Mississippi HB 1725: Medicaid; seek federal waiver for plan to allow Medicaid coverage for persons described in the federal Affordable Care Act.

Bill Text

HB1725_S_Cmte_Amend_01 

Adopted

COMMITTEE AMENDMENT NO 1 
PROPOSED TO

House Bill No. 1725

BY: Committee

���� Amend by striking all 
after the enacting clause and inserting in lieu thereof the following:

���� SECTION 1.� (1) 
�The Office of the Governor, Division of Medicaid, shall 
enter into negotiations with the Centers for Medicare and Medicaid Services (CMS) 
to obtain a waiver for applicable provisions of the Medicaid laws and regulations 
under Section 1115 of the Social Security Act to create a plan to allow Medicaid 
coverage in Mississippi for individuals described in this act, which contains 
the following provisions:

���� ���� (a) �Coverage group. �Individuals 
eligible for coverage under this section shall be persons who are not less than 
nineteen (19) years of age but less than sixty-five (65) years of age, who currently 
reside in households that have an income of less than one hundred percent (100%) 
of federal poverty level, who are:

���� ���� ���� (i) �Employed for at 
least one hundred twenty (120) hours per month in a position for which health insurance 
is not paid for by the employer;

���� ���� ���� (ii) �Enrolled as a 
full-time student in secondary or post-secondary education;

���� ���� ���� (iii) �Enrolled full-time 
in a workforce training program;

���� ���� ���� (iv) �Enrolled for 
at least six (6) credit hours, or its equivalent, as a student in secondary education, 
post-secondary education, or a workforce training program and is employed for at 
least sixty (60) hours per month in a position for which health insurance is not 
paid for by the employer; 

���� ���� ���� (v) �The parent or 
guardian and the primary caregiver of a child under six (6) years of age; 

���� ���� ���� (vi) �A person who 
is physically, mentally or intellectually unable to meet the requirements of subparagraphs 
(i) through (iv) of this paragraph (a) as documented by a medical professional; 
or

���� ���� ���� (vii) �The primary 
caregiver for a disabled child, spouse or parent, provided that such disabled person 
qualifies for Medicaid coverage in accordance with the federal Social Security Act.

���� ���� (b) �Beneficiary enrollment. 
�Any individual otherwise eligible for coverage under this section who has 
health insurance coverage through his or her employer or through private health 
insurance and who voluntarily disenrolls from that health insurance coverage 
shall not be in the coverage group until twelve (12) months after the ending date 
of that coverage. �The coverage group shall not include non-United States 
citizens who are ineligible for Medicaid benefits. �The division shall verify eligibility 
of each beneficiary in this coverage group no less than on a quarterly basis. �The 
division may consider seasonal or part-time employees who are cumulatively employed 
for an average of one hundred twenty (120) hours per month over a twelve-month period 
as satisfying the work requirements of subsection (1)(a)(i) of this section.

���� The division shall provide 
qualified providers with such forms as are necessary for an individual in the 
coverage group to make application for Medicaid and information on how to 
assist such individuals in completing and filing such forms. �The division shall 
make those application forms and the application process itself as simple as 
possible. �In addition to the efforts of the division, the Department of Health 
shall administer a public awareness program regarding the coverage and 
eligibility offered in accordance with this act. �Such program shall promote 
public awareness of the coverage offered in accordance with this act to ensure 
that all eligible citizens of the State of Mississippi are aware of and have 
the opportunity to apply for eligibility.

���� ���� (c) �Delivery systems. �All individuals in the coverage 

group shall be enrolled in and their 
services shall be provided by 

the managed care organizations 
(MCOs), coordinated care

organizations (CCOs), provider-sponsored 
health plans (PSHPs) and 

other such organizations paid for 
services to the Medicaid 

population on a capitated basis 
by the division as described in 

Section 43-13-117(H).

���� ���� (d)� Benefit packages.� 
Individuals enrolled under this act who are not less 
than nineteen (19) years of age but less than sixty five (65) years of age shall 
be provided essential health services as determined by the division, which shall, 
at a minimum, include ambulatory patient services, emergency services, hospitalization, 
prescription drugs, rehabilitative services, laboratory services, primary care services, 
preventive and wellness services and chronic disease management. 

���� ���� (e)� Funding of the 
plan.� (i)� The Section 1115 waiver described in this section shall describe 
the funding for this act, which shall be a combination of state matching funds 
and federal matching funds in the proportions specified under the federal 
Affordable Care Act at the time