House Bill 454

(COMMITTEE SUBSTITUTE)

AN ACT TO AUTHORIZE THE EXECUTIVE DIRECTOR OF THE DIVISION OF MEDICAID TO APPLY TO THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) FOR ANY NECESSARY WAIVERS FOR THE APPROVAL OF EXPERIMENTAL, PILOT OR DEMONSTRATION PROJECTS THAT PROMOTE THE OBJECTIVES OF MEDICAID OR THE CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP) UNDER SECTION 1115 OF THE FEDERAL SOCIAL SECURITY ACT; TO PRESCRIBE THE PROVISIONS THAT ANY SUCH WAIVER MAY CONTAIN; AND FOR RELATED PURPOSES.

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

SECTION 1. To the maximum extent allowed by state and federal law, the Executive Director of the Division of Medicaid is authorized to apply to the Centers for Medicare and Medicaid Services (CMS) for any necessary waivers for the approval of experimental, pilot or demonstration projects that promote the objectives of providing services to eligible individuals through Medicaid or the Children's Health Insurance Program (CHIP) under Section 1115 of the federal Social Security Act, as amended. Any such waiver may contain any or all of the following provisions, or any variation of those provisions, to the extent allowed by state and federal law:

(a) Require, on a monthly basis, a full redetermination of eligibility, including, but not limited to:

(i) Personal income and family income;

(ii) Residency;

(iii) Assets;

(iv) Employment and wages;

(v) Other government benefits;

(vi) Retirement and pension benefits;

(vii) Criminal record; and

(viii) Any other earnings and income;

(b) Require point-of-service eligibility verification;

(d) Implement a ban on enrollment for the failure to report a change in family income or for knowingly making a false statement regarding eligibility compliance for a period ranging from one (1) year of ineligibility to permanent disqualification of eligibility;

(e) Require a meaningful asset test, at a minimum, using federal guidelines employed before the implementation of the federal Patient Protection and Affordable Care Act (PPACA);

(f) Incorporate direct primary care and direct surgical care arrangements;

(g) More extensively incorporate and encourage telemedicine options;

(h) Experiment with flexible policies aimed at reducing costs for mandated benefits, including consideration of the use of nontraditional medical transportation services or elimination of nonemergency transportation services as a covered service;

(i) As necessary, impose work requirements on able-bodied, working-age adults;

(j) Develop and impose meaningful copayments to deter the nonemergency use of emergency departments and to deter the use of ambulance services for nonemergency transportation;

(k) Impose meaningful co-pays for missed appointments;

(l) Implement health savings accounts that encourage and reward eligible persons for choosing high-value providers;

(m) Transition pregnant women and children onto private insurance by using existing Medicaid funding to offer a tax credit or limited subsidy that covers part of the premium cost;

(n) Blend funding streams for multiple programs;

(o) Require annual health screenings as a condition of eligibility;

(p) Require participation in a medical home;

(q) To the fullest reasonable extent, require obese persons to participate in online obesity programs;

(r) Require able-bodied, adult recipients who are not employed to participate in a job skills training program;

(s) Implement value-based payment arrangements with enrolled Medicaid providers; and

(t) Revise Medicaid reimbursement for enrolled Medicaid providers as necessary to accomplish the goals of the program.

The division shall consult with the chairmen of the House and Senate Medicaid Committees at least sixty (60) days before submitting the waiver.

The division shall redetermine eligibility for all categories of recipients described in each paragraph of this section for which a waiver has been granted not less frequently than required by federal law.

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