reglab/statecodes huggingface dataset:
Mississippi Code 1972 (2023) › Title 83 - INSURANCE (§§ 83-1-1 — 83-NEW-004) › Chapter 9 - ACCIDENT, HEALTH AND MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-1 — 83-9-NEW-005) › ACCIDENT AND HEALTH INSURANCE (§§ 83-9-1 — 83-9-36.2) › Section 83-9-21 - Judicial review

Any order or decision of the commissioner under Sections
83-9-1
through
83-9-21
shall be subject to review by appeal (writ of certiorari) to the circuit court at the instance of any party in interest. The filing of the appeal (petition for such writ) shall operate as a stay of any such order or decision until the court directs otherwise. The court may review all the facts and, in disposing of the issue before it, may modify, affirm, or reverse the order or decision of the commissioner in whole or in part.
Codes, 1942, § 5687-10; Laws, 1956, ch. 330, § 10, eff. 7/1/1956.
Mississippi Code 1972 (2023) › Title 83 - INSURANCE (§§ 83-1-1 — 83-NEW-004) › Chapter 9 - ACCIDENT, HEALTH AND MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-1 — 83-9-NEW-005) › ACCIDENT AND HEALTH INSURANCE (§§ 83-9-1 — 83-9-36.2) › Section 83-9-23 - Health and accident insurance for resident senior citizens

(1)
Any insurance company authorized to do business of health insurance in this state may join with one or more other such insurance companies to offer to any resident of this state who is sixty-five (65) years of age or older, and to the spouse of such resident, insurance against major financial loss from accident or disease. Such insurance may be offered by such companies in their own names or in the name of a voluntary unincorporated association or other organization formed by such companies solely for the purpose of this section. The forms of applications, certificates, and policies of such insurance and the applicable premium rates shall be filed with the insurance commissioner, who may require additional pertinent information.
(2)
A financial summary concerning any insurance written under the authority of this section shall be furnished annually to the insurance commissioner in such form as he may prescribe. If the insurance commissioner finds that any forms for such insurance are not in the public interest or that the premium rates charged are, by reasonable assumptions, excessive in relation to the benefits provided, he may disapprove such forms or premium rates after notice of at least twenty (20) days and hearing.
(3)
Any person aggrieved by the decision of the commissioner under the provisions of this section may appeal therefrom within thirty (30) days after receipt of notice thereof to the Chancery Court of the First Judicial District of Hinds County by writ of certiorari, upon giving bond with surety or sureties and in such penalty as shall be approved by the chancery court of said county, conditioned that such appellant will pay all cost of the appeal in the event such appeal is unsuccessful. The said chancery court shall have the authority and jurisdiction to hear said appeal and render its decision in regard thereto, either in term time or vacation.
Codes, 1942, § 5687-21; Laws, 1962, ch. 470, §§ 1-3, eff. 2/13/1962.
Mississippi Code 1972 (2023) › Title 83 - INSURANCE (§§ 83-1-1 — 83-NEW-004) › Chapter 9 - ACCIDENT, HEALTH AND MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-1 — 83-9-NEW-005) › ACCIDENT AND HEALTH INSURANCE (§§ 83-9-1 — 83-9-36.2) › Section 83-9-24 - Prohibition against requiring higher co-payment, coinsurance, etc., for patient-administered anti-cancer medications than is required for anti-cancer medications injected or intravenously administered by health care provider

(1)
(a)
As used in this section, the following terms shall be defined as provided in this subsection:
(b)
"Anti-cancer medication" means drugs and biologics that are used to kill, slow, or prevent the growth of cancerous cells.
(c)
"Health plan or policy" means any hospital, health or medical expense insurance policy, hospital or medical service contract, employee welfare benefit plan, contract or agreement with a health maintenance organization or a preferred provider organization, health and accident insurance policy, or any other insurance contract of this type, including a group insurance plan and the State and School Employees Life and Health Insurance Plan.
(2)
Any health plan or policy delivered, issued for delivery or renewed in this state on or after January 1, 2016, that covers anti-cancer medications that are injected or intravenously administered by a health care provider and patient-administered anti-cancer medications, including, but not limited to, those orally administered or self-injected, may not require a higher co-payment, deductible or coinsurance amount for patient-administered anti-cancer medications than it requires for injected or intravenously administered anti-cancer medications, regardless of the formulation or benefit category determination by the policy or plan.
(3)
The health insurance policy or plan may not comply with subsection (2) of this section by:
(a)
Increasing the co-payment, deductible or coinsurance amount required for injected or intravenously administered anti-cancer medications that are covered under the policy or plan; or
(b)
Reclassifying benefits with respect to anti-cancer medications.
Added by Laws, 2015, ch. 490, HB 952, 1, eff. 7/1/2015.
Mississippi Code 1972 (2023) › Title 83 - INSURANCE (§§ 83-1-1 — 83-NEW-004) › Chapter 9 - ACCIDENT, HEALTH AND MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-1 — 83-9-NEW-005) › ACCIDENT AND HEALTH INSURANCE (§§ 83-9-1 — 83-9-36.2) › Section 83-9-25 - Examination and return of policy

Every individual accident and health policy or service contract, except travel or nonrenewable accident policies, issued for delivery in the State of Mississippi on or after July 1, 1971, by an insurance company, nonprofit hospital service plan, or medical service corporation shall have printed thereon or attached thereto a notice stating, in substance, that the person to whom the policy or contract is issued shall be permitted to return the policy or contract within not less than ten (10) days of its delivery to said purchaser and to have the premium paid refunded if, after examination of the policy or contract, the purchaser is not satisfied with it for any reason. If a policyholder or purchaser, pursuant to such notice, returns the policy or service contract to the insurance company or association at its home or branch office or to the agent through whom it was purchased, it shall be void from the beginning, and the parties shall be in the same position as if no policy or service contract had been issued.
Codes, 1942, § 5687-31; Laws, 1971, ch. 452, § 1, eff. 7/1/1971.
Mississippi Code 1972 (2023) › Title 83 - INSURANCE (§§ 83-1-1 — 83-NEW-004) › Chapter 9 - ACCIDENT, HEALTH AND MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-1 — 83-9-NEW-005) › ACCIDENT AND HEALTH INSURANCE (§§ 83-9-1 — 83-9-36.2) › Section 83-9-27 - Alcoholism care and treatment; coverage

Notwithstanding any provision of any policy of accident or sickness insurance as defined by Section
83-9-1
, issued on or after January 1, 1975, whenever such policy provides for the reimbursement for loss resulting from sickness, or from bodily injury by accidental means, or both, said reimbursement shall include health service benefits to any insured or any person covered thereunder, on the same basis as other benefits, for care and treatment of alcoholism.
For purposes of Sections
83-9-27
through
83-9-31
, alcoholism is defined as the chronic and habitual use of alcoholic beverages by any person to the extent that such person has lost the power of self-control with respect to the use of such beverages.
Laws, 1974, ch. 522, § 1, eff. 1/1/1975.
Mississippi Code 1972 (2023) › Title 83 - INSURANCE (§§ 83-1-1 — 83-NEW-004) › Chapter 9 - ACCIDENT, HEALTH AND MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-1 — 83-9-NEW-005) › ACCIDENT AND HEALTH INSURANCE (§§ 83-9-1 — 83-9-36.2) › Section 83-9-29 - Alcoholism care and treatment; application of law

The provisions of Sections
83-9-27
through
83-9-31
shall apply only to group policies or group plans of health affording coverage from sickness, or bodily injury by accidental means, or both, or nonprofit health plans corporations regulated by the Mississippi Insurance Commission issued or renewed after January 1, 1975.
The provisions of Sections
83-9-27
through
83-9-31
shall not apply to any plan or policy which is individually underwritten or provided for a specific individual and the members of his family as a nongroup policy.
Laws, 1974, ch. 522, § 2, eff. 1/1/1975.
Mississippi Code 1972 (2023) › Title 83 - INSURANCE (§§ 83-1-1 — 83-NEW-004) › Chapter 9 - ACCIDENT, HEALTH AND MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-1 — 83-9-NEW-005) › ACCIDENT AND HEALTH INSURANCE (§§ 83-9-1 — 83-9-36.2) › Section 83-9-31 - Alcoholism care and treatment; limitation of coverage

The coverage required under Section
83-9-27
shall not exceed One Thousand Dollars ($1,000.00) during any calendar year, and shall extend only to treatment and services rendered by a physician and hospitals licensed by the state wherein the service or hospitalization is rendered.
Laws, 1974, ch. 522, § 3, eff. 1/1/1975.
Mississippi Code 1972 (2023) › Title 83 - INSURANCE (§§ 83-1-1 — 83-NEW-004) › Chapter 9 - ACCIDENT, HEALTH AND MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-1 — 83-9-NEW-005) › ACCIDENT AND HEALTH INSURANCE (§§ 83-9-1 — 83-9-36.2) › Section 83-9-32 - Coverage for medical benefits when dental care provided under physician-supervised anesthesia

Every hospital, health or medical expenses insurance policy, hospital or medical service contract, health maintenance organization and preferred provider organization that is delivered or issued for delivery in this state and otherwise provides anesthesia benefits shall offer benefits for anesthesia and for associated facility charges when the mental or physical condition of the child or mentally handicapped adult requires dental treatment to be rendered under physician-supervised general anesthesia in a hospital setting, surgical center or dental office. This coverage shall be offered on an optional basis, and each primary insured must accept or reject such coverage in writing and accept responsibility for premium payment.
An insurer may require prior authorization for the anesthesia and associated facility charges for dental care procedures in the same manner that prior authorization is required for treatment of other medical conditions under general anesthesia. An insurer may require review for medical necessity and may limit payment of facility charges to certified facilities in the same manner that medical review is required and payment of facility charges is limited for other services. The benefit provided by this coverage shall be subject to the same annual deductibles or coinsurance established for all other covered benefits within a given policy, plan or contract. Private third-party payers may not reduce or eliminate coverage due to these requirements.
A dentist shall consider the Indications for General Anesthesia as published in the reference manual of the American Academy of Pediatric Dentistry as utilization standards for determining whether performing dental procedures necessary to treat the particular condition or conditions of the patient under general anesthesia constitutes appropriate treatment.
The provisions of this section shall apply to anesthesia services provided by oral and maxillofacial surgeons as permitted by the Mississippi State Board of Dental Examiners.
The provisions of this section shall not apply to treatment rendered for temporal mandibular joint (TMJ) disorders.
Laws, 1999, ch. 528, § 1, eff. 7/1/1999.
Mississippi Code 1972 (2023) › Title 83 - INSURANCE (§§ 83-1-1 — 83-NEW-004) › Chapter 9 - ACCIDENT, HEALTH AND MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-1 — 83-9-NEW-005) › ACCIDENT AND HEALTH INSURANCE (§§ 83-9-1 — 83-9-36.2) › Section 83-9-33 - Coverage for newly born children

(1)
All individual and group health insurance policies providing coverage on an expense incurred basis and individual and group service or indemnity type contracts issued after January 1, 1980, by an insurer or nonprofit corporation which provides coverage for a family member of the insured or subscriber shall, as to such family members' coverage, also provide that the health insurance benefits applicable for children shall be payable with respect to a newly born child of the insured or subscriber from the moment of birth.
(2)
The coverage for newly born children shall consist of coverage of injury or sickness including the necessary care and treatment of medically diagnosed congenital defects, prematurities and birth abnormalities, but need not include routine well baby care. For purposes of this section, "necessary care and treatment" shall include transportation of the newborn to and from the nearest appropriately staffed and equipped facility for the treatment of such newborn child, when the attending physician certifies that special transportation is necessary to protect the health and safety of the newborn child. Cost of such transportation shall not exceed usual and customary charges up to Two Hundred Dollars ($200.00).
(3)
If payment of a specific premium or subscription fee is required to provide coverage for a child, the policy or contract may require that notification of birth of a newly born child must be furnished to the insurer or nonprofit service or indemnity corporation within thirty-one (31) days after the date of birth in order to have the coverage continue beyond such thirty-one day period, and may require that payment of the required premium or fee be made within thirty (30) days after the mailing by the insurer or nonprofit corporation of the notice of premium or fee to the insured.
(4)
The requirements of this section shall apply to all insurance policies and subscriber contracts delivered or issued for delivery in this state more than one hundred twenty (120) days after April 4, 1974.
Laws, 1974, ch. 523; Laws, 1979, ch. 435, eff. 3/27/1979.
Mississippi Code 1972 (2023) › Title 83 - INSURANCE (§§ 83-1-1 — 83-NEW-004) › Chapter 9 - ACCIDENT, HEALTH AND MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-1 — 83-9-NEW-005) › ACCIDENT AND HEALTH INSURANCE (§§ 83-9-1 — 83-9-36.2) › Section 83-9-36.1 - Reimbursement under health care policy for gender transition procedures prohibited

(1)
As used in this section, the term "gender transition procedures" means the same as defined in Section
41-141-3
.
(2)
A health benefit plan under an insurance policy or other plan providing health care coverage in this state shall not include reimbursement for gender transition procedures for a person under eighteen (18) years of age.
(3)
A health benefit plan under an insurance policy or other plan providing health care coverage in this state is not required to provide coverage for gender transition procedures for a person under eighteen (18) years of age.
Added by Laws, 2023, ch. 303, HB 1125,§ 12, eff. 2/28/2023.
Mississippi Code 1972 (2023) › Title 83 - INSURANCE (§§ 83-1-1 — 83-NEW-004) › Chapter 9 - ACCIDENT, HEALTH AND MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-1 — 83-9-NEW-005) › ACCIDENT AND HEALTH INSURANCE (§§ 83-9-1 — 83-9-36.2) › Section 83-9-36.2 - Plan sponsor authorized to provide consent to electronic communications on behalf of covered persons; requirements

(1)
For the purposes of this section, the following words and phrases shall have the meanings as defined herein unless the context clearly indicates otherwise:
(a)
"Health benefit plan" means a policy, contract, certificate or agreement entered into, offered by or issued by an insurer to provide, deliver, arrange for, pay for or reimburse any of the costs of healthcare services, including a vision or dental benefit plan.
(b)
"Plan sponsor" means a person, other than a regulated entity, who establishes, adopts or maintains a health benefit plan that covers residents of this state, including a plan established, adopted or maintained by an employer or jointly by an employer and one or more employee organizations, an association, a committee, a joint board of trustees or any similar group of representatives who establish, adopt or maintain a plan.
(2)
The plan sponsor of a health benefit plan may, on behalf of covered persons in the plan, provide the consent required in Section
83-5-857
to the mailing of all communications related to the plan by electronic means.
(3)
Before consenting on behalf of a party, a plan sponsor shall confirm that the party routinely uses electronic communications during the normal course of employment.
(4)
Before providing delivery by electronic means, the insurer for the health benefit plan shall:
(a)
Provide the party an opportunity to opt out of delivery by electronic means; and
(b)
Document that the remaining conditions under Sections
83-5-857(b)
and Sections
83-5-859
,
83-5-861
,
83-5-867
and
83-5-869
are satisfied.
(5)
The Commissioner of Insurance may adopt rules to implement the provisions of this section.
Added by Laws, 2023, ch. 354, HB 1190,§ 1, eff. 7/1/2023.
Mississippi Code 1972 (2023) › Title 83 - INSURANCE (§§ 83-1-1 — 83-NEW-004) › Chapter 9 - ACCIDENT, HEALTH AND MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-1 — 83-9-NEW-005) › COVERAGE FOR TREATMENT OF MENTAL ILLNESS, TEMPOROMANDIBULAR JOINT DISORDER AND CRANIOMANDIBULAR DISORDER (§§ 83-9-37 — 83-9-46) › Section 83-9-37 - Definitions

As used in Sections
83-9-37
through
83-9-43
, Mississippi Code of 1972:
(a)
"Alternative delivery system" means a health maintenance organization (HMO), preferred provider organization (PPO), exclusive provider organization (EPO), individual practice association (IPA), medical staff hospital organization (MESH), physician hospital organization (PHO), and any other plan or organization which provides health care services through a mechanism other than insurance and is regulated by the State of Mississippi.
(b)
"Covered benefits" means the health care services or treatment available to an insured party under a health insurance policy for which the insurer will pay part or all of the costs.
(c)
"Hospital" means a facility licensed as a hospital by the Mississippi Department of Health.
(d)
"Health service provider" means a physician or psychologist who is authorized by the facility in which services are delivered to provide mental health services in an inpatient or outpatient setting, within his or her scope of licensure.
(e)
"Inpatient services" means therapeutic services which are available twenty-four (24) hours a day in a hospital or other treatment facility licensed by the State of Mississippi.
(f)
"Mental illness" means any psychiatric disease identified in the current edition of The International Classification of Diseases or The American Psychiatric Association Diagnostic and Statistical Manual.
(g)
"Outpatient services" means therapeutic services which are provided to a patient according to an individualized treatment plan which does not require the patient's full-time confinement to a hospital or other treatment facility licensed by the State of Mississippi. The term "outpatient services" refers to services which may be provided in a hospital, an outpatient treatment facility or other appropriate setting licensed by the State of Mississippi.
(h)
"Outpatient treatment facility" means
(i)
a clinic or other similar location which is certified by the State of Mississippi as a qualified provider of outpatient services for the treatment of mental illness or (ii) the office of a health service provider.
(i)
"Partial hospitalization" means inpatient treatment, other than full twenty-four-hour programs, in a treatment facility licensed by the State of Mississippi; the term includes day, night and weekend treatment programs.
(j)
"Physician" means a physician licensed by the State of Mississippi to practice therein.
(k)
"Psychologist" means a psychologist licensed by the State of Mississippi to practice therein.
Laws, 1991, ch. 570, § 1; reenacted without change by Laws, 1994, ch. 354, § 1, eff. 7/1/1994.
Mississippi Code 1972 (2023) › Title 83 - INSURANCE (§§ 83-1-1 — 83-NEW-004) › Chapter 9 - ACCIDENT, HEALTH AND MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-1 — 83-9-NEW-005) › COVERAGE FOR TREATMENT OF MENTAL ILLNESS, TEMPOROMANDIBULAR JOINT DISORDER AND CRANIOMANDIBULAR DISORDER (§§ 83-9-37 — 83-9-46) › Section 83-9-40 - [Repealed]

Laws, 2001, ch. 533, § 3, eff. 1/1/2002.
Repealed by Laws, 2014, ch. 308, SB 2331, 3, eff. 7/1/2014.
Mississippi Code 1972 (2023) › Title 83 - INSURANCE (§§ 83-1-1 — 83-NEW-004) › Chapter 9 - ACCIDENT, HEALTH AND MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-1 — 83-9-NEW-005) › COVERAGE FOR TREATMENT OF MENTAL ILLNESS, TEMPOROMANDIBULAR JOINT DISORDER AND CRANIOMANDIBULAR DISORDER (§§ 83-9-37 — 83-9-46) › Section 83-9-41 - Mental illness benefits

(1)
Covered benefits for services in this section shall be limited to coverage of treatment of clinically significant mental illness.
(2)
Treatment under this section shall be covered for a minimum of thirty (30) days per year for inpatient services, a minimum of sixty (60) days per year for partial hospitalization, and a minimum of fifty-two (52) outpatient visits per year.
(3)
The rate of payment for inpatient services, outpatient services, and partial hospitalization shall be the same as provided for any other condition.
Laws, 1991, ch. 570, § 3; reenacted without change by Laws, 1994, ch. 354, § 3; Laws, 2001, ch. 533, § 2, eff. 1/1/2002.
Amended by Laws, 2014, ch. 308, SB 2331, 2, eff. 7/1/2014.
Mississippi Code 1972 (2023) › Title 83 - INSURANCE (§§ 83-1-1 — 83-NEW-004) › Chapter 9 - ACCIDENT, HEALTH AND MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-1 — 83-9-NEW-005) › COVERAGE FOR TREATMENT OF MENTAL ILLNESS, TEMPOROMANDIBULAR JOINT DISORDER AND CRANIOMANDIBULAR DISORDER (§§ 83-9-37 — 83-9-46) › Section 83-9-43 - Nondiscrimination

Methods of determining levels of payment or reimbursement for services or for the type of facility charges eligible for payment or reimbursement pursuant to Sections
83-9-37
through
83-9-43
shall be consistent with those for medical illnesses in general and shall take into consideration customary charges for those services. Deductible or co-payment plans, methods of determination, and limits on total amounts payable to an individual in a calendar year or lifetime payment limits may be applied to benefits paid to or on behalf of patients during the course of treatment as described in Sections
83-9-37
through
83-9-43
, but in any case shall not be less favorable than those applied to medical illnesses generally in each policy or contract, except as provided under Section
83-9-41
, Mississippi Code of 1972.
Laws, 1991, ch. 570, § 5; reenacted without change by Laws, 1994, ch. 354, § 4, eff. 7/1/1994.
Mississippi Code 1972 (2023) › Title 83 - INSURANCE (§§ 83-1-1 — 83-NEW-004) › Chapter 9 - ACCIDENT, HEALTH AND MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-1 — 83-9-NEW-005) › COVERAGE FOR TREATMENT OF MENTAL ILLNESS, TEMPOROMANDIBULAR JOINT DISORDER AND CRANIOMANDIBULAR DISORDER (§§ 83-9-37 — 83-9-46) › Section 83-9-45 - Coverage and benefits for treatment of temporomandibular joint disorder and craniomandibular disorder

Except for policies which only provide coverage for specified diseases and other limited benefit health insurance policies, no policy or certificate of health, medical, hospitalization or accident and sickness insurance and no subscriber contract provided by a nonprofit health service plan corporation or health maintenance organization shall be issued, renewed, continued, issued for delivery or executed in this state after July 1, 1991, unless the policy, plan or contract specifically offers coverage for diagnostic and surgical treatment of temporomandibular joint disorder and craniomandibular disorder. Coverage for diagnostic services and surgery shall be the same as that for treatment to any other joint in the body and shall apply if the treatment is administered or prescribed by a physician or dentist. The minimum lifetime coverage for temporomandibular joint disorder and craniomandibular treatment shall be no less than Five Thousand Dollars ($5,000.00).
Laws, 1991, ch. 570, § 4; reenacted without change by Laws, 1994, ch. 354, § 5, eff. 7/1/1994.
Mississippi Code 1972 (2023) › Title 83 - INSURANCE (§§ 83-1-1 — 83-NEW-004) › Chapter 9 - ACCIDENT, HEALTH AND MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-1 — 83-9-NEW-005) › COVERAGE FOR TREATMENT OF MENTAL ILLNESS, TEMPOROMANDIBULAR JOINT DISORDER AND CRANIOMANDIBULAR DISORDER (§§ 83-9-37 — 83-9-46) › Section 83-9-46 - Diabetes treatment; coverage; service providers; enforcement; application to other policies

(1)
Except as otherwise provided herein, from and after January 1, 1999, all individual and group health insurance policies or plans, pooled risk policies and all other forms of managed/capitated care plans or policies regulated by the State of Mississippi shall offer coverage for diabetes treatments, including, but not limited to, equipment, supplies used in connection with the monitoring of blood glucose and insulin administration and self-management training/education and medical nutrition therapy in an outpatient, inpatient or home health setting. An amount of coverage not to exceed Two Hundred Fifty Dollars ($250.00) shall be offered annually for self-management training/education and medical nutrition therapy under this section. The coverage shall be offered on an optional basis, and each primary insured must accept or reject such coverage in writing and accept responsibility for premium payment. The coverage shall include treatment of all forms of diabetes, including, but not limited to, Type I, Type II, Gestational and all secondary forms of diabetes regardless of mode of treatment if such treatment is prescribed by a health care professional legally authorized to prescribe such treatment and regardless of the age of onset or duration of the disease. Such health insurance plans and policies shall not reduce, eliminate or delay coverage due to the requirements of this section.
(2)
The services provided in an outpatient, inpatient or home health setting shall be provided by a Certified Diabetes Educator (CDE), who is appropriately certified, licensed or registered to practice in the State of Mississippi. Medical nutrition therapy shall be provided by a Registered Dietician (RD) appropriately licensed to practice in the State of Mississippi. All services shall be based on nationally recognized standards including, but not limited to, the American Diabetes Association Practice Guidelines.
(3)
The benefits provided in this section shall be subject to the same annual deductibles or coinsurance established for all other covered benefits within a given policy.
(4)
The Commissioner of Insurance shall enforce the provisions of this section.
(5)
Nothing in this section shall apply to accident-only, specified disease, hospital indemnity, Medicare supplement, long-term care or other limited benefit health insurance policies.
Laws, 1998, ch. 483, § 1, eff. 1/1/1999.
Mississippi Code 1972 (2023) › Title 83 - INSURANCE (§§ 83-1-1 — 83-NEW-004) › Chapter 9 - ACCIDENT, HEALTH AND MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-1 — 83-9-NEW-005) › NOTICE OF PAYMENT FOR SERVICES MADE DIRECTLY TO PATIENT (§§ 83-9-47 — 83-9-53) › Section 83-9-47 - Third-party payors required to notify health care providers of payment for services made directly to patient

(1)
As used in this section, the following terms shall be defined as follows:
(a)
"Third-party payor" means any insurer, nonprofit hospital service plan, health care service plan, health maintenance organization, self-insurer or any person or other entity which provides payment for medical and related services.
(b)
"Health care provider" means a physician, optometrist, chiropractor, dentist, podiatrist, pharmacist, psychologist or hospital licensed by the State of Mississippi.
(c)
"Patient" means any natural person who has received medical care or services from any medical care provider within the State of Mississippi.
(2)
Any third-party payor who pays a patient or policyholder on behalf of a patient directly for medical care or services rendered by a health care provider shall provide information concerning the amount, date and nature of any such payment to the provider of services. The information may be provided by telephone, facsimile or by mailing a copy of the "explanation of benefits" to the provider. If the information is provided by sending a copy of the "explanation of benefits" to the provider, then the third-party payor may require that the reasonable cost of producing and mailing the information be paid by the provider. The requirements of this subsection shall not apply to the following: a fixed-indemnity policy, a limited benefit health insurance policy, medical payment coverage or personal injury protection coverage in a motor vehicle policy, coverage issued as a supplement to liability insurance or workers' compensation.
Laws, 1991, ch. 474, § 1, eff. 7/1/1991.
Mississippi Code 1972 (2023) › Title 83 - INSURANCE (§§ 83-1-1 — 83-NEW-004) › Chapter 9 - ACCIDENT, HEALTH AND MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-1 — 83-9-NEW-005) › NOTICE OF PAYMENT FOR SERVICES MADE DIRECTLY TO PATIENT (§§ 83-9-47 — 83-9-53) › Section 83-9-49 - Limit on exclusion of preexisting condition from health and accident insurance coverage; definition of preexisting condition; exceptions

(1)
Any group hospital, health or medical expense insurance policy, hospital or medical service contract, health and accident insurance policy or any other insurance contract of this type which is delivered or issued for delivery in this state on or after January 1, 1994, shall not deny, exclude or limit benefits for a covered individual for losses due to a preexisting condition incurred more than twelve (12) months following the effective date of the individual's coverage. Any group policy, contract or plan subject to this section shall not contain a definition of a preexisting condition more restrictive than the following:
(a)
A condition that would have caused an ordinary prudent person to seek medical advice, diagnosis, care or treatment during the six (6) months immediately preceding the effective date of coverage;
(b)
A condition for which medical advice, diagnosis, care or treatment was recommended or received during the six (6) months immediately preceding the effective date of coverage.
(2)
Any individual hospital, health or medical expense insurance policy, hospital or medical service contract, health and accident insurance policy or any other insurance contract of this type which is delivered or issued for delivery in this state on or after January 1, 1994, shall not deny, exclude or limit benefits for a covered individual for losses due to a preexisting condition incurred more than twelve (12) months following the effective date of the individual's coverage. Any individual policy, contract or plan subject to this section shall not contain a definition of a preexisting condition more restrictive than the following:
(a)
A condition that would have caused an ordinary prudent person to seek medical advice, diagnosis, care or treatment during the twelve (12) months immediately preceding the effective date of coverage;
(b)
A condition for which medical advice, diagnosis, care or treatment was recommended or received during the twelve (12) months immediately preceding the effective date of coverage;
(c)
A pregnancy existing on the effective date of coverage.
(3)
This section shall not apply to hospital daily indemnity plans, specified disease only policies, or other limited, supplemental benefit insurance policies.
Laws, 1993, ch. 492, § 2; Laws, 1997, ch. 340, § 1, eff. 7/1/1997.
Mississippi Code 1972 (2023) › Title 83 - INSURANCE (§§ 83-1-1 — 83-NEW-004) › Chapter 9 - ACCIDENT, HEALTH AND MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-1 — 83-9-NEW-005) › NOTICE OF PAYMENT FOR SERVICES MADE DIRECTLY TO PATIENT (§§ 83-9-47 — 83-9-53) › Section 83-9-53 - Authorization to establish rules and regulations

The Commissioner of Insurance may establish such rules and regulations as may be necessary or desirable to carry out Sections
83-9-47
through
83-9-53
.
Laws, 1993, ch. 492, § 4, eff. 7/1/1993.
Mississippi Code 1972 (2023) › Title 83 - INSURANCE (§§ 83-1-1 — 83-NEW-004) › Chapter 9 - ACCIDENT, HEALTH AND MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-1 — 83-9-NEW-005) › MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-101 — 83-9-115) › Section 83-9-101 - Definitions

As used in Sections
83-9-101
through
83-9-115
:
(a)
"Applicant" means:
(i)
In the case of an individual Medicare supplement policy, the person who seeks to contract for insurance benefits, and
(ii)
In the case of a group Medicare supplement policy, the proposed certificate holder.
(b)
"Certificate" means any certificate delivered or issued for delivery in this state under a group Medicare supplemental policy.
(c)
"Certificate form" means the form on which the certificate is delivered or issued for delivery by the issuer.
(d)
"Commissioner" means the Commissioner of Insurance of this state.
(e)
"Issuer" includes insurance companies, fraternal benefit societies, health care service plans, health maintenance organizations and any other entity delivering or issuing for delivery in this state Medicare supplement policies or certificates.
(f)
"Medicare supplement policy" means a group or individual policy of accident and health insurance, or a subscriber contract of hospital and medical service associations or health maintenance organizations, other than a policy issued pursuant to a contract under Section 1876 of the federal Social Security Act, or an issued policy under a demonstration project specified in 42 USCS Section 1395ss(g)(1), which is advertised, marketed or designed primarily as a supplement to reimbursements under Medicare for the hospital, medical or surgical expenses of persons eligible for Medicare.
(g)
"Medicare" means the "Health Insurance for the Aged Act," Title XVIII of the Social Security Amendments of 1965, as then constituted or later amended.
(h)
"Policy form" means the form on which the policy is delivered or issued for delivery by the issuer.
Laws, 1981, ch. 433, § 1; Laws, 1992, ch. 337 § 1; Laws, 1996, ch. 321, § 1, eff. 3/17/1996.
Mississippi Code 1972 (2023) › Title 83 - INSURANCE (§§ 83-1-1 — 83-NEW-004) › Chapter 9 - ACCIDENT, HEALTH AND MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-1 — 83-9-NEW-005) › MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-101 — 83-9-115) › Section 83-9-102 - Applicability of provisions

(1)
Sections
83-9-101
through
83-9-115
shall apply to:
(a)
All Medicare supplement policies delivered or issued for delivery in this state on or after April 20, 1992, and
(b)
All certificates issued under group Medicare supplement policies, which certificates have been delivered or issued for delivery in this state.
(2)
Sections
83-9-101
through
83-9-115
shall not apply to a policy of one or more employers or labor organizations, or of the trustees of a fund established by one or more employers or labor organizations, or combination thereof, for employees or former employees or a combination thereof, or for members or former members, or a combination thereof, of the labor organizations.
(3)
Except as otherwise specifically provided in Section
83-9-109(4)
, Sections
83-9-101
through
83-9-115
are not intended to prohibit or apply to insurance policies or health care benefit plans, including group conversion policies, provided to Medicare eligible persons which policies are not marketed or held to be Medicare supplement policies or benefit plans.
Laws, 1992, ch. 337 § 2; Laws, 1996, ch. 321, § 2, eff. 3/17/1996.
Mississippi Code 1972 (2023) › Title 83 - INSURANCE (§§ 83-1-1 — 83-NEW-004) › Chapter 9 - ACCIDENT, HEALTH AND MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-1 — 83-9-NEW-005) › MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-101 — 83-9-115) › Section 83-9-103 - Regulations to be issued by commissioner

(1)
The commissioner shall adopt reasonable regulations to establish specific standards for policy provisions of Medicare supplement policies and certificates. Such standards shall be in addition to and in accordance with applicable laws of this state including Sections
83-9-1
through
83-9-21
, Mississippi Code of 1972. No requirement of the insurance code relating to minimum required policy benefits, other than the minimum standards contained in Sections
83-9-101
through
83-9-115
, shall apply to Medicare supplement policies and certificates. The standards may cover, but not be limited to:
(a)
Terms of renewability;
(b)
Initial and subsequent conditions of eligibility;
(c)
Nonduplication of coverage;
(d)
Probationary periods;
(e)
Benefit limitations, exceptions and reductions;
(f)
Elimination periods;
(g)
Requirements for replacement;
(h)
Recurrent conditions; and
(i)
Definitions of terms.
(2)
The commissioner may adopt reasonable regulations that specify prohibited policy provisions not otherwise specifically authorized by statute which, in the opinion of the commissioner, are unjust, unfair or unfairly discriminatory to any person insured or proposed to be insured under a Medicare supplement policy or certificate.
(3)
Notwithstanding any other provisions of law, a Medicare supplement policy or certificate shall not exclude or limit benefits for losses incurred more than six (6) months from the effective date of coverage because it involved a preexisting condition. The policy or certificate shall not define a preexisting condition more restrictively than a condition for which medical advice was given or treatment was recommended by or received from a physician within six (6) months before the effective date of coverage.
(4)
The commissioner may adopt such reasonable regulations as are necessary to conform Medicare supplement policies and certificates to the requirements of federal law and regulations promulgated thereunder, including but not limited to:
(a)
Requiring refunds or credits if the policies or certificates do not meet loss ratio requirements;
(b)
Establishing a uniform methodology for calculating and reporting loss ratios;
(c)
Assuring public access to policies, premiums and loss ratio information of issuers of Medicare supplement insurance;
(d)
Establishing a process for approving or disapproving policy forms and certificate forms and proposed premium increases; and
(e)
Establishing a policy for holding public hearings prior to approval of premium increases.
(5)
No Medicare supplement policy or certificate in force in the State shall contain benefits that duplicate benefits provided by Medicare.
Laws, 1981, ch. 433, § 2; Laws, 1992, ch. 337 § 3, eff. 4/20/1992.
Mississippi Code 1972 (2023) › Title 83 - INSURANCE (§§ 83-1-1 — 83-NEW-004) › Chapter 9 - ACCIDENT, HEALTH AND MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-1 — 83-9-NEW-005) › MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-101 — 83-9-115) › Section 83-9-105 - Adoption of minimum standards for benefits; claim payments, etc

The commissioner shall adopt reasonable regulations to establish minimum standards for benefits, claims payment, marketing practices and compensation arrangements and reporting practices for Medicare supplement policies and certificates.
Laws, 1981, ch. 433, § 3; Laws, 1992, ch. 337 § 4, eff. 4/20/1992.
Mississippi Code 1972 (2023) › Title 83 - INSURANCE (§§ 83-1-1 — 83-NEW-004) › Chapter 9 - ACCIDENT, HEALTH AND MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-1 — 83-9-NEW-005) › MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-101 — 83-9-115) › Section 83-9-106 - Minimum reserves for accident and health insurance companies

The Commissioner of Insurance shall establish regulations setting forth standards to provide minimum reserves for accident and health insurance companies, including nonprofit hospital, medical and surgical service corporations.
Laws, 1992, ch. 426, § 1, eff. 7/1/1992.
Mississippi Code 1972 (2023) › Title 83 - INSURANCE (§§ 83-1-1 — 83-NEW-004) › Chapter 9 - ACCIDENT, HEALTH AND MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-1 — 83-9-NEW-005) › MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-101 — 83-9-115) › Section 83-9-107 - Minimum standards for loss ratios

Medicare supplement policies shall return to policyholders benefits which are reasonable in relation to the premium charged. The commissioner shall issue reasonable regulations to establish minimum standards for loss ratios of Medicare supplement policies on the basis of incurred claims experience, or incurred health care expenses when coverage is provided by a health maintenance organization on a service rather than reimbursement basis, and earned premiums in accordance with accepted actuarial principles and practices.
Laws, 1981, ch. 433, § 4; Laws, 1992, ch. 337 § 5, eff. 4/20/1992.
Mississippi Code 1972 (2023) › Title 83 - INSURANCE (§§ 83-1-1 — 83-NEW-004) › Chapter 9 - ACCIDENT, HEALTH AND MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-1 — 83-9-NEW-005) › MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-101 — 83-9-115) › Section 83-9-108 - Mammography; optional coverage; written acceptance or rejection; application of section

(1)
Every insurer shall offer in each group or individual policy, contract or certificate of health insurance issued or renewed for persons who are residents of this state, coverage for annual screenings by low-dose mammography for all women thirty-five (35) years of age or older for the presence of occult breast cancer within the provisions of the policy, contract or certificate. This coverage shall be offered on an optional basis, and each primary insured must accept or reject such coverage in writing and accept responsibility for premium payment.
(2)
Such benefits shall be at least as favorable as for other radiological examinations and subject to the same dollar limits, deductibles and coinsurance factors. For purposes of this section, "low-dose mammography" means the X-ray examination of the breast using equipment dedicated specifically for mammography, including the X-ray tube, filter, compression device, screens, films and cassettes with a radiation exposure which is diagnostically valuable and in keeping with the recommended "Average Patient Exposure Guides" as published by the Conference of Radiation Control Program Directors, Inc.
(3)
Except for cancer policies, nothing in this section shall apply to accident-only, specified disease, hospital indemnity, Medicare supplement, long-term care or limited benefit health insurance policies.
(4)
The provisions of Section 10 of this act shall be applicable to the coverage for mammography screenings provided by insurers under the provisions of this section.
Laws, 1998, ch. 483, § 3, eff. 1/1/1999.
Amended by Laws, 2024, ch. 432, SB 2858,§ 11, eff. 7/1/2024.
Mississippi Code 1972 (2023) › Title 83 - INSURANCE (§§ 83-1-1 — 83-NEW-004) › Chapter 9 - ACCIDENT, HEALTH AND MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-1 — 83-9-NEW-005) › MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-101 — 83-9-115) › Section 83-9-109 - Outline of coverage

(1)
In order to provide for full and fair disclosure in the sale of Medicare supplement policies, no Medicare supplement policy or certificate shall be delivered in this state unless an outline of coverage is delivered to the applicant at the time application is made.
(2)
The commissioner shall prescribe the format and content of the outline of coverage required by subsection (1). For purposes of this section, "format" means style, arrangement and overall appearance, including such items as the size, color and prominence of type and the arrangement of text and captions. Such outline of coverage shall include:
(a)
A description of the principal benefits and coverage provided in the policy;
(b)
A statement of the renewal provisions including any reservation by the insurer of a right to change premiums and disclosure of any automatic renewal premium increases based on the policyholder's age;
(c)
A statement that the outline of coverage is a summary of the policy issued or applied for and that the policy should be consulted to determine governing contractual provisions.
(3)
The commissioner may prescribe by regulation a standard form and the contents of an informational brochure for persons eligible for Medicare which is intended to improve the buyer's ability to select the most appropriate coverage and improve the buyer's understanding of Medicare. Except in the case of direct response insurance policies, the commissioner may require by regulation that the informational brochure be provided to any prospective insureds eligible for Medicare concurrently with delivery of the outline of coverage. With respect to direct response insurance policies, the commissioner may require by regulation that the prescribed brochure be provided upon request to any prospective insureds eligible for Medicare, but in no event later than the time of policy delivery.
(4)
The commissioner may adopt regulations for captions or notice requirements, determined to be in the public interest and designed to inform prospective insureds that particular insurance coverages are not Medicare supplement coverages, for all accident and health insurance policies sold to persons eligible for Medicare other than:
(a)
Medicare supplement policies; or
(b)
Disability income policies.
(5)
The commissioner may adopt reasonable regulations to govern the full and fair disclosure of information in connection with the replacement of accident and health policies, subscriber contracts or certificates by persons eligible for Medicare.
Laws, 1981, ch. 433, § 5; Laws, 1992, ch. 337 § 6; Laws, 1996, ch. 321, § 3, eff. 3/17/1996.
Mississippi Code 1972 (2023) › Title 83 - INSURANCE (§§ 83-1-1 — 83-NEW-004) › Chapter 9 - ACCIDENT, HEALTH AND MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-1 — 83-9-NEW-005) › MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-101 — 83-9-115) › Section 83-9-110 - Review and approval of advertising by commissioner

(1)
Every issuer of Medicare supplement insurance policies or certificates in this state shall provide a copy of any Medicare supplement advertisement intended for use in this state, whether through written, radio or television medium, to the commissioner for review and approval.
(2)
An issuer may not make or cause to be made a telephone solicitation, as that term is defined in Section
77-3-705
, for the purpose of advertising the sale or soliciting the purchase of a Medicare supplement policy or certificate. This subsection (2) shall not apply to the extent it is preempted under
42 USC Section 1395w-26(b)(3)
.
Laws, 1992, ch. 337 § 7, eff. 4/20/1992.
Amended by Laws, 2024, ch. 453, HB 1350,§ 7, eff. 7/1/2024.
Mississippi Code 1972 (2023) › Title 83 - INSURANCE (§§ 83-1-1 — 83-NEW-004) › Chapter 9 - ACCIDENT, HEALTH AND MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-1 — 83-9-NEW-005) › MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-101 — 83-9-115) › Section 83-9-111 - Right to return policy or certificate

Medicare supplement policies or certificates shall have a notice prominently printed on the first page of the policy or certificate or attached thereto stating in substance that the applicant shall have the right to return the policy or certificate within thirty (30) days of its delivery and to have the premium refunded if, after examination of the policy or certificate, the applicant is not satisfied for any reason. Any refund made pursuant to this section shall be paid directly to the applicant by the issuer in a timely manner.
Laws, 1981, ch. 433, § 6; Laws, 1992, ch. 337 § 8, eff. 4/20/1992.
Mississippi Code 1972 (2023) › Title 83 - INSURANCE (§§ 83-1-1 — 83-NEW-004) › Chapter 9 - ACCIDENT, HEALTH AND MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-1 — 83-9-NEW-005) › MEDICARE SUPPLEMENT INSURANCE (§§ 83-9-101 — 83-9-115) › Section 83-9-112 - Penalty for issuers violating statutory provisions

In addition to any other applicable penalties for violations of the insurance code, the commissioner may require issuers violating any provision of Sections
83-9-101
through
83-9-115
or regulations promulgated pursuant to Sections
83-9-101
through
83-9-115
to cease marketing any Medicare supplement policy or certificate in this state which is related directly or indirectly to a violation or may require such issuer to take such actions as are necessary to comply with the provisions of Sections
83-9-101
through
83-9-115
, or both.
Laws, 1992, ch. 337 § 9, eff. 4/20/1992.