23 Miss. Code. R. 208-4.2 - [Effective until 7/1/2025] Eligibility
A. Eligibility is limited to individuals with
the following disease(s) or condition(s):
1.
Traumatic brain injury which the Division of Medicaid defines as an insult to
the skull, brain, or its covering resulting from external trauma, which
produces an altered state of consciousness or anatomic, motor, sensory, or
cognitive/behavioral deficits.
2.
Spinal cord injury which the Division of Medicaid defines as a traumatic injury
to the spinal cord or cauda equina with evidence of motor deficit, sensory
deficit, and/or bowel and bladder dysfunction. The lesions must have
significant involvement with two (2) of the above three (3) deficits.
B. The extent of injury
must be certified by the physician.
C. Brain or spinal cord injury that is due to
a degenerative or congenital condition, or that result, intentionally or
unintentionally, from medical intervention is excluded.
D. Individuals must be certified as medically
stable by their physician. The Division of Medicaid defines medically stable as
the absence of all of the following:
1. An
active, life threatening condition requiring systematic therapeutic measures.
2. Intravenous drip to control or
support blood pressure.
3.
Intracranial pressure or arterial monitoring.
E. Individuals must qualify for full Medicaid
benefits in one (1) of the following Categories of Eligibility (COE):
1. Supplemental Security Income (SSI),
2. Parents and Other Caretaker
Relatives Program,
3. Disabled
Child Living at home program,
4.
Working Disabled,
5. Infants and
Children under age nineteen (19) who meet the applicable income requirements,
6. Disabled Adult Child,
7. Protected Foster Care
Adolescents,
8. Child Welfare
Services (CWS) Foster Children and Adoption Assistance Children,
9. IV-E Foster Children and Adoption
Assistance Children, or
10. An
aged, blind or disabled individual who meets all factors of institutional
eligibility. If income exceeds the current institutional limit, the individual
must pay the Division of Medicaid the portion of their income that is due under
the terms of an Income Trust in order to qualify.
F. Persons enrolled in the TBI/SCI Waiver who
elect to receive hospice care may not receive waiver services which are
duplicative of any services rendered through hospice. Persons may receive
non-duplicative waiver services in coordination with hospice
services.
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
A. Eligibility is limited to individuals with the following disease(s) or condition(s):
1. Traumatic brain injury which the Division of Medicaid defines as an insult to the skull, brain, or its covering resulting from external trauma, which produces an altered state of consciousness or anatomic, motor, sensory, or cognitive/behavioral deficits.
2. Spinal cord injury which the Division of Medicaid defines as a traumatic injury to the spinal cord or cauda equina with evidence of motor deficit, sensory deficit, and/or bowel and bladder dysfunction. The lesions must have significant involvement with two (2) of the above three (3) deficits.
B. The extent of injury must be certified by the physician.
C. Brain or spinal cord injury that is due to a degenerative or congenital condition, or that result, intentionally or unintentionally, from medical intervention is excluded.
D. Individuals must be certified as medically stable by their physician. The Division of Medicaid defines medically stable as the absence of all of the following:
1. An active, life threatening condition requiring systematic therapeutic measures.
2. Intravenous drip to control or support blood pressure.
3. Intracranial pressure or arterial monitoring.
E. Individuals must qualify for full Medicaid benefits in one (1) of the following Categories of Eligibility (COE):
1. Supplemental Security Income (SSI),
2. Parents and Other Caretaker Relatives Program,
3. Disabled Child Living at home program,
4. Working Disabled,
5. Infants and Children under age nineteen (19) who meet the applicable income requirements,
6. Disabled Adult Child,
7. Protected Foster Care Adolescents,
8. Child Welfare Services (CWS) Foster Children and Adoption Assistance Children,
9. IV-E Foster Children and Adoption Assistance Children, or
10. An aged, blind or disabled individual who meets all factors of institutional eligibility. If income exceeds the current institutional limit, the individual must pay the Division of Medicaid the portion of their income that is due under the terms of an Income Trust in order to qualify.
F. Persons enrolled in the TBI/SCI Waiver who elect to receive hospice care may not receive waiver services which are duplicative of any services rendered through hospice. Persons may receive non-duplicative waiver services in coordination with hospice services.