Mississippi Administrative Code
Title 23 - Division of Medicaid
Part 306 - Third Party Recovery
Chapter 1 - Third Party Recovery
Rule 23-306-1.5 - Reimbursement
Universal Citation: MS Code of Rules 23-306-1.5
Current through September 24, 2024
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.
42 U.S.C. § 1396(a)(25); Miss. Code Ann. § 43-13-121.
Disclaimer: These regulations may not be the most recent version. Mississippi may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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