Mississippi HB 794: Medicaid; expand eligibility for certain persons to receive services through provider sponsored health plan.

Bill Text

HB 794 (As Introduced) - 2021 Regular Session 

MISSISSIPPI LEGISLATURE

2021 Regular Session

To: Medicaid; Rules

By: Representative Scoggin

House Bill 794

AN ACT TO AMEND SECTION 43-13-115, MISSISSIPPI CODE OF 1972, 
TO PROVIDE MEDICAID COVERAGE FOR INDIVIDUALS WHO ARE AT LEAST 19 YEARS OF AGE 
BUT UNDER 65 YEARS OF AGE AND WHOSE INCOME DOES NOT EXCEED 138% OF THE FEDERAL 
POVERTY LEVEL, WHO SATISFY THE CRITERIA OF A WAIVER APPROVED BY THE CENTERS FOR 
MEDICARE AND MEDICAID SERVICES TO RECEIVE SPECIFIC BENEFITS INCLUDING CARE 
COORDINATION SERVICES PROVIDED BY A PROVIDER SPONSORED HEALTH PLAN AS DEFINED 
BY MISSISSIPPI LAW AND WHOSE BENEFITS ARE PROVIDED AT NO LESS THAN A 90% 
FEDERAL MEDICAL ASSISTANCE PERCENTAGE WITH THE REMAINDER OF NEEDED FUNDS 
CONTRIBUTED BY THE INDIVIDUAL AND THROUGH HOSPITAL TAXES; AND FOR RELATED 
PURPOSES.

���� BE IT ENACTED BY THE 
LEGISLATURE OF THE STATE OF MISSISSIPPI:

���� SECTION 1.� Section 
43-13-115, Mississippi Code of 1972, is amended as follows:

���� 43-13-115.� Recipients of 
Medicaid shall be the following persons only:

��������� (1)� Those who are 
qualified for public assistance grants under provisions of Title IV-A and E of 
the federal Social Security Act, as amended, including those statutorily deemed 
to be IV-A and low-income families and children under Section 1931 of 
the federal Social Security Act.� For the purposes of this paragraph (1) and 
paragraphs (8), (17) and (18) of this section, any reference to Title IV-A or 
to Part A of Title IV of the federal Social Security Act, as amended, or the 
state plan under Title IV-A or Part A of Title IV, shall be considered as a 
reference to Title IV-A of the federal Social Security Act, as amended, and the 
state plan under Title IV-A, including the income and resource standards and 
methodologies under Title IV-A and the state plan, as they existed on July 16, 
1996.� The Department of Human Services shall determine Medicaid eligibility 
for children receiving public assistance grants under Title IV-E.� The division 
shall determine eligibility for low-income families under Section 1931 
of the federal Social Security Act and shall redetermine eligibility for those 
continuing under Title IV-A grants.

��������� (2)� Those qualified 
for Supplemental Security Income (SSI) benefits under Title XVI of the federal 
Social Security Act, as amended, and those who are deemed SSI eligible as 
contained in federal statute.� The eligibility of individuals covered in this 
paragraph shall be determined by the Social Security Administration and 
certified to the Division of Medicaid.

��������� (3)� Qualified pregnant 
women who would be eligible for Medicaid as a low-income family member 
under Section 1931 of the federal Social Security Act if her child were born.� 
The eligibility of the individuals covered under this paragraph shall be 
determined by the division.

��������� (4)� [Deleted]

��������� (5)� A child born on or 
after October 1, 1984, to a woman eligible for and receiving Medicaid under the 
state plan on the date of the child's birth shall be deemed to have applied for 
Medicaid and to have been found eligible for Medicaid under the plan on the 
date of that birth, and will remain eligible for� Medicaid for a period of one 
(1) year so long as the child is a member of the woman's household and the 
woman remains eligible for Medicaid or would be eligible for Medicaid if 
pregnant.� The eligibility of individuals covered in this paragraph shall be 
determined by the Division of Medicaid.

��������� (6)� Children certified 
by the State Department of Human Services to the Division of Medicaid of whom 
the state and county departments of human services have custody and financial 
responsibility, and children who are in adoptions subsidized in full or part by 
the Department of Human Services, including special needs children in non-Title 
IV-E adoption assistance, who are approvable under Title XIX of the Medicaid 
program.� The eligibility of the children covered under this paragraph shall be 
determined by the State Department of Human Services.

��������� (7)� Persons certified 
by the Division of Medicaid who are patients in a medical facility (nursing 
home, hospital, tuberculosis sanatorium or institution for treatment of mental 
diseases), and who, except for the fact that they are patients in that medical 
facility, would qualify for grants under Title IV, Supplementary Security 
Income (SSI) benefits under Title XVI or state supplements, and those aged, 
blind and disabled persons who would not be eligible for Supplemental Security 
Income (SSI) benefits under Title XVI or state supplements if they were not 
institutionalized in a medical facility but whose income is below the maximum 
standard set by the Division of Medicaid, which standard shall not exceed that 
prescribed by federal regulation.

��������� (8)� Children under 
eighteen (18) years of age and pregnant women (including thos