House Bill 1565

AN ACT TO DIRECT THE DIVISION OF MEDICAID TO ENTER INTO NEGOTIATIONS WITH THE FEDERAL GOVERNMENT TO OBTAIN A WAIVER OF APPLICABLE PROVISIONS OF THE MEDICAID LAWS AND REGULATIONS FOR A DEMONSTRATION PROJECT TO PROVIDE MEDICAID BENEFITS TO INDIVIDUALS WHO ARE IN NEED OF MENTAL HEALTH SERVICES OR SUBSTANCE USE DISORDER SERVICES DURING A PRESUMPTIVE ELIGIBILITY PERIOD; TO PROVIDE THAT DURING THE PRESUMPTIVE ELIGIBILITY PERIOD, THE MEDICAID BENEFITS AVAILABLE FOR THOSE INDIVIDUALS WILL BE LIMITED TO MENTAL HEALTH SERVICES OR SUBSTANCE USE DISORDER SERVICES, AS APPLICABLE; TO PROVIDE THAT THE DEMONSTRATION PROJECT WILL INCLUDE, AT A MINIMUM, PROVISIONS FOR THE PRESUMPTIVE ELIGIBILITY PERIOD, QUALIFIED ENTITIES, NOTIFICATION REQUIREMENTS, AND A REQUIREMENT TO APPLY FOR MEDICAID BENEFITS; AND FOR RELATED PURPOSES.

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

SECTION 1. (1) The Office of the Governor, Division of Medicaid shall enter into negotiations with the Centers for Medicare and Medicaid Services (CMS) to obtain a waiver of applicable provisions of the Medicaid laws and regulations under Section 1115 of the Social Security Act for a demonstration project to provide Medicaid benefits to individuals who are in need of mental health services or substance use disorder services during a presumptive eligibility period. During the presumptive eligibility period, the Medicaid benefits available for those individuals will be limited to mental health services or substance use disorder services, as applicable. The demonstration project will include, at a minimum, the provisions of subsections (2) through (5) of this section.

(2) Presumptive eligibility period. The presumptive eligibility period for those individuals will be the period that (a) begins with the date on which a qualified entity determines, on the basis of preliminary information, that the individual is otherwise eligible for Medicaid benefits, and (b) ends with and includes the earlier of (i) the day on which a determination is made with respect to the eligibility of the individual for Medicaid benefits, or (ii) in the case of such an individual who does not file an application by the last day of the month following the month during which the entity makes the determination that the individual is otherwise eligible for Medicaid benefits, such last day.

(3) Qualified entities. The determination of presumptive eligibility for those individuals will be made qualified entities approved by the division that are Medicaid providers and determined by the division to be capable of making Medicaid eligibility determinations for those types of individuals.

(4) Notification requirements. A qualified entity that determines that an individual is presumptively eligible for Medicaid benefits shall (a) notify the division of the determination within five (5) working days after the date on which determination is made, and (b) inform the individual at the time the determination is made that an application for Medicaid benefits is required to be made by not later than the last day of the month following the month during which the determination is made.

(5) Requirement to apply Medicaid benefits. In the case of an individual who is determined by a qualified entity to be presumptively eligible for Medicaid benefits, the individual must apply for Medicaid benefits by not later than the last day of the month following the month during which the determination is made.

(6) The division shall submit the application for the waiver described in this section not later than October 1, 2025.

SECTION 2. This act shall take effect and be in force from and after July 1, 2025.