MISSISSIPPI LEGISLATURE
2005 Regular Session
To: Medicaid
By: Representative Wells-Smith
AN ACT TO BRING FORWARD SECTIONS 41-86-1, 41-81-3, 41-86-5, 41-86-7, 41-86-9, 41-86-11, 41-86-13, 41-86-15, 41-86-17, 41-86-19 AND 41-86-21, MISSISSIPPI CODE OF 1972, WHICH ARE THE MISSISSIPPI CHILDREN'S HEALTH CARE ACT (THE CHIP PROGRAM); AND FOR RELATED PURPOSES.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:
SECTION 1. Section 41-86-1, Mississippi Code of 1972, is brought forward as follows:
41-86-1. This chapter shall be known as and may be cited as the Mississippi Children's Health Care Act.
SECTION 2. Section 41-81-3, Mississippi Code of 1972, is brought forward as follows:
41-81-3. The State Department of Health is authorized to enter into contracts with and provide grants to health care providers in order to implement a statewide regionalization program.
SECTION 3. Section 41-86-5, Mississippi Code of 1972, is brought forward as follows:
41-86-5. As used in Sections 41-86-5 through 41-86-17, the following definitions shall have the meanings ascribed in this section, unless the context indicates otherwise:
(a) "Act" means the Mississippi Children's Health Care Act.
(b) "Administering agency" means the agency designated by the Mississippi Children's Health Insurance Program Commission to administer the program.
(c) "Board" means the State and Public School Employees Health Insurance Management Board created under Section 25-15-303.
(d) "Child" means an individual who is under nineteen (19) years of age who is not eligible for Medicaid benefits and is not covered by other health insurance.
(e) "Commission" means the Mississippi Children's Health Insurance Program Commission created by Section 41-86-7.
(f) "Covered benefits" means the types of health care benefits and services provided to eligible recipients
under the Children's Health Care Program.
(g) "Division" means the Division of Medicaid in the Office of the Governor.
(h) "Low-income child" means a child whose family income does not exceed two hundred percent (200%) of the poverty level for a family of the size involved.
(i) "Plan" means the State Child Health Plan.
(j) "Program" means the Children's Health Care Program established by Sections 41-86-5 through 41-86-17.
(k) "Recipient" means a person who is eligible for assistance under the program.
(l) "State Child Health Plan" means the permanent plan that sets forth the manner and means by which the State of Mississippi will provide health care assistance to eligible uninsured, low-income children consistent with the provisions of Title XXI of the federal Social Security Act, as amended.
SECTION 4. Section 41-86-7, Mississippi Code of 1972, is brought forward as follows:
41-86-7. There is established a Children's Health Care Program in Mississippi, which shall become effective upon the full implementation of the permanent State Child Health Plan authorized under Section 41-86-9. The program shall be financed by state appropriations and federal matching funds received by the state under the State Children's Health Insurance Program established by Title XXI of the federal Social Security Act, as amended.
SECTION 5. Section 41-86-9, Mississippi Code of 1972, is brought forward as follows:
41-86-9. (1) A Mississippi Children's Health Insurance Program Commission is created to develop and adopt the permanent State Child Health Plan. The commission shall be composed of the following members:
(a) The Executive Director of the Division of Medicaid;
(b) The Executive Director of the State Department of Health;
(c) The Mississippi Commissioner of Insurance;
(d) Two (2) members to be appointed by the Lieutenant Governor, one (1) of whom shall be a nurse practitioner who provides health care services to children, and one (1) of whom shall be a person with experience in administering or working with plans for reimbursement or payment of health care expenses;
(e) Two (2) members to be appointed by the Speaker of the House of Representatives, one (1) of whom shall be a physician who provides health care services to children, and one (1) of whom shall be a person with experience in administering or working with plans for reimbursement or payment of health care expenses; and
(f) Two (2) members to be appointed by the Governor, one (1) of whom shall be a physician who provides health care services to children, and who shall serve as chairman of the commission, and one (1) of whom shall be a person with experience in administering or working with plans for reimbursement or payment of health care expenses.
In making appointments to the commission, the appointing authorities shall reflect the gender and racial composition of the state.
Not later than May 1, 1998, the Governor, the Lieutenant Governor and the Speaker shall appoint the members of the commission. After the members are appointed, the commission shall meet on a date designated by the chairman of the commission in Jackson, Mississippi, to organize the commission and establish rules for transacting its business and keeping records. A majority of the members of the commission shall constitute a quorum at all commission meetings. An affirmative vote of a majority of the members shall be required in the adoption of rules, resolutions and reports. All members of the commission shall be notified in writing of all regular and special meetings of the commission, which notices shall be mailed at least five (5) days before the dates of the meetings. The commission may establish any subcommittees that it deems desirable to study and report to the commission with respect to any matter that is within the scope of the commission.
The Division of Medicaid shall provide clerical and administrative support for the Children's Health Insurance Program Commission. In carrying out the provisions of this section, the commission may utilize the services, facilities and personnel of all departments, agencies, offices and institutions of the state. In particular, the commission shall consult with the Division of Medicaid, the Office of Insurance of the Department of Finance and Administration, the State Department of Health and the Mississippi Department of Insurance, and those agencies shall cooperate with the commission and provide the commission with any information and other assistance requested by the commission. The commission may consult and seek advice from various groups in the state in order to understand the effect of any existing laws or any changes in law being considered by the commission. For attending meetings of the commission, each member who is not a state official shall be paid per diem compensation in the amount authorized by Section 25-3-69 and each member shall receive expense reimbursement as authorized by Section 25-3-41. All expenses incurred by and on behalf of the commission shall be paid from any funds appropriated or otherwise made available for the purpose of this program, and from any grants or contributions made to the commission for its purpose. The commission shall be dissolved on August 1, 1998.
(2) The Children's Health Insurance Program Commission shall develop the State Child Health Plan, which shall set forth the manner and means by which the State of Mississippi will provide health care assistance to eligible uninsured, low-income children under the Children's Health Care Program. The commission shall consider all options in developing the plan. The plan must be consistent with and meet the applicable requirements of Title XXI of the federal Social Security Act, as amended, and shall include:
(a) A designation of the agency of the state that will be the administering agency for the program, which shall be either the Division of Medicaid or the State and Public School Employees Health Insurance Management Board created under Section 25-15-303;
(b) Whether the administering agency will have the authority provided under Section 41-86-11(4);
(c) A description of the covered benefits and the eligibility standards for recipients;
(d) The method by which health care benefits and services provided under the program will be coordinated with other sources of health benefits coverage for children; and
(e) Methods used to assure the quality and appropriateness of care and access to covered benefits.
(3) The Division of Medicaid shall submit the permanent plan adopted by the commission to the United States Secretary of Health and Human Services for approval on or before August 1, 1998.
(4) After the permanent plan has been developed and approved, the Children's Health Care Program shall be implemented and administered by the administering agency designated by the commission.
SECTION 6. Section 41-86-11, Mississippi Code of 1972, is brought forward as follows:
41-86-11. (1) The administering agency shall adopt, in accordance with Section 25-43-1 et seq., rules and regulations for the implementation of the program, and for the coordination of the program with the state's other medical assistance programs.
(2) If the Division of Medicaid is designated as the administering agency for the program, the division shall have all of the authority set forth in Section 43-13-101 et seq.
(3) The administering agency shall make reports to the federal government and to the Legislature on the providing of benefits to those children under the program.
(4) (a) If the commission provides that the administering agency will have such authority, the administering agency shall execute a contract or contracts to provide the health care coverage and services under the program, after first receiving bids. The contract or contracts may be executed with one or more corporations or associations authorized to do business in Mississippi. All of the coverage and services to be provided under the program may be included in one or more similar contracts, or the coverage and services may be classified into different types with each type included under one or more similar contracts issued by the same or different corporations or associations.
(b) The administering agency shall execute a contract or contracts with one or more corporations or associations that have submitted the best and most cost-effective bids, or shall reject all bids. If the administering agency rejects all bids, it shall notify all bidders of the rejection and shall actively solicit new bids.
SECTION 7. Section 41-86-13, Mississippi Code of 1972, is brought forward as follows:
41-86-13. (1) The Division of Medicaid shall receive state appropriations for the program and federal matching funds under the State Children's Health Insurance Program established by Title XXI of the federal Social Security Act, as amended, and the division shall provide those funds to the administering agency for the administration of the program. The Legislature shall include those funds as a line item in the appropriation to the Division of Medicaid.
(2) The program is subject to the availability of state funds specifically appropriated by the Legislature for the purpose of the program and federal matching funds under the State Children's Health Insurance Program established by Title XXI of the federal Social Security Act, as amended. The division may limit enrollment as necessary to ensure that the costs of the program do not exceed the total amount of state and federal funds appropriated by the Legislature for that purpose.
SECTION 8. Section 41-86-15, Mississippi Code of 1972, is brought forward as follows:
41-86-15. (1) Persons eligible to receive covered benefits under Sections 41-86-5 through 41-86-17 shall be low-income children who meet the eligibility standards set forth in the plan. Any person who is eligible for benefits under the Mississippi Medicaid Law, Section 43-13-101 et seq., shall not be eligible to receive benefits under Sections 41-86-5 through 41-86-17. A person who is without insurance coverage at the time of application for the program and who meets the other eligibility criteria in the plan shall be eligible to receive covered benefits under the program, if federal approval is obtained to allow eligibility with no waiting period of being without insurance coverage. If federal approval is not obtained for the preceding provision, the Division of Medicaid shall seek federal approval to allow eligibility after the shortest waiting period of being without insurance coverage for which approval can be obtained. After federal approval is obtained to allow eligibility after a certain waiting period of being without insurance coverage, a person who has been without insurance coverage for the approved waiting period and who meets the other eligibility criteria in the plan shall be eligible to receive covered benefits under the program. If the plan includes any waiting period of being without insurance coverage before eligibility, the State and School Employees Health Insurance Management Board shall adopt regulations to provide exceptions to the waiting period for families who have lost insurance coverage for good cause or through no fault of their own.
(2) The eligibility of children for covered benefits under the program shall be determined annually by the same agency or entity that determines eligibility under Section 43-13-115(9) and shall cover twelve (12) continuous months under the program.
SECTION 9. Section 41-86-17, Mississippi Code of 1972, is brought forward as follows:
41-86-17. The covered benefits under the program shall include all health care benefits and services required to be included as covered benefits under Title XXI of the federal Social Security Act, as amended, and shall include early and periodic screening and diagnosis services at least equal to those provided under the Medicaid program. The benefits and services offered and available to state employees under the State and School Employees Health Insurance Plan shall be used as the benchmark for benefits and services under the program, with an emphasis on preventive and primary care. Benefits and services to be provided under the program shall include: vision and hearing screening, eyeglasses and hearing aids, preventive dental care and routine dental fillings. No deductibles, coinsurance or any other cost-sharing shall be allowed for any of the benefits and services named in the preceding sentence. The program also may cover other dental services including amalgam and composite restorations, extractions, space maintainers, stainless steel crowns, sealants, pulpotomies, pulpectomies, and treatment of periodontal disease. The program may exclude from participation in the program any health care providers who do not agree to hold the families of recipients harmless for charges in excess of plan payments for covered benefits.
SECTION 10. Section 41-86-19, Mississippi Code of 1972, is brought forward as follows:
41-86-19. (1) The Division of Medicaid shall develop a Children's Health Insurance Program enrollment outreach initiative in cooperation with the State Department of Education's federal free and reduced lunch program, the State Department of Health, the Department of Human Services, the Department of Finance and Administration, community health centers, the Mississippi State Medical Association, the Mississippi State Hospital Association, other health provider associations and community action agencies/Headstart centers. The enrollment outreach initiative shall be the responsibility of the CHIP Information Coordinator within the Division of Medicaid. The Division of Medicaid is authorized to maintain a statewide in-coming wide area telephone service for the purpose of providing information for and encouraging Children's Health Insurance Program enrollment.
(2) (a) The CHIP Advisory Board established under Section 41-86-21(1) shall conduct a community-based outreach and education campaign to provide information relating to the availability of health benefits for children through Medicaid and the Children's Health Insurance Program. The CHIP Advisory Board shall conduct the campaign in a manner that promotes enrollment in all state child health programs and supports existing outreach and enrollment initiatives, including the initiative mandated under subsection (1) of this section.
(b) The CHIP Advisory Board may contract with community-based organizations or coalitions of community-based organizations to implement the community-based outreach and education campaign, and shall promote and encourage voluntary efforts to implement the campaign. The CHIP Advisory Board shall procure any contracts through a process designed by the advisory board to encourage broad participation of organizations, including those organizations that target population groups with high levels of uninsured children.
(c) Funding for the community-based outreach and education campaign and for any contracts executed by the CHIP Advisory Board to implement the campaign shall be provided by the Division of Medicaid.
SECTION 11. Section 41-86-21, Mississippi Code of 1972, is brought forward as follows:
41-86-21. (1) There is hereby established a C.H.I.P. Advisory Board to advise the State and Public School Employees' Health Insurance Management Board relative to the Children's Health Insurance Program. The C.H.I.P. Advisory Board shall be composed of the Executive Director of the Mississippi State Department of Health, the Executive Director of the Division of Medicaid, Office of the Governor, one (1) member of the State and Public School Employees' Health Insurance Management Board to be appointed by the chairman of the board, and two (2) health care providers of services to children appointed by the Governor for terms concurrent with that of the Governor. For attending meetings of the C.H.I.P. Advisory Board, those members who are not state officials or state employees shall receive the per diem authorized under Section 25-3-69 and shall receive expense reimbursement as authorized under Section 25-3-41.
(2) There is hereby established a Joint C.H.I.P. Advisory Committee to meet with the C.H.I.P. Advisory Board and advise the State and Public School Employees' Health Insurance Management Board relative to the Children's Health Insurance Program. The Joint C.H.I.P. Advisory Committee shall be composed of the Chairman of the House Public Health and Welfare Committee, the Chairman of the Senate Public Health and Welfare Committee, one (1) member of the Senate appointed by the Lieutenant Governor to serve at the will and pleasure of the Lieutenant Governor, and one (1) member of the House of Representatives appointed by the Speaker of the House to serve at the will and pleasure of the Speaker. The committee shall meet upon the call of the Chairman of the C.H.I.P. Advisory Board. The appointing authorities may designate an alternate member from their respective houses to serve when the regular designee is unable to attend such meetings of the committee. For attending meetings of the Joint C.H.I.P. Advisory Committee, such legislators shall receive per diem and expenses which shall be paid from the contingent expense funds of their respective houses in the same amounts as provided for committee meetings when the Legislature is not in session; however, no per diem and expenses for attending meetings of the committee will be paid while the Legislature is in session.
SECTION 12. This act shall take effect and be in force from and after July 1, 2005.