MISSISSIPPI LEGISLATURE

1998 Regular Session

To: Insurance

By: Representative Howell

AN ACT TO AMEND SECTION 83-41-317, MISSISSIPPI CODE OF 1972, TO REQUIRE EACH HEALTH MAINTENANCE ORGANIZATION THAT HAS A CONTRACT WITH THE STATE OF MISSISSIPPI TO PROVIDE HEALTH CARE SERVICES TO RESIDENTS OF MISSISSIPPI THROUGH A MANAGED CARE PLAN TO FILE AN ANNUAL REPORT WITH THE INSURANCE COMMISSIONER THAT LISTS ALL OF THE EXPENDITURES AND RECEIPTS RELATED TO THE MANAGED CARE PLAN DURING THE PRECEDING CALENDAR YEAR; TO AMEND SECTION 83-41-415, MISSISSIPPI CODE OF 1972, IN CONFORMITY TO THE PRECEDING PROVISION; AND FOR RELATED PURPOSES. 

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

SECTION 1. Section 83-41-317, Mississippi Code of 1972, is amended as follows:

83-41-317. (1) Every health maintenance organization shall annually, on or before the first day of March, file a report verified by at least two principal officers with the commissioner, with a copy to the State Health Officer, covering the preceding calendar year. Such report shall be on and in accordance to the National Association of Insurance Commissioner's Annual Statement Blanks and Instruction thereto and the NAIC Accounting Practices and Procedures Manual. The health maintenance organization shall file by the first day of March of each year, unless otherwise stated:

(a) Audited financial statements on or before June 1;

(b) A list of the providers who have executed a contract that complies with Section 83-41-325(12); and

(c) (i) A description of the grievance procedures, and

(ii) The total number of grievances handled through such procedures, a compilation of the causes underlying those grievances, and a summary of the final disposition of those grievances.

(2) In addition to the report required under subsection (1) of this section, each health maintenance organization that has a contract with the State of Mississippi or any agency, department or institution of the state to provide health care services to residents of Mississippi through a managed care plan, as defined in Section 83-41-403, shall file a report annually with the commissioner, the State Health Officer and the Legislative Budget Office, on or before the first day of March, that lists all of the expenditures and receipts related to the managed care plan during the preceding calendar year.

(3) The commissioner may require such additional reports as are deemed necessary and appropriate to enable the commissioner to carry out his duties and responsibilities under this article.

SECTION 2. Section 83-41-415, Mississippi Code of 1972, is amended as follows:

83-41-415. Articles 7 and 9 do not apply to the Division of Medicaid in the Office of the Governor. However, this section does not exempt any health maintenance organization from filing the report required under Section 83-41-317(2) if the health maintenance organization's contract is with the Division of Medicaid for providing health care services to Medicaid recipients.

SECTION 3. This act shall take effect and be in force from and after July 1, 1998.