The Reeves Administration has announced temporary Medicaid changes in response to coronavirus outbreak. Additional information on policies, coding, and reimbursement related to the COVID-19 outbreak will continue to be added to a resource page on the agency’s website at https://medicaid.ms.gov/coronavirus-updates/.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
In November, the Mississippi Division of Medicaid (DOM) introduced a new Provider Satisfaction Survey, which is a brief, electronic survey distributed to the provider community on a quarterly basis. If members haven’t yet had a chance to fill it out, the survey will remain open for another 30 days. Each survey will cover a different topic, and we will share the results once each survey is closed and the answers are compiled. For the first survey, the Department wants to hear what topics/challenges are of most interest to providers. Mississippi Division of Medicaid Provider Satisfaction Survey. The survey will remain open through the end of December.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
In state-wide elections this week, current Lt. Governor Tate Reeves (R) defeated Attorney General Jim Hood (D) in the gubernatorial race. Mississippi requires that gubernatorial candidates not only win the popular vote, but also that they secure a majority of legislative districts as well. Of note, current State Treasurer Lynn Fitch (R) will become the state's first female Attorney General. Additionally, Republicans gained a supermajority in the Senate and maintained their supermajority in the House. Speaker Phil Gunn (R) is expected to remain Speaker in
Also in Mississippi… the Mississippi Division of Medicaid's (DOM) Universal Preferred Drug List (PDL) is updated on a quarterly basis each year, with off-cycle changes made as the need arises. As a reminder to pharmacies and prescribing Medicaid providers, effective Nov. 1, 2019, three off-cycle PDL changes will occur. For more information please click here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
The Mississippi Division of Medicaid is researching payment mechanisms pharmacists currently use to bill payers for vaccine administration. Pharmacy providers are being asked to complete this brief survey as it will be a valuable tool in future decision-making processes.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
On August 1, Alliant Health Solutions began performing prior authorization reviews as the Division of Medicaid (DOM) transitions to a new Utilization Management/Quality Improvement Organization vendor. All prior authorization reviews in process before August 1 will be completed by eQHealth Solutions as part of the transition to Alliant. Alliant has scheduled a series of informational webinars with one date remaining in August on the 16th. To sign up for a webinar or to learn more about these changes, visit Alliant’s Mississippi Medicaid portal.
Also in Mississippi… On August 1, the DOM implemented a new opioid initiative, which affects pharmacy point-of-sale claims and applies to beneficiaries enrolled in Medicaid fee-for-service and all three MississippiCAN coordinated care plans. The initiative involves four changes that will directly impact Medicaid pharmacy/prescribing providers.
Also in Mississippi… On Friday, November 1, the DOM will implement new three-year contracts for the Children’s Health Insurance Program (CHIP). CHIP will continue to be administered by two vendors, but providers should be aware that there is one important change. Molina Healthcare will replace Magnolia Health as one of the two coordinated care organizations administering the program. UnitedHealthcare Community Plan will continue to serve as the other CHIP vendor.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
The Division of Medicaid, in conjunction with its contractors Conduent, Alliant UM/QIO and the MSCAN plans – Magnolia Health, Molina Healthcare and UnitedHealthcare Community Plan, will conduct “FREE” Medicaid Provider Workshops beginning Tuesday, June 11 through Tuesday, July 30, at locations throughout the state. These workshops are designed to provide information and changes related to Medicaid and managed care programs. Office directors, office managers, coders, practitioners and billing staff are encouraged to attend. Please RSVP because space is limited.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Effective April 1, the Division of Medicaid (DOM) updated its Voluntary 90-Day Drug Maintenance List for prescribing/pharmacy providers. This list is a resource to help clinicians manage a Medicaid beneficiary’s monthly prescription drug limit, unless clinically contraindicated.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
On October 1, the Division of Medicaid (DOM) began requiring an FDA-approved indication or compendia-supported indication for each stimulant prescription. It has come to DOM’s attention that the MississippiCAN pharmacy claims systems do not interface with the medical claims systems and may not be able to perform a search for diagnoses in the past 24 months of medical claims. The fee-for-service system is capable of performing this look-back function. To ensure that stimulant prescriptions process without delay or the need for prior authorization, DOM advises providers to write the diagnosis and ICD-10 code on each of their patient’s ADHD (attention deficit hyperactivity disorder) prescriptions. Pharmacy providers must then enter the ICD-10 code on prescription claims. A list of FDA-approved or compendia-supported indications covered by DOM, along with corresponding ICD-10 codes, can be found on DOM’s Pharmacy Resource webpage.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Effective Thursday, November 1, the Division of Medicaid (DOM) is implementinga mandatory billing policy whereby providers must identify 340B purchased drugs on claims. This billing policy is in response to CMS’ requirement that DOM define its policies and oversight activities related to 340B purchased drugs as outlined in CMS State Release No. 161, dated October 26, 2012. This represents a mandatory change to DOM billing policy only and will not impact 340B reimbursement.
Also in Mississippi…The Mississippi Headache Symposium will be held on October 17-18. All licensed healthcare providers interested in improving outcomes for headache sufferers are welcome to attend.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
