Mississippi SB 2735: Medicaid; make various amendments to the provisions of the program.

Bill Text

S. B. No. 2735 *SS08/R1040CS* ~ OFFICIAL ~ G1/2
26/SS08/R1040CS
PAGE 1

To: Medicaid
MISSISSIPPI LEGISLATURE REGULAR SESSION 2026

By: Senator(s) Blackwell

COMMITTEE SUBSTITUTE
FOR
SENATE BILL NO. 2735

AN ACT TO AMEND SECTION 43-13-115, MISSISSIPPI CODE OF 1972, 1
TO MAKE CERTAIN TECHNICAL AMENDMENTS TO THE PROVISIONS THAT 2
PROVIDE FOR MEDICAID ELIGIBILITY AND TO MODIFY AGE AND INCOME AND 3
ELIGIBILITY CRITERIA TO REFLECT THE CURRENT CRITERIA; TO PROVIDE 4
THAT MEN OF REPRODUCTIVE AGE ARE ELIGIBLE UNDER THE FAMILY 5
PLANNING PROGRAM; TO CONFORM WITH FEDERAL LAW TO ALLOW CHILDREN IN 6
FOSTER CARE TO BE ELIGIBLE UNTIL THEIR 26TH BIRTHDAY; TO ELIMINATE 7
THE REQUIREMENT THAT THE DIVISION MUST APPLY TO CMS FOR WAIVERS TO 8
PROVIDE SERVICES FOR CERTAIN INDIVIDUALS WHO ARE END STAGE RENAL 9
DISEASE PATIENTS ON DIALYSIS, CANCER PATIENTS ON CHEMOTHERAPY OR 10
ORGAN TRANSPLANT RECIPIENTS ON ANTIREJECTION DRUGS; TO AMEND 11
SECTION 43-13-117, MISSISSIPPI CODE OF 1972, TO MAKE CERTAIN 12
TECHNICAL AMENDMENTS TO THE PROVISIONS THAT PROVIDE FOR MEDICAID 13
SERVICES TO COMPLY WITH FEDERAL LAW; TO ENABLE RURAL HOSPITALS TO 14
ELECT AGAINST REIMBURSEMENT FOR OUTPATIENT HOSPITAL SERVICES USING 15
THE AMBULATORY PAYMENT CLASSIFICATION (APC) METHODOLOGY; TO 16
AUTHORIZE THE DIVISION TO MAKE PAYMENT TO NURSING FACILITIES AND 17
TO INTERMEDIATE CARE FACILITIES FOR EACH DAY, NOT EXCEEDING 21 18
DAYS PER YEAR FOR NURSING FACILITIES OR 31 DAYS PER YEAR FOR 19
INTERMEDIATE CARE FACILITIES, THAT A PATIENT IS ABSENT FROM THE 20
FACILITY ON HOME LEAVE; TO REQUIRE THE DIVISION TO UPDATE THE 21
CASE-MIX PAYMENT SYSTEM AND FAIR RENTAL REIMBURSEMENT SYSTEM AS 22
NECESSARY TO MAINTAIN COMPLIANCE WITH FEDERAL LAW; TO AUTHORIZE 23
THE DIVISION TO IMPLEMENT A QUALITY OR VALUE-BASED COMPONENT TO 24
THE NURSING FACILITY PAYMENT SYSTEM; TO REQUIRE THE DIVISION TO 25
REIMBURSE PEDIATRICIANS FOR CERTAIN PRIMARY CARE SERVICES AS 26
DEFINED BY THE DIVISION AT 100% OF THE RATE ESTABLISHED UNDER 27
MEDICARE; TO AUTHORIZE THE DIVISION TO REIMBURSE AMBULATORY 28
SURGICAL CARE (ASC) BASED ON 85% OF THE MEDICARE ASC PAYMENT 29
SYSTEM RATE IN EFFECT JULY 1 OF EACH YEAR AS SET BY CMS; TO 30
PROVIDE THAT THE DIVISION MAY DEVELOP ALTERNATIVE MODELS FOR 31
DISTRIBUTION OF MEDICAL CLAIMS AND SUPPLEMENTAL PAYMENTS FOR 32
INPATIENT AND OUTPATIENT HOSPITAL SERVICES; TO AUTHORIZE THE 33
DIVISION TO CONTRACT WITH THE STATE DEPARTMENT OF HEALTH TO 34

S. B. No. 2735 *SS08/R1040CS* ~ OFFICIAL ~
26/SS08/R1040CS
PAGE 2
ST: Medicaid; make various amendments to the
provisions of the program.
PROVIDE FOR A PERINATAL HIGH RISK-MANAGEMENT/INFANT SERVICES 35
SYSTEM FOR ANY ELIGIBLE BENEFICIARY THAT CANNOT RECEIVE SUCH 36
SERVICES UNDER A DIFFERENT PROGRAM; TO AUTHORIZE THE DIVISION TO 37
REIMBURSE FOR SERVICES AT CERTIFIED COMMUNITY BEHAVIORAL HEALTH 38
CENTERS; TO DELETE THE PROVISION OF LAW THAT PROVIDES THAT THE 39
DIVISION SHALL REIMBURSE FOR OUTPATIENT HOSPITAL SERVICES PROVIDED 40
TO ELIGIBLE MEDICAID BENEFICIARIES UNDER THE AGE OF 21 YEARS BY 41
BORDER CITY UNIVERSITY-AFFILIATED PEDIATRIC TEACHING HOSPITALS, 42
WHICH WAS REPEALED BY OPERATION OF LAW IN 2024; TO REDUCE THE 43
LENGTH OF NOTICE THE DIVISION MUST PROVIDE THE MEDICAID COMMITTEE 44
CHAIRMEN FOR PROPOSED RATE CHANGES AND TO PROVIDE THAT SUCH 45
LEGISLATIVE NOTICE MAY BE EXPEDITED; TO AUTHORIZE THE DIVISION, 46
EFFECTIVE JULY 1, 2027, TO REIMBURSE AMBULANCE TRANSPORTATION 47
SERVICE PROVIDERS THAT PROVIDE AN ASSESSMENT, TRIAGE OR TREATMENT 48
FOR ELIGIBLE MEDICAID BENEFICIARIES; TO SET CERTAIN REIMBURSEMENT 49
LEVELS FOR SUCH PROVIDERS; TO DELETE THE DATE OF THE REPEALER ON 50
SUCH SECTION; TO AMEND SECTION 43-13-121, MISSISSIPPI CODE OF 51
1972, TO AUTHORIZE THE DIVISION TO EXTEND ITS MEDICAID ENTERPRISE 52
SYSTEM AND FISCAL AGENT SERVICES, INCLUDING ALL RELATED COMPONENTS 53
AND SERVICES, CONTRACTS IN EFFECT ON JUNE 30, 2026, FOR ADDITIONAL 54
CONTRACT PERIODS AT THE DISCRETION OF THE DIVISION; TO AUTHORIZE 55
THE DIVISION TO ENTER INTO A TWO-YEAR CONTRACT ENDING NO LATER 56
THAN JUNE 30, 2028, WITH A VENDOR TO PROVIDE SUPPORT OF THE 57
DIVISION'S ELIGIBILITY SYSTEM; TO REDUCE THE LENGTH OF NOTICE THE 58
DIVISION MUST PROVIDE THE MEDICAID COMMITTEE CHAIRMEN FOR A 59
PROPOSED STATE PLAN AMENDMENT AND TO PROVIDE THAT SUCH LEGISLATIVE 60
NOTICE MAY BE EXPEDITED; TO AMEND SECTION 43-13-305, MISSISSIPPI 61
CODE OF 1972, TO PROVIDE THAT WHEN A THIRD PARTY PAYOR REQUIRES 62
PRIOR AUTHORIZATION FOR AN ITEM OR SERVICE FURNISHED TO A MEDICAID 63
RECIPIENT, THE PAYOR SHALL ACCEPT AUTHORIZATION PROVIDED BY THE 64
DIVISION OF MEDICAID THAT THE ITEM OR SERVICE IS COVERED UNDER THE 65
STATE PLAN AS IF SUCH AUTHORIZATION WERE THE PRIOR AUTHORIZATION 66
MADE BY THE THIRD PARTY PAYOR FOR SUCH ITEM OR SERVICE; TO AMEND 67
SECTION 43-13-117.7, MISSISSIPPI CODE OF 1972, TO PROVIDE THAT THE 68
DIVISION SHALL NOT REIMBURSE OR PROVIDE COVERAGE FOR GENDER 69
TRANSITION PROCEDURES FOR ANY PERSON; TO AMEND SECTION 43-13-145, 70
MIS