23 Miss. Code. R. 306-1.4 - Casualty Cases

A. In the event a provider has knowledge that an individual is a Medicaid beneficiary and is receiving or has received health care services which may be covered by Medicaid as a result of the accident or incident, the provider is prohibited from:

1. Demanding any payment from the Medicaid beneficiary or his representative, or

2. Pursuing collection of any type against the Medicaid beneficiary or his representative.

B. A provider who has filed and accepted Medicaid payment and who fails to notify the Division of Medicaid that the provider has also received payment from a third party will be referred to the Medicaid Fraud Control Unit for investigation/prosecution for any possible violation of federal or state laws.

C. A provider may be excluded from participation in the Medicaid Program if the provider:

1. Accepts payment from a third party and fails to comply with the provisions of this policy, or

2. Fails to refund to Medicaid a duplicate payment within thirty (30) days of receipt of the duplicate payment.

Notes

23 Miss. Code. R. 306-1.4

Miss. Code Ann. §§ 43-13-121, 43-13-313.

Amended 6/1/2015 Amended 4/1/2021