reglab/statecodes huggingface dataset:
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 43-13-139 - Governor authorized to discontinue or limit medical assistance to optional groups; division to cease state funding upon discontinuance of federal funding

Nothing contained in this article shall be construed to prevent the Governor, in his discretion, from discontinuing or limiting medical assistance to any individuals who are classified or deemed to be within any optional group or optional category of recipients as prescribed under Title XIX of the federal Social Security Act or the implementing federal regulations. If the Congress or the United States Department of Health and Human Services ceases to provide federal matching funds for any group or category of recipients or any type of care and services, the division shall cease state funding for such group or category or such type of care and services, notwithstanding any provision of this article. If any state plan amendment submitted to comply with the provisions of Section
43-13-117
is disapproved by the United States Department of Health and Human Services, the division may operate under the state plan as previously approved by the United States Department of Health and Human Services in order to preserve federal matching funds. The division shall provide notice of the disapproval to the Chairmen of the House and Senate Medicaid Committees.
Laws, 1994, ch. 649, § 6, eff. 7/1/1994.
Amended by Laws, 2022, ch. 456, HB 657,§ 3, eff. 4/18/2022.
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THE AGED; MEDICAID (§§ 43-13-1 — 43-13-607) › Article 3 - MEDICAID (§§ 43-13-101 — 43-13-149) › Section 43-13-141 - [Repealed]

Repealed by Laws, 2004 ch. 593, § 8.
Laws, 1991, ch. 612, § 1; Laws, 1992, ch. 487, § 4, eff. 5/8/1992.
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 43-13-143 - Medical Care Fund

There is created in the State Treasury a special fund to be known as the "Medical Care Fund," which shall be comprised of monies transferred by public or private health care providers, governing bodies of counties, municipalities, public or community hospitals and other political subdivisions of the state, individuals, corporations, associations and any other entities for the purpose of providing health care services. Any transfer made to the fund shall be paid to the State Treasurer for deposit into the fund, and all such transfers shall be considered as unconditional transfers to the fund. The monies in the Medical Care Fund shall be expended only for health care services, and may be expended only upon appropriation of the Legislature. All transfers of monies to the Division of Medicaid by health care providers and by governing bodies of counties, municipalities, public or community hospitals and other political subdivisions of the state shall be deposited into the fund. Unexpended monies remaining in the fund at the end of a fiscal year shall not lapse into the State General Fund, and any interest earned on monies in the fund shall be deposited to the credit of the fund.
Laws, 1991, ch. 612, § 2; Laws, 1992, ch. 487, § 5, eff. 5/8/1992.
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 43-13-147 - Mississippi Medicaid Program and Children's Health Insurance Program to examine and improve hospital discharge and follow-up care procedures for certain premature infants and implement programs to improve newborn outcomes; reporting of data regarding rehospitalization of certain premature infants

(1)
The Mississippi Medicaid Program and the Children's Health Insurance Program, in consultation with statewide organizations focused on premature infant healthcare, shall:
(a)
Examine and improve hospital discharge and follow-up care procedures for premature infants born earlier than thirty-seven (37) weeks gestational age to ensure standardized and coordinated processes are followed as premature infants leave the hospital from either a Level 1 (well baby nursery), Level 2 (step down or transitional nursery) or Level 3 (neonatal intensive care unit) unit and transition to follow-up care by a health care provider in the community; and
(b)
Use guidance from the Centers for Medicare and Medicaid Services' Neonatal Outcomes Improvement Project to implement programs to improve newborn outcomes, reduce newborn health costs and establish ongoing quality improvement for newborns.
(2)
Data regarding the incidence and cause of rehospitalization in the first six (6) months of life for infants born premature at earlier than thirty-seven (37) weeks gestational age shall be reported to the Chairman of the House Public Health and Human Services Committee and the Chairman of the Senate Public Health and Welfare Committee by the Mississippi State Department of Health utilizing the mandated hospital discharge data system authorized in Section
41-63-4
.
Laws, 2009, ch. 553, § 3, eff. 7/1/2009.
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 43-13-149 - [Repealed]

Added by Laws, 2015, ch. 473, HB 545, 4, 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 5 - MEDICAID FRAUD CONTROL ACT (§§ 43-13-201 — 43-13-233) › Section 43-13-201 - Short title

This article shall be known and may be cited as the "Medicaid Fraud Control Act."
Laws, 1984, ch. 503, § 1, eff. 5/15/1984.
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 5 - MEDICAID FRAUD CONTROL ACT (§§ 43-13-201 — 43-13-233) › Section 43-13-203 - Definitions

As used in this article:
(a)
"Benefit" means the receipt of money, goods, services or anything of pecuniary value.
(b)
"False statement" or "false representation" means a statement or representation knowingly and wilfully made by a person knowing of the falsity of the statement or representation.
(c)
"Knowing" and "knowingly" means that a person is aware of the nature of his conduct and that such conduct is substantially certain to cause the intended result.
(d)
"Medicaid benefit" means a benefit paid or payable under the Medicaid program established under Section
43-13-101
et seq.
(e)
"Person" means an individual, corporation, unincorporated association, partnership or other form of business association.
Laws, 1984, ch. 503, § 2, eff. 5/15/1984.
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 5 - MEDICAID FRAUD CONTROL ACT (§§ 43-13-201 — 43-13-233) › Section 43-13-205 - False representations or statements in application for Medicaid benefits; concealment or nondisclosure of facts

(1)
A person shall not knowingly make or cause to be made a false representation of a material fact in an application for Medicaid benefits.
(2)
A person shall not knowingly make or cause to be made a false statement of a material fact for use in determining rights to a Medicaid benefit.
(3)
A person, who having knowledge of the occurrence of an event affecting his initial or continued right to receive a Medicaid benefit, shall not conceal or fail to disclose that event with intent to obtain a medicaid benefit to which the person or any other person is not entitled or in an amount greater than that to which the person or any other person is entitled.
Laws, 1984, ch. 503, § 3, eff. 5/15/1984.
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 5 - MEDICAID FRAUD CONTROL ACT (§§ 43-13-201 — 43-13-233) › Section 43-13-207 - Kickbacks and bribes

A person shall not solicit, offer or receive a kickback or bribe in the furnishing of goods or services for which payment is or may be made in whole or in part pursuant to the Medicaid program, or make or receive any such payment, or receive a rebate of a fee or charge for referring an individual to another person for the furnishing of such goods or services.
Laws, 1984, ch. 503, § 4, eff. 5/15/1984.
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 5 - MEDICAID FRAUD CONTROL ACT (§§ 43-13-201 — 43-13-233) › Section 43-13-209 - False statements or false representations as to conditions or operation of institution or facility

A person shall not knowingly and wilfully make, induce or seek to induce the making of a false statement or false representation of a material fact with respect to the conditions or operation of an institution or facility in order that the institution or facility may qualify, upon initial certification or upon recertification, to receive Medicaid benefits as a hospital, skilled nursing facility, intermediate care facility or home health agency.
Laws, 1984, ch. 503, § 5, eff. 5/15/1984.
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 5 - MEDICAID FRAUD CONTROL ACT (§§ 43-13-201 — 43-13-233) › Section 43-13-211 - Conspiracy

A person shall not enter into an agreement, combination or conspiracy to defraud the state by obtaining or aiding another to obtain the payment or allowance of a false, fictitious or fraudulent claim for Medicaid benefits.
Laws, 1984, ch. 503, § 6, eff. 5/15/1984.
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 5 - MEDICAID FRAUD CONTROL ACT (§§ 43-13-201 — 43-13-233) › Section 43-13-213 - False or fraudulent claim

A person shall not make, present or cause to be made or presented a claim for Medicaid benefits, knowing the claim to be false, fictitious or fraudulent.
Laws, 1984, ch. 503, § 7, eff. 5/15/1984.
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 5 - MEDICAID FRAUD CONTROL ACT (§§ 43-13-201 — 43-13-233) › Section 43-13-215 - Penalties

A person who violates any provision of Sections
43-13-205
through
43-13-213
shall be guilty of a felony, and, upon conviction thereof, shall be punished by imprisonment for not more than five (5) years, or by a fine of not more than Fifty Thousand Dollars ($50,000.00), or both. Sentences imposed for convictions of separate offenses under this article may run consecutively.
Laws, 1984, ch. 503, § 8, eff. 5/15/1984.
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 5 - MEDICAID FRAUD CONTROL ACT (§§ 43-13-201 — 43-13-233) › Section 43-13-217 - Evidentiary matters concerning false statements or representations

In any prosecution under this article, it shall not be necessary to show that the person had knowledge of similar acts having been performed in the past on the part of persons acting on his behalf, nor to show that the person had actual notice that the acts by persons acting on his behalf occurred, in order to establish the fact that a false statement or representation was knowingly made.
Laws, 1984, ch. 503, § 9, eff. 5/15/1984.
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 5 - MEDICAID FRAUD CONTROL ACT (§§ 43-13-201 — 43-13-233) › Section 43-13-219 - Medicaid fraud control unit

There is hereby created within the office of the attorney general a "Medicaid Fraud Control Unit." The unit shall consist of a director appointed by the attorney general and such attorneys, auditors, investigator and other such personnel as are necessary to conduct the activities of the unit.
Laws, 1984, ch. 503, § 10, eff. 5/15/1984.
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 5 - MEDICAID FRAUD CONTROL ACT (§§ 43-13-201 — 43-13-233) › Section 43-13-221 - Attorney General; investigation and prosecution; investigator status as law enforcement officer

The Attorney General, acting through the Director of the Fraud Control Unit, may, in any case involving alleged violations of this article, conduct an investigation or prosecution. In conducting such actions, the Attorney General, acting through the director, shall have all the powers of a district attorney, including the powers to issue or cause to be issued subpoenas or other process.
Persons employed by the Attorney General as investigators in the Medicaid Fraud Control Unit shall serve as law enforcement officers as defined in Section
45-6-3
, and they shall be empowered to make arrests and to serve and execute search warrants and other valid legal process anywhere within the State of Mississippi.
Laws, 1984, ch. 503, § 11; Laws, 1998, ch. 374, § 1, eff. 7/1/1998.
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 5 - MEDICAID FRAUD CONTROL ACT (§§ 43-13-201 — 43-13-233) › Section 43-13-223 - Jurisdiction; service of process

(1)
An action brought in connection with any matter under this article may be filed in the circuit court of the First Judicial District of Hinds County or in the circuit court of the county in which the defendant resides, and may be prosecuted to final judgment in satisfaction there.
(2)
Process issued by a court in which an action is filed may be served anywhere in the state.
Laws, 1984, ch. 503, § 12, eff. 5/15/1984.
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 5 - MEDICAID FRAUD CONTROL ACT (§§ 43-13-201 — 43-13-233) › Section 43-13-225 - Civil liability and penalty of health care provider

(1)
A health care provider or vendor committing any act or omission in violation of this article shall be directly liable to the state and shall forfeit and pay to the state a civil penalty equal to the full amount received, plus an additional civil penalty equal to triple the full amount received.
(2)
A criminal action need not be brought against a person for that person to be civilly liable under this article.
Laws, 1984, ch. 503, § 13, eff. 5/15/1984.
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 5 - MEDICAID FRAUD CONTROL ACT (§§ 43-13-201 — 43-13-233) › Section 43-13-227 - Injunction; appointment of receiver for residential health care facility

(1)
As a means of protecting the health, safety and welfare of patients in residential health care facilities, including hospitals and nursing homes, whenever there is probable cause that any acts or omissions in violation of this article have been committed by a person who is in control of assets purchased, in whole or in part, directly or indirectly, with funds from the Medicaid program and is likely to convert, destroy or remove those assets, the attorney general, acting through the director of the fraud control unit, shall be authorized to petition the chancery court of the county in which those assets may be found to enjoin the person in control of the assets from converting, destroying or removing those assets, and to appoint a receiver to manage those assets until the investigation and any litigation are completed.
(2)
The chancery court shall, immediately upon receipt of the petition of the attorney general, acting through the director of the fraud control unit, enjoin the person in control of the assets from converting, destroying or removing those assets.
(3)
The chancery court shall issue an order to show cause why a receiver should not be appointed, returnable within ten (10) days after filing of the petition.
(4)
If the chancery court finds that the facts warrant the granting of the petition to appoint a receiver, the court shall appoint a receiver to take charge of the residential health care facility and any other assets involved. The court may determine fair compensation for the receiver.
Laws, 1984, ch. 503, § 14, eff. 5/15/1984.
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 5 - MEDICAID FRAUD CONTROL ACT (§§ 43-13-201 — 43-13-233) › Section 43-13-229 - Inspection and audit of health care provider records; cessation of reimbursement for failure to disclose

(1)
During any investigation under this article, the attorney general, acting through the director of the fraud control unit, shall have the right to audit and to inspect the records of any health care provider or vendor of Medicaid benefits.
(2)
Reimbursement under the Medicaid program shall not be available for services furnished by a provider or vendor who is otherwise eligible for Medicaid benefits during any period when such provider or vendor has refused to provide the attorney general and the director of the fraud control unit such information as the unit may request in order to complete its investigation.
(3)
Suspension of Medicaid reimbursement payments shall continue during all periods during which any part of any requested records are not produced, notwithstanding any administrative, legal or other proceedings which may be brought or maintained by such provider or vendor or by any other party to forestall, modify or prevent the request for records.
(4)
As used in this section, "requested records" means those records required by the unit for investigative or prosecutorial purposes, and requested by subpoena, subpoena duces tecum, grand jury subpoena, administrative demand, search warrant, or other process, demand or written request.
Laws, 1984, ch. 503, § 15, eff. 5/15/1984.
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 5 - MEDICAID FRAUD CONTROL ACT (§§ 43-13-201 — 43-13-233) › Section 43-13-231 - Power of local authorities

The powers of the attorney general, acting through the director of the fraud control unit, under this article shall not diminish the powers of local authorities to investigate and/or prosecute criminal conduct within their respective jurisdictions.
Laws, 1984, ch. 503, § 16, eff. 5/15/1984.
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 5 - MEDICAID FRAUD CONTROL ACT (§§ 43-13-201 — 43-13-233) › Section 43-13-233 - Existing law not affected

Nothing in this article shall in any way limit any penalties or remedies which may be available under any other statute or law of this state.
Laws, 1984, ch. 503, § 17, eff. 5/15/1984.
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 7 - THIRD PARTY LIABILITY FOR MEDICAL PAYMENTS (§§ 43-13-301 — 43-13-317) › Section 43-13-301 - Identification of cases involving third-party liability

The State Department of Public Welfare shall assist the Division of Medicaid in the Office of the Governor in identifying cases involving third-party liability, including without limitation, third-party insurance benefits, health insurance or other health coverage maintained by the recipient or absent parent through intake, initial determinations, and redeterminations of eligibility, and shall promptly transmit such information to the Division of Medicaid or the fiscal agent of the Division of Medicaid.
Laws, 1985, ch. 497, § 1, eff. 7/1/1985.
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 7 - THIRD PARTY LIABILITY FOR MEDICAL PAYMENTS (§§ 43-13-301 — 43-13-317) › Section 43-13-305 - Assignment of rights against third parties; appointment of Division as attorney-in-fact; direction of payments to Division

(1)
By accepting Medicaid from the Division of Medicaid in the Office of the Governor, the recipient shall, to the extent of the payment of medical expenses by the Division of Medicaid, be deemed to have made an assignment to the Division of Medicaid of any and all rights and interests in any third-party benefits, hospitalization or indemnity contract or any cause of action, past, present or future, against any person, firm or corporation for Medicaid benefits provided to the recipient by the Division of Medicaid for injuries, disease or sickness caused or suffered under circumstances creating a cause of action in favor of the recipient against any such person, firm or corporation as set out in Section
43-13-125
. The recipient shall be deemed, without the necessity of signing any document, to have appointed the Division of Medicaid as his or her true and lawful attorney-in-fact in his or her name, place and stead in collecting any and all amounts due and owing for medical expenses paid by the Division of Medicaid against such person, firm or corporation.
(2)
Whenever a provider of medical services or the Division of Medicaid submits claims to an insurer on behalf of a Medicaid recipient for whom an assignment of rights has been received, or whose rights have been assigned by the operation of law, the insurer must respond within sixty (60) days of receipt of a claim by forwarding payment or issuing a notice of denial directly to the submitter of the claim. The failure of the insuring entity to comply with the provisions of this section shall subject the insuring entity to recourse by the Division of Medicaid in accordance with the provision of Section
43-13-315
. The Division of Medicaid shall be authorized to endorse any and all, including, but not limited to, multi-payee checks, drafts, money orders or other negotiable instruments representing Medicaid payment recoveries that are received by the Division of Medicaid.
(3)
Court orders or agreements for medical support shall direct such payments to the Division of Medicaid, which shall be authorized to endorse any and all checks, drafts, money orders or other negotiable instruments representing medical support payments which are received. Any designated medical support funds received by the State Department of Human Services or through its local county departments shall be paid over to the Division of Medicaid. When medical support for a Medicaid recipient is available through an absent parent or custodial parent, the insuring entity shall direct the medical support payment(s) to the provider of medical services or to the Division of Medicaid.
Laws, 1985, ch. 497, § 3; Laws, 1991, ch. 579, § 3; Laws, 1993, ch. 609, § 7; Laws, 2000, ch. 301, § 13, 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 7 - THIRD PARTY LIABILITY FOR MEDICAL PAYMENTS (§§ 43-13-301 — 43-13-317) › Section 43-13-307 - Loss of eligibility upon refusal to cooperate with Division or local agency

Any applicant or recipient, inclusive of the grantee relative of a dependent child who refuses to cooperate with or to provide reasonable assistance to the Division of Medicaid against a liable third party in accordance with Section
43-13-125
, Mississippi Code of 1972, or fails to pay over to the Division of Medicaid third-party payments as provided in this article, or fails or refuses to cooperate with the local county department of public welfare shall not be eligible for Medicaid benefits under the Mississippi Medicaid Law.
Laws, 1985, ch. 497, § 4, eff. 7/1/1985.
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 7 - THIRD PARTY LIABILITY FOR MEDICAL PAYMENTS (§§ 43-13-301 — 43-13-317) › Section 43-13-309 - State and federal funding

The State Department of Public Welfare shall obtain an appropriation of state funds from the State Legislature in carrying out its medical support responsibilities under this article and shall organize its programs and budgets in such a manner as to secure maximum federal funding directly or through the Division of Medicaid under Title XIX of the Federal Social Security Act, as amended. If Title XIX federal funds are secured through the Division of Medicaid, such funds shall not be considered a part of the budget of the Division of Medicaid in providing medical assistance under the Mississippi Medical Assistance Act.
Laws, 1985, ch. 497, § 5, eff. 7/1/1985.
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 7 - THIRD PARTY LIABILITY FOR MEDICAL PAYMENTS (§§ 43-13-301 — 43-13-317) › Section 43-13-311 - Requirement of cooperation by providers

Providers of medical services participating in the Medicaid program shall, in submitting claims for the payment of services, identify, if known to the provider, the third party or parties who are or may be liable for the injuries, disease, or sickness of the recipient and shall cooperate with the Division of Medicaid in the recoupment of the payments from such third party or parties.
Any provider submitting claims for the payment of medical services by the Division of Medicaid, who, having knowledge of the liability or potential liability of a third party for the injuries, disease, or sickness of the recipient, fails to identify such third party or parties to the Division of Medicaid or who fails to cooperate with the Division of Medicaid in the recoupment of its payments from such third party or parties shall be liable to the Division of Medicaid to the extent of the payments made to the provider for medical assistance or services rendered to a recipient to which the third party or parties is, are, or may be liable.
Laws, 1985, ch. 497, § 6, eff. 7/1/1985.
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 7 - THIRD PARTY LIABILITY FOR MEDICAL PAYMENTS (§§ 43-13-301 — 43-13-317) › Section 43-13-313 - Denotation on medical information furnished by provider; provider to direct copy of medical information and authorization to Division of Medicaid; effect of failure to comply

(1)
In furnishing medical information to the recipient, his attorney or any other party upon written authorization, a provider participating in the Medicaid program shall denote in writing on such medical information that the patient is a Medicaid recipient and his Medicaid identification number, and if the medical charges have been paid by the Division of Medicaid, the provider shall, in addition, write or cause to be stamped or printed thereon "paid by the Division of Medicaid." If the provider has not been paid by the Division of Medicaid but seeks to bill the Division of Medicaid for medical services rendered the recipient, the provider shall denote in writing on such medical information the same information as herein provided and shall advise the recipient, his attorney, or any other party upon written authorization that it intends to bill the Division of Medicaid for medical services rendered the recipient.
(2)
At the time the requested medical information is furnished to the recipient, his attorney, or other party, including medical information produced under court order, subpoena, interrogatory or deposition, the participating provider shall immediately direct a copy of the medical information so furnished or produced to the Division of Medicaid along with the authorization for the production of such information. The failure of the provider of medical services to comply with the provisions of this section shall subject the provider to recourse by the Division of Medicaid in accordance with the provisions of Section
43-13-311
.
Laws, 1985, ch. 497, § 7; Laws, 1989, ch. 408, § 2, eff. 7/1/1989.
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 7 - THIRD PARTY LIABILITY FOR MEDICAL PAYMENTS (§§ 43-13-301 — 43-13-317) › Section 43-13-315 - Liability for failure or refusal to honor subrogation rights of Division

Any person, firm, or corporation who fails or refuses to honor the subrogation rights of the Division of Medicaid and, specifically, without limitation, hospital insurance and indemnity benefits accruing to a recipient, after advanced written notice and a reasonable opportunity of responding, shall be liable to the division, should suit become necessary by the division and liability be established, for double the amount of Medicaid benefits paid by the Division of Medicaid or double the amount of the insurance policy limits, whichever is the lesser, inclusive of the assessment of a reasonable attorney's fee and all costs of court.
Laws, 1985, ch. 497, § 8; Laws, 1995, ch. 614, § 5, eff. 7/1/1995.
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 7 - THIRD PARTY LIABILITY FOR MEDICAL PAYMENTS (§§ 43-13-301 — 43-13-317) › Section 43-13-317 - Recovery of Medicaid payments from estate of deceased recipient; waiver of claim

(1)
The division shall be noticed as an identified creditor against the estate of any deceased Medicaid recipient under Section
91-7-145
.
(2)
In accordance with applicable federal law and rules and regulations, including those under Title XIX of the federal Social Security Act, the division may seek recovery of payments for nursing facility services, home- and community-based services and related hospital and prescription drug services from the estate of a deceased Medicaid recipient who was fifty-five (55) years of age or older when he or she received the assistance. The claim shall be waived by the division (a) if there is a surviving spouse; or (b) if there is a surviving dependent who is under the age of twenty-one (21) years or who is blind or disabled; or (c) as provided by federal law and regulation, if it is determined by the division or by court order that there is undue hardship.
Laws, 1994, ch. 649, § 8; Laws, 2004, ch. 593, § 7, eff. 7/1/2004.
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 9 - HEALTH CARE TRUST FUND FOR TOBACCO SETTLEMENT FUNDS (§§ 43-13-401 — 43-13-409) › Section 43-13-401 - Declaration of legislative intent

It is declared by the Legislature that the funds received by the State of Mississippi from tobacco companies in settlement of a certain lawsuit brought against those companies by the State of Mississippi, or as a result of the settlement of any lawsuit brought against tobacco companies by another state, should be applied toward improving the health and health care of the citizens and residents of the state. It is the intent of the Legislature by this article to provide the manner and means necessary to carry out those purposes.
Laws, 1999, ch. 493, § 1, eff. 3/30/1999.
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 9 - HEALTH CARE TRUST FUND FOR TOBACCO SETTLEMENT FUNDS (§§ 43-13-401 — 43-13-409) › Section 43-13-403 - Definitions

When used in this article, the following definitions shall apply, unless the context requires otherwise:
(a)
"Health Care Trust Fund" means the trust fund established by Section
43-13-405
for the deposit of the funds received by the State of Mississippi as a result of the tobacco settlement, including income from the investment of those funds.
(b)
"Health Care Expendable Fund" means the fund established by Section
43-13-407
for the annual transfer of certain funds from the Health Care Trust Fund that are available for appropriation by the Legislature.
(c)
"Income" means all interest and dividends derived from the investment of any tobacco settlement funds and any capital gains from the sale or exchange of those investments.
(d)
"Tobacco settlement" means the settlement of the case of Mike Moore, Attorney General ex rel. State of Mississippi v. The American Tobacco Company et al. (Chancery Court of Jackson County, Mississippi, Cause No. 94-1429) and the settlement of any case brought against tobacco companies by another state.
Laws, 1999, ch. 493, § 2, eff. 3/30/1999.
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 9 - HEALTH CARE TRUST FUND FOR TOBACCO SETTLEMENT FUNDS (§§ 43-13-401 — 43-13-409) › Section 43-13-405 - [Repealed]

Laws, 1999, ch. 493, § 3; Laws, 2002, ch. 304, § 3; Laws, 2004, ch. 571, § 1; Laws, 2006, ch. 584, § 1; Laws, 2007, ch. 514, § 19; Laws, 2009, ch. 563, § 5; Laws, 2011, ch. 469, § 5; Laws, 2011, ch. 506, § 4, eff. 4/26/2011.
Repealed internally, eff. 7/1/2017.
Amended by Laws, 2016, ch. 460, HB 878, 7, eff. 7/1/2016.
Amended by Laws, 2013, ch. 518, HB 901, 2, 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 11 - DRUG REPOSITORY PROGRAM (§§ 43-13-501 — 43-13-509) › Section 43-13-501 - Definitions

As used in Sections
43-13-501
through
43-13-509
, the following terms have the following meanings, unless the context requires otherwise:
(a)
"Board" means the State Board of Pharmacy.
(b)
"Health care facility" means any of the following:
(i)
A hospital as defined under Section
41-9-3
;
(ii)
An institution for the aged or infirm as defined in Section
43-11-1
;
(iii)
A hospice as defined in Section
41-85-3
;
(c)
"Hospital" has the meaning as defined in Section
41-9-3
.
(d)
"Nonprofit clinic" means a charitable nonprofit corporation organized and operated under Section
79-11-101
et seq., or any charitable organization not organized and not operated for profit, that provides health care services to indigent and uninsured persons. "Nonprofit clinic" does not include a health care facility as defined in this section or a facility that is operated for profit.
(e)
"Pharmacy" has the meaning as defined under Section
73-21-73
.
(f)
"Prescription drug" means any drug to which the following applies:
(i)
Under the federal Food, Drug, and Cosmetic Act, as amended (21 USCS Section 301), the drug is required to bear a label containing the legend, "Caution: Federal law prohibits dispensing without prescription" or "Caution: Federal law restricts this drug to be used by or on the order of a licensed veterinarian" or any similar restrictive statement, or the drug may be dispensed only upon a prescription.
(ii)
Under the Uniform Controlled Substances Law, (Section
41-29-101
et seq.), the drug may be dispensed only upon a prescription.
Laws, 2003, ch. 543, § 9, 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 11 - DRUG REPOSITORY PROGRAM (§§ 43-13-501 — 43-13-509) › Section 43-13-503 - Establishment of plan for drug repository program; eligible drugs

(1)
Not later than January 1, 2005, the State Board of Pharmacy and the State Department of Health jointly shall establish a plan for a drug repository program to accept and dispense prescription drugs donated for the purpose of being dispensed to individuals who meet the eligibility standards established in the rules adopted by the board under Section
43-13-509
. The plan shall be submitted to the Chairmen of the Public Health and Welfare Committees of the Mississippi House of Representatives and Senate for their review. Under the drug repository program:
(a)
Only drugs in their original sealed and tamper-evident packaging may be accepted and dispensed.
(b)
The packaging must be unopened, except that drugs packaged in single unit doses may be accepted and dispensed when the outside packaging is opened if the single unit dose packaging is undisturbed.
(c)
The drugs must have been properly stored such that the integrity of the medicine remains intact.
(d)
A drug shall not be accepted or dispensed if there is reason to believe that it is adulterated as described in Section
75-29-3
.
(e)
Subject to the limitation specified in this subsection, unused drugs dispensed for the purposes of the Medicaid program may be accepted and dispensed.
(2)
Nothing in subsection (1) of this section shall be construed as prohibiting a pharmacy from accepting drugs that are not eligible to be dispensed under the drug repository program, for the proper disposal of those drugs.
(3)
The drug repository program shall be fully implemented not later than July 1, 2005.
Laws, 2003, ch. 543, § 10, 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 11 - DRUG REPOSITORY PROGRAM (§§ 43-13-501 — 43-13-509) › Section 43-13-505 - Criteria for donating, accepting, and dispensing drugs under the program

(1)
Any person, including a drug manufacturer, health care facility or government entity may donate prescription drugs to the drug repository program. The drugs must be donated at a pharmacy, hospital, or nonprofit clinic that participates in the drug repository program under the criteria for participation established in the rules adopted by the board under Section
43-13-509
.
(2)
A pharmacy, hospital, or nonprofit clinic that participates in the drug repository program shall dispense drugs donated under this section to individuals who meet the eligibility standards established in the rules adopted by the board under Section
43-13-509
, or to other government entities and nonprofit private entities to be dispensed to individuals who meet the eligibility standards. A drug may be dispensed only pursuant to a prescription issued by a licensed practitioner as defined in Section
73-21-73
. A pharmacy, hospital, or nonprofit clinic that accepts donated drugs shall comply with all applicable federal laws and laws of this state dealing with storage and distribution of dangerous drugs, and shall inspect all drugs before dispensing them to determine that they are not adulterated. The pharmacy, hospital, or nonprofit clinic may charge individuals receiving donated drugs a handling fee established in accordance with the rules adopted by the board under Sections
43-13-501
through
43-13-509
. Drugs donated to the repository may not be resold.
Laws, 2003, ch. 543, § 11, 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 11 - DRUG REPOSITORY PROGRAM (§§ 43-13-501 — 43-13-509) › Section 43-13-507 - Health care professional defined; immunity for participants in program

(1)
As used in this section, the term "health care professional" means any of the following:
(a)
Physicians and osteopaths licensed under Section
73-25-1
et seq.;
(b)
Podiatrists licensed under Section
73-27-1
et seq.;
(c)
Dentists and dental hygienists licensed under Section
73-9-1
et seq.;
(d)
Optometrists licensed under Section
73-19-1
et seq.;
(e)
Pharmacists licensed under Section
73-21-71
et seq.;
(f)
Registered nurses and licensed practical nurses licensed under Section
73-15-1
et seq.; and
(g)
Physician assistants licensed under Section
73-26-1
et seq.
(2)
The State Board of Pharmacy; the State Department of Health; the Division of Medicaid; any person, including a drug manufacturer, or health care facility or government entity that donates drugs to the repository program; any pharmacy, hospital, nonprofit clinic or health care professional that accepts or dispenses drugs under the program; and any pharmacy, hospital, or nonprofit clinic that employs a health care professional who accepts or dispenses drugs under the program, shall not be subject to any of the following for matters related to donating, accepting, or dispensing drugs under the program: criminal prosecution; liability in tort or other civil action or professional disciplinary action.
A drug manufacturer shall not be subject to criminal prosecution or liability in tort or other civil action for matters related to the donation, acceptance, or dispensing of a drug manufactured by the drug manufacturer that is donated by any person, health care facility or government entity under the program, including, but not limited to, liability for failure to transfer or communicate product or consumer information, or for improper storage or for the expiration date of the donated drug.
Laws, 2003, ch. 543, § 12, 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 11 - DRUG REPOSITORY PROGRAM (§§ 43-13-501 — 43-13-509) › Section 43-13-509 - Implementation of program

(1)
Not later than January 1, 2005, the State Board of Pharmacy, in consultation with the State Department of Health, shall adopt rules, in accordance with the Administrative Procedures Law (Section
25-43-1
et seq.), governing the drug repository program that establish all of the following:
(a)
Eligibility criteria for pharmacies, hospitals and nonprofit clinics to receive and dispense donated drugs under the program;
(b)
Standards and procedures for accepting, safely storing and dispensing donated drugs;
(c)
Standards and procedures for inspecting donated drugs to determine that the original unit dose packaging is sealed and tamper-evident and that the drugs are unadulterated, safe and suitable for dispensing;
(d)
Eligibility standards based on economic need for individuals to receive drugs;
(e)
A means, such as an identification card, by which an individual who is eligible to receive donated drugs may demonstrate eligibility to the pharmacy, hospital, or nonprofit clinic dispensing the drugs;
(f)
A form that an individual receiving a drug from the repository must sign before receiving the drug to confirm that the individual understands the immunity provisions of the program, and waiving all right to sue any individual or entity involved in the program;
(g)
A formula to determine the amount of a handling fee that pharmacies, hospitals and nonprofit clinics may charge to drug recipients to cover restocking and dispensing costs;
(h)
In addition, for drugs donated to the repository by individuals:
(i)
A list of drugs, arranged either by category or by individual drug, that the repository will accept from individuals;
(ii)
A list of drugs, arranged either by category or by individual drug, that the repository will not accept from individuals. The list must include a statement as to why the drug is ineligible for donation; and
(iii)
A form each donor must sign stating that the donor is the owner of the drugs and intends to voluntarily donate them to the repository;
(i)
In addition, for drugs donated to the repository by health care facilities or government entities:
(i)
A list of drugs, arranged either by category or by individual drug, that the repository will accept from health care facilities or government entities; and
(ii)
A list of drugs, arranged either by category or by individual drug, that the repository will not accept from health care facilities or government entities. The list must include a statement as to why the drug is ineligible for donation; and
(j)
Any other standards and procedures the board considers appropriate.
(2)
The provisions of paragraphs (h)(ii) and (i)(ii) of subsection (1) of this section shall not be construed as prohibiting a pharmacy from accepting drugs that are not eligible to be dispensed under the drug repository program, for the proper disposal of those drugs.
Laws, 2003, ch. 543, § 13, 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 13 - MISSISSIPPI LONG-TERM CARE PARTNERSHIP PROGRAM (§§ 43-13-601 — 43-13-607) › Section 43-13-601 - Legislative findings

The Legislature finds that in order to alleviate the financial burden on the state's Medicaid program, the state must encourage better access to and utilization of affordable long-term care insurance that will pay for some or all of the cost of long-term care services.
Added by Laws, 2014, ch. 433, HB 1269, 1, eff. 7/1/2014.
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 13 - MISSISSIPPI LONG-TERM CARE PARTNERSHIP PROGRAM (§§ 43-13-601 — 43-13-607) › Section 43-13-603 - Definitions

As used in this article:
(a)
"Long-term care facility" means a facility required to be licensed under Section
43-11-1
et seq.
(b)
"Long-term care insurance" means the same as in 26 USCS Section 7702B.
(c)
"Long-term care services" means the following necessary services that originate in a setting other than an acute care hospital and that are provided to individuals whose functional capacities are chronically impaired:
(i)
Physician's services;
(ii)
Nursing services;
(iii)
Diagnostic services;
(iv)
Therapeutic services including physical therapy, speech therapy, and occupational therapy;
(v)
Rehabilitative services;
(vi)
Maintenance services;
(vii)
Personal care services individually designed to assist with an individual's physical dependency needs related to bathing, bladder and bowel requirements, dressing, eating, personal hygiene, medications, mobility, incidental housekeeping, laundry, and shopping for personal maintenance items;
(viii)
Transportation services;
(ix)
Day care services;
(x)
Respite care services; and
(xi)
Services provided by chiropractors, podiatrists, and optometrists.
Added by Laws, 2014, ch. 433, HB 1269, 2, eff. 7/1/2014.