23 Miss. Code. R. 205-1.2 - Provider Enrollment Requirements

Providers of hospice must comply with all federal, state, and local laws and regulations related to the health and safety of beneficiaries and:

A. Meet the conditions of participation set forth in 42 C.F.R. Part 418, Subpart D,

B. Be licensed and certified for participation by the Mississippi State Department of Health (MSDH), Division of Health Facilities Licensure and Certification (HFLC), and meet all requirements in accordance with the rules and regulations as defined in the Minimum Standards of Operation for Hospice per the MSDH,

C. Enter into a provider agreement with the Mississippi Division of Medicaid,

D. Satisfy all requirements set forth in Part 200, Rule 4.8 and must provide to the Division of Medicaid:

1. A National Provider Identifier (NPI), verification from National Plan and Provider Enumeration System (NPPES),

2. Written confirmation from the Internal Revenue Service (IRS) confirming the provider's tax identification number and legal business name,

3. A copy of the provider's current Medicare certification or Tie-In Notice from the Medicare Intermediary. An Explanation of Medicare Benefits (EOMB) is not acceptable, and

4. A copy of the provider's current license or certification letter from the state of the servicing location.

Notes

23 Miss. Code. R. 205-1.2

42 C.F.R. Part 418; Miss. Code Ann. § 43-13-121.

Amended 4/1/2018