HB146

Mississippi HB146 requires managed care organizations to use level of care guidelines in determining medical necessity.

Mississippi HB146 amends the Medicaid program to mandate that managed care organizations use clear level of care guidelines in determining medical necessity and in all utilization management practices. These guidelines must be consistent with widely accepted professional standards of care. The bill prohibits these organizations from using additional criteria that would deny care deemed appropriate and medically necessary by the guidelines. The legislation aims to ensure consistent and fair medical necessity determinations across managed care programs.