Senate Bill 2224

AN ACT TO CREATE NEW SECTION 83-9-37, MISSISSIPPI CODE OF 1972, TO PROHIBIT AN INSURER OR OTHER PAYOR FROM SETTING A MAXIMUM DOLLAR AMOUNT OF REIMBURSEMENT FOR NON-INVASIVE VENTILATION OR VENTILATION TREATMENTS PROPERLY ORDERED AND BEING USED IN AN APPROPRIATE CARE SETTING; TO INCLUDE SPECIFIC SERVICES THAT THE DURABLE MEDICAL EQUIPMENT SUPPLIER SHALL BE REQUIRED TO PROVIDE; TO REQUIRE AN INSURER, SUBCONTRACTOR, THIRD-PARTY ADMINISTRATOR OR OTHER PAYOR TO REIMBURSE DURABLE MEDICAL EQUIPMENT SUPPLIERS FOR HOME USE NON-INVASIVE AND INVASIVE VENTILATORS ON A CONTINUOUS MONTHLY PAYMENT BASIS FOR THE DURATION OF MEDICAL NEED THROUGHOUT A PATIENT'S VALID PRESCRIPTION PERIOD; AND FOR RELATED PURPOSES.

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

SECTION 1. The following shall be codified as Section 83-9-37, Mississippi Code of 1972:

83-9-37. (1) Notwithstanding any provision of law to the contrary, an insurer, subcontractor, third-party administrator or other payor shall not set a maximum dollar amount of reimbursement for non-invasive ventilation or ventilation treatments properly ordered and being used in an appropriate care setting.

(2) (a) The durable medical equipment supplier shall be required to provide the patient regular and comprehensive service and preventative maintenance by a certified or registered respiratory therapist. The service shall include, but not be limited to, masks, tubing, filters and other supporting supplies and equipment. Reimbursement shall be at a rate negotiated with the payors to insure that a sustained level of service can be provided to the patient.

(b) Notwithstanding any provision of law to the contrary, an insurer, subcontractor, third-party administrator or other payor shall reimburse durable medical equipment suppliers for home use non-invasive and invasive ventilators on a continuous monthly payment basis for the duration of medical need throughout a patient's valid prescription period.

SECTION 2. This act shall take effect and be in force from and after July 1, 2023.