23 Miss. Code. R. 302-2.2 - Program Oversight
A. The Division of
Medicaid's Office of Program Integrity:
1.
Manages the Beneficiary Health Management (BHM) program,
2. Screens beneficiaries against criteria
designed to identify drug seeking behavior and inappropriate use of
prescription drugs, and
3. Reviews
claims and pharmacy point-of-sale data to identify patterns of inappropriate,
excessive or duplicative use of pharmacy services.
B. The Division of Medicaid may request the
Mississippi Coordinated Access Network (MSCAN) contractor to lock-in
beneficiaries who have had prior lock-ins with the Medicaid fee-for-service
program or other Medicaid-participating Coordinated Care Organizations
(CCOs).
Notes
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