23 Miss. Code. R. 306-1.5 - Reimbursement

A. The Division of Medicaid must be billed as the payor of last resort.

B. Providers are required to file a claim with the third party prior to filing with the Division of Medicaid except in the following circumstances:

1. Preventive pediatric service, including EPSDT services, claims must be paid in accordance with the usual payment schedule.

2. Covered services furnished to an individual on whose behalf child support enforcement is being carried out by the state Title IV-D program must be paid in accordance with the usual payment schedule.

C. Medicaid will not pay for services denied by Medicare due to lack of medical necessity but may pay claims denied for other reasons as long as the services are covered under the Medicaid program.

Notes

23 Miss. Code. R. 306-1.5

42 U.S.C. § 1396(a)(25); Miss. Code Ann. § 43-13-121.

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