MISSISSIPPI LEGISLATURE
2023 Regular Session
To: Appropriations
By: Representatives Read, Mims, Arnold, Bounds, Clark, Clarke, Currie, Hines, Hood, Horan, Sanford, Scoggin, Watson, Young
AN ACT MAKING AN APPROPRIATION TO THE GOVERNOR'S OFFICE-DIVISION OF MEDICAID FOR THE PURPOSE OF PROVIDING MEDICAL ASSISTANCE UNDER THE MISSISSIPPI MEDICAID LAW AND DEFRAYING THE EXPENSES OF THE ADMINISTRATION OF THAT LAW FOR THE FISCAL YEAR 2024.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:
SECTION 1. The following sum, or so much thereof as may be necessary, is appropriated out of any money in the State General Fund not otherwise appropriated, to the Governor's Office - Division of Medicaid for the purpose of providing medical assistance under the Mississippi Medicaid Law and defraying the expenses of the administration of such law, as provided in Section 43-13-101 et seq., Mississippi Code of 1972, for the fiscal year beginning July 1, 2023, and ending June 30, 2024
............................................ $ 846,380,488.00.
SECTION 2. The following sum, or so much thereof as may be necessary, is appropriated out of any money in the State Treasury to the credit of the Medical Care Fund created by Section 43-13-143, Mississippi Code of 1972, for the purpose of providing medical assistance under the Mississippi Medicaid Law for the fiscal year beginning July 1, 2023, and ending June 30, 2024...........................................
............................................ $ 352,666,905.00.
SECTION 3. The following sum, or so much thereof as may be necessary, is appropriated out of any money in any special fund in the State Treasury to the credit of the Governor's Office - Division of Medicaid which is comprised of special source funds collected by or otherwise available to the Division, for the purpose of providing medical assistance under the Mississippi Medicaid Law and defraying the expenses of the administration of such law, for the fiscal year beginning July 1, 2023, and ending June 30, 2024........ $ 6,046,663,411.00.
Prior period recovery of funds may be maintained and expended by the division when the recovery is received or finalized. Any recoveries due to audits or third party recoveries may be used to offset the cost of such audits and third party recoveries and as such, the division may escalate Contractual Services as needed for these purposes.
SECTION 4. The following sum, or so much thereof as may be necessary, is appropriated out of any money in the State Treasury to the credit of the Health Care Expendable Fund, for the purpose of defraying the expenses of the Governor's Office - Division of Medicaid for the fiscal year beginning July 1, 2023, and ending June 30, 2024.... $ 63,230,003.00.
The above funds shall be allocated as follows:
CHIP Program at up to 209% level of poverty. $ 9,000,000.00.
Medical Program Matching Funds.............. $ 54,230,003.00.
It is the intention of the Legislature that funds may be shifted among the above allocated line items where needed at the discretion of the Executive Director of Governor's Office - Division of Medicaid.
SECTION 5. Of the funds appropriated under the provisions of this act, the following positions are authorized:
AUTHORIZED HEADCOUNT:
Permanent: 927
Time-Limited: 82
With the funds herein appropriated, it shall be the agency’s responsibility to make certain that funds required for Personal Services for Fiscal Year 2025 do not exceed Fiscal Year 2024 funds appropriated for that purpose unless programs or positions are added to the agency’s Fiscal Year 2024 budget by the Mississippi Legislature. The Legislature shall determine the agency’s personal services appropriation, which the State Personnel Board shall publish. The agency’s personal services appropriation may consist of restricted funds for approved vacancies for Fiscal Year 2024 that may not be utilized for active Fiscal Year 2023 Headcount. It shall be the agency's responsibility to ensure that the funds provided for vacancies are used to increase headcount and not for promotions, title changes, in-range salary adjustments or any other mechanism for increasing salaries for current employees. It is the Legislature’s intention that no employee salary falls below the minimum salary established by the Mississippi State Personnel Board.
Additionally, the State Personnel Board shall determine and publish the projected annualized payroll costs based on current employees. It shall be the responsibility of the agency head to ensure that actual personnel expenditures for Fiscal Year 2024 do not exceed the data provided by the Legislative Budget Office. If the agency’s Fiscal Year 2024 projected cost exceeds the annualized costs, no salary actions shall be processed by the State Personnel Board except for new hires determined to be essential for the agency.
Any transfers or escalations shall be made in accordance with the terms, conditions, and procedures established by law or allowable under the terms set forth within this act. The State Personnel Board shall not escalate positions without written approval from the Department of Finance and Administration. The Department of Finance and Administration shall not provide written approval to escalate any funds for salaries and/or positions without proof of availability of new or additional funds above the appropriated level.
No general funds authorized to be expended herein shall be used to replace federal funds and/or other special funds used for salaries authorized under the provisions of this act and which are withdrawn and no longer available.
None of the funds herein appropriated shall be used in violation of the Internal Revenue Service’s Publication 15-A relating to the reporting of income paid to contract employees, as interpreted by the Office of the State Auditor.
SECTION 6. It is the intention of the Legislature that the Governor's Office - Division of Medicaid shall maintain complete accounting and personnel records related to the expenditure of all funds appropriated under this act and that such records shall be in the same format and level of detail as maintained for Fiscal Year 2023. It is further the intention of the Legislature that the agency's budget request for Fiscal Year 2025 shall be submitted to the Joint Legislative Budget Committee in a format and level of detail comparable to the format and level of detail provided during the Fiscal Year 2024 budget request process with the Children's Health Insurance Program (CHIP) being separated from the Medical Services Program and submitted as a separate program. All Medicaid 1915 (C) Home and Community Based Services Waivers shall be presented as a budget program separate from the Medical Services Program. In addition, the performance measures reported for the Medical Services Program shall include an unduplicated case count of individuals served by eligibility status, and the number and the costs of emergency room visits.
SECTION 7. In compliance with the "Mississippi Performance Budget and Strategic Planning Act of 1994," it is the intent of the Legislature that the funds provided herein shall be utilized in the most efficient and effective manner possible to achieve the intended mission of this agency. Based on the funding authorized, this agency shall make every effort to attain the targeted performance measures provided below:
FY2024
Performance Measures Target
Administrative Services
Admin as a Percent of Total Budget 3.66
Third Party Liability Cost Avoided (Thou) 1,176,412.00
Percent of Clean Claims Processed within
30 Days of Receipt 99.50
Percent of Clean Claims Processed within
90 Days of Receipt 100.00
Percent of Applications Processed within
Std. of Promptness - Medicaid 90.00
Third Party Funds Recovered 7,998,051.00
Number of Providers Submitting
Electronic Claims 31,500
Turnover Rate of Employees 15.00
Medical Services
Costs of Emergency Room Visits 171,539,318
Number of Emergency Room Visits 418,177
Medicaid Recipients - Enrolled (Persons) 793,762
Child Physical Exams (Ages 0-20) 317,675
Adult Physical Exams (21-Older) 10,595
Number of Fraud and Abuse Cases Investigated 300
Number of Medicaid Providers 45,000
Number of Medicaid Beneficiaries
Assigned to a Managed Care Company 450,000
Percent of MSCAN Diabetic Members Aged
17-75 Receiving HBA1c Test 88.69
Percent of MSCAN Members with Persistent
Asthma are Appropriately Prescribed
Medication 71.08
Rate of EPSDT Well Child Screening 75.00
Percent Change in Number of Recipients
Enrolled From Last Year 2.50
Percent Change in Number of Providers
From Last Year 29.15
Children's Health Insur Prg (chip)
Number of CHIP Enrollees 47,000
Percent of CHIP Applications Processed
within Std. of Promptness 90.00
Home & Comm-based Waiver Prg
Elderly and Disabled - Persons Served 20,559
Elderly and Disabled - Funded Slots 20,121
Elderly and Disabled - Total Authorized
Slots 22,200
Assisted Living - Persons Served 945
Assisted Living - Funded Slots 918
Assisted Living - Total Authorized Slots 1,100
Independent Living - Persons Served 3,675
Independent Living - Funded Slots 3,615
Independent Living - Total Authorized Slots 5,800
Traumatic Brain Injury - Persons Served 1,103
Traumatic Brain Injury - Funded Slots 1,050
Traumatic Brain Injury - Total
Authorized Slots 1,150
Intellectual Disability - Persons Served 3,250
Intellectual Disability - Funded Slots 3,250
Intellectual Disability - Total
Authorized Slots 4,150
Percent Change in Persons On Waiting
List (E&D) 10.00
Percent Change in Persons On Waiting
List (AL) 10.00
Percent Change in Persons On Waiting
List (IL) 10.00
Percent Change in Persons On Waiting
List (TBI) 10.00
Percent Change in Persons On Waiting
List (IDD) 10.00
A reporting of the degree to which the performance targets set above have been or are being achieved shall be provided in the agency's budget request submitted to the Joint Legislative Budget Committee for Fiscal Year 2025.
SECTION 8. It is the intention of the Legislature that whenever two (2) or more bids are received by this agency for the purchase of commodities or equipment, and whenever all things stated in such received bids are equal with respect to price, quality and service, the Mississippi Industries for the Blind shall be given preference. A similar preference shall be given to the Mississippi Industries for the Blind whenever purchases are made without competitive bids.
SECTION 9. The Governor's Office - Division of Medicaid shall provide statistical and financial reports on a monthly basis to the Legislative Budget Office and the PEER Committee. These reports shall include, but are not limited to, an accounting of all funds spent in the medical program, the CHIP program, the Dialysis Transportation program, and each of the Home and Community Based Waiver programs, and an accounting of all funds spent in the administrative program, participant statistics and any other information requested by the Legislative Budget Office and the PEER Committee.
The Governor's Office - Division of Medicaid shall perform its cash flow projections on a predetermined monthly schedule and make this and any other information requested available, upon request, to the Chair of the Senate Public Health and Welfare Committee, the House Public Health and Human Services Committee, the House and Senate Medicaid Committees, the House and Senate Appropriations Committees, the Legislative Budget Office and the PEER Committee. A summary of this cash flow projection shall also be presented in the report referenced in the above paragraph.
SECTION 10. Of the funds appropriated under the provisions of this act in an amount not to exceed, Two Million Seven Hundred Fifty Thousand Dollars ($2,750,000.00) is provided for the purpose of funding a temporary program to provide nonemergency transportation to locations for necessary dialysis services for end-stage renal disease patients who are sixty-five (65) years of age or older or are disabled as determined under Section 1614(a)(3) of the federal Social Security Act, as amended, whose income did not exceed one hundred thirty-five percent (135%) of the nonfarm official poverty level as defined by the Office of Management and Budget and whose eligibility was covered under the former category of eligibility known as Poverty Level Aged and Disabled (PLADS).
SECTION 11. Of the funds appropriated in Sections 1 and 3, Three Hundred Ninety-eight Thousand Five Hundred Fifty Dollars ($398,550.00) General Funds and One Million One Hundred One Thousand Four Hundred Fifty Dollars ($1,101,450.00) Special Funds are provided to maintain five (5) additional slots in the Assisted Living Waiver program for persons with Traumatic Brain Injury and in need of Cognitive Rehabilitation.
SECTION 12. Of the funds appropriated in Section 1, Eight Hundred Five Thousand Six Hundred Thirty Dollars ($805,630.00) is provided to maintain additional slots in the Assisted Living Home and Community Based Waiver program and One Million One Hundred Ninety-two Thousand Seven Hundred Seventy Dollars ($1,192,770.00) is provided to maintain additional slots in the Elderly and Disabled Home and Community Based Waiver program.
SECTION 13. Of the funds appropriated in Section 2 and Section 3, One Million Nine Hundred Thirty-four Thousand Two Hundred Ninety-two Dollars ($1,934,292.00) Special Funds are provided for One Hundred (100) slots for the Department of Rehabilitation Services and Ten Million Two Hundred Seventy-two Thousand Six Hundred Seventy-six Dollars ($10,272,676.00) for Two Hundred (200) slots for the Department of Mental Health for the Home and Community Based waiver program for Independent Living and the IDD Waiver program. These funds shall be used for these additional slots.
SECTION 14. It is the intention of the Legislature that the funds appropriated in this act to the Governor's Office - Division of Medicaid for the Mississippi Coordinated Access Network (MS-CAN) program be used in the most efficient and effective manner possible to achieve the intended mission of the division. The division and the coordinated care organizations with which the division has contracted to conduct the MS-CAN program shall establish baselines for the health-related outcome measurement for each of the following health focus areas for presentation at the Joint Legislative Budget Committee hearings for Fiscal Year 2024, which will be used as the baseline levels for establishing targets for improvements in quality of care performance measures for the MS-CAN program in Fiscal Year 2024 and later fiscal years:
a. Comprehensive Diabetes Care (CDC) or successive measure.
b. Medication Management for People with Asthma (MMA) or successive measure.
c. Annual Monitoring for Patients on Persistent Medications (MPM) or successive measure.
d. Adult BMI Assessment (ABA) and Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC) or successive measure.
In addition, for comparison purposes, these same baselines for the health-related outcome measurements shall be established for similar Medicaid recipients who are not enrolled in the MS-CAN program.
SECTION 15. It is the intention of the Legislature that the Governor's Office - Division of Medicaid and the Department of Human Services shall continue to work together to implement Section 43-12-1, Mississippi Code of 1972, known as the "Medicaid and Human Services Transparency and Fraud Prevention Act".
SECTION 16. The Governor's Office - Division of Medicaid is authorized to expend funds appropriated herein as necessary to provide currently existing home and community based services through any CMS approved state plan or home and community based services waiver to individuals who qualify for those services to avoid institutionalization or to transition an individual from an institution to any home and community based setting. Provision of such services shall not count against any limit imposed under this act. It is the intention of the Legislature that the cost of providing home and community based services shall not exceed the cost of nursing facility services, as determined by the Division.
SECTION 17. Of the funds appropriated herein, no more than Sixty-seven Thousand Two hundred Dollars ($67,200.00) may be used to pay invoices from Fiscal Year 2022 for expenses to Bulletproof Solutions, Inc. for a Medicaid information technology security assessment.
SECTION 18. The money herein appropriated shall be paid by the State Treasurer out of any money in the State Treasury to the credit of the proper fund or funds as set forth in this act, upon warrants issued by the State Fiscal Officer; and the State Fiscal Officer shall issue his warrants upon requisitions signed by the proper person, officer or officers, in the manner provided by law.
SECTION 19. This act shall take effect and be in force from and after July 1, 2023.