laws, 1975, ch. 339; Laws, 1976, ch. 436; Laws, 1977, ch. 383; Laws, 1979, ch. 495, § 3; Laws, 1980, ch. 306; Laws, 1980, ch. 402; Laws, 1981, ch. 301, § 1; Laws, 1981, ch. 326, § 1; Laws, 1983, 2nd Ex Sess, ch. 9; Laws, 1984, ch. 372; Laws, 1988, ch. 306, § 1; Laws, 1989, ch. 527, § 7; Laws, 1990, ch. 390, § 1; Laws, 1991, ch. 612, § 4; Laws, 1992, ch. 487, § 3.
Mississippi Code 1972 (2023) › Title 43 - PUBLIC WELFARE (§§ 43-1-1 — 43-NEW01-012) › Chapter 13 - MEDICAL ASSISTANCE FOR THE AGED; MEDICAID (§§ 43-13-1 — 43-13-607) › Article 3 - MEDICAID (§§ 43-13-101 — 43-13-149) › Section 43-13-137 - Division to comply with Administrative Procedure Law

The division is an agency as defined under Section
25-43-3
and, therefore, must comply in all respects with the Administrative Procedures Law, Section
25-43-1
et seq.
Codes, 1942, § 7290-50; Laws, 1969, Ex Sess, ch. 37, § 21; Laws, 1981, ch. 451, § 2; Laws, 2000, ch. 301, § 12, eff. 7/1/1999.