MISSISSIPPI LEGISLATURE

2016 Regular Session

To: Medicaid

By: Senator(s) Blackmon

Senate Bill 2798

AN ACT TO PROHIBIT THE DIVISION OF MEDICAID FROM REQUIRING PRIOR AUTHORIZATION BEFORE EMERGENCY ROOM SERVICES OR HOSPITAL IN-PATIENT SERVICES MAY BE PROVIDED WHEN A LICENSED PHYSICIAN HAS DETERMINED THE NEED; AND FOR RELATED PURPOSES.

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

SECTION 1.  (1)  As used in this act:

          (a)  "Division" means the Division of Medicaid in the Office of the Governor.

          (b)  "Prior authorization" means the approval process used by the division before health care benefits may be provided.

     (2)  In providing for emergency room or urgent care services and admission for in-patient hospital care as a covered service, the Division of Medicaid:

          (a)  Shall not require prior authorization for benefits if ordered by a licensed physician; and

          (b)  Shall not deny payment based on the provider's failure to notify the carrier in advance of seeking treatment or within a certain period of time after the care is given.

     SECTION 2.  This act shall take effect and be in force from and after July 1, 2016.