MISSISSIPPI LEGISLATURE
2024 Regular Session
To: Insurance
By: Representative Turner
AN ACT TO REQUIRE ANY INSURER, SUBCONTRACTOR, THIRD PARTY ADMINISTRATOR OR OTHER PAYOR THAT ADMINISTERS A HEALTH BENEFIT POLICY ISSUED IN ANOTHER STATE THAT COVERS A PERSON IN THIS STATE TO REIMBURSE PROVIDERS AT THE REIMBURSEMENT RATE AS PROVIDED IN THE STATE OF ISSUANCE, IF THAT REIMBURSEMENT RATE IS HIGHER THAN THE REIMBURSEMENT RATE IN THIS STATE; TO PROVIDE THAT IF A BENEFIT IS PROVIDED IN THE ISSUING STATE, THAT BENEFIT MUST BE PROVIDED TO COVERED PERSONS IN THIS STATE; 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. Any insurer, subcontractor, third-party administrator or other payor that administers a health benefit policy issued in another state that covers a person in this state, shall reimburse providers at the reimbursement rate as provided in the state of issuance, if that reimbursement rate is higher than the reimbursement rate in this state. Furthermore, if a benefit is provided in the issuing state, that benefit must be provided to covered persons in this state. The Commissioner of Insurance may adopt rules and regulations necessary to ensure compliance with this section.
SECTION 2. (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(3) This section shall stand repealed on July 1, 2028.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 3. This act shall take effect and be in force from and after July 1, 2024.