Modifies outpatient hospital reimbursement for outpatient hospital services

Update to add the non-MAGI methodologies.

Changing the current limitations of beds allowed in a therapeutic group home from eight to sixteen.

Modifies supplemental payments for outpatient hospital reimbursement for outpatient hospital services.

Amends the requirements for participation to allow youth 16 and older to elect to receive care under this service.

Reimbursement update for Prevention Breast and Cervical Cancer Early Detection

Amends Attachment 4.19-B of the Medicaid State Plan to incorporate the 2019 Healthcare Common Procedure Coding System (HCPCS) changes (additions, deletions and description changes) to the Medical Equipment, Devices and Supplies (MEDS) and Early Intervention Services (EIS) pursuant to Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services fee schedules.

Allow residents in professional counseling, psychology and supervisees in social work who completed the education requirements for licensure but have yet to meet the experience requirements to provide billable outpatient behavioral health services to Medicaid members. Removed also is the 21-day limit on inpatient psychiatric services.

Allows the Mississippi Division of Medicaid to: a) add Autism Spectrum Disorder (ASD) as a covered diagnosis, b) remove the needs-based criteria, c) revise the qualifications and training requirements for Targeted Case Managers, and d) revise the reimbursement for TCM for beneficiaries with IDD in community-based settings from $14.88 per fifteen (15) minute unit to a rate of $151.01 per month.

Submitted to correspond with the new NET Broker contract, operational.