House Bill 1166

AN ACT TO AUTHORIZE THE COMMISSIONER OF INSURANCE TO ADOPT RULES AND REGULATIONS TO ALLOW HIM, DURING A COMPANY EXAMINATION, TO EXAMINE AND ADDRESS ANY INEQUALITIES REGARDING PROVIDER REIMBURSEMENT RATES PAID BY AN INSURER, SUBCONTRACTOR, OTHER PAYOR OR BY THIRD-PARTY ADMINISTRATORS; TO PROVIDE THAT FAILURE TO COMPLY WITH RULES AND REGULATIONS ADOPTED BY THE COMMISSIONER MAY RESULT IN A FINE NOT TO EXCEED $10,000.00 PER VIOLATION; TO ADD A FOUR-YEAR REPEALER TO THE SECTION; AND FOR RELATED PURPOSES.

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

SECTION 1. (1) The Commissioner of Insurance may adopt rules and regulations to allow him, during a company examination, to examine and address any inequalities or irregularities regarding provider reimbursement rates paid by an insurer, subcontractor, third-party administrator or other payor regarding covered services received by covered persons in this state. Such rules and regulations shall allow an insurer to show evidence as to why any inequality or irregularity may be justified. Failure to comply with rules and regulations adopted by the Commissioner under this section may result in a fine not to exceed Ten Thousand Dollars ($10,000.00) per violation.

(2) This section shall not apply to Medicaid health plans.

(3) This section shall stand repealed on July 1, 2028.

SECTION 2. This act shall take effect and be in force from and after its passage.