Medicaid; require managed care organizations to use certain level of care guidelines in determining medical necessity.

An Act To Amend Section 43-13-117, Mississippi Code Of 1972, To Require Managed Care Organizations Under Any Managed Care Program Implemented By The Division Of Medicaid To Use A Clear Set Of Level Of Care Guidelines In The Determination Of Medical Necessity And In All Utilization Management Practices That Are Consistent With Widely Accepted Professional Standards Of Care; To Prohibit Those Organizations From Using Any Additional Criteria That Would Result In Denial Of Care That Would Be Determi…

Source: OpenStates · fetched February 3, 2026