MS SB2837

Authorizes rural hospitals with 50 or fewer licensed beds to opt out of Ambulatory Payment Classification (APC) reimbursement methodology and instead receive 101% of Medicare outpatient rates for a two-year period.

Requires physicians with family medicine, general internal medicine, pediatrics, obstetrics/gynecology, or recognized primary care specialties to be reimbursed at 100% of Medicare rates; mandates psychiatrist services be reimbursed at 100% of Medicare rates.

Adds coverage for substance abuse disorder treatment (including tobacco cessation, alcohol, chemical dependency, and opioid addiction) with limits of 30 inpatient days annually; allows physician-administered drugs to be billed as medical or pharmacy claims; authorizes pharmacy vaccination administration for ages 10-18.

Requires Medicaid managed care organizations to implement standardized credentialing processes and uniform prior authorization criteria by January 1, 2019; mandates annual independent audits of managed care programs to measure financial and performance metrics.

Establishes a five-year pilot program to evaluate provider-sponsored health plans covering at least 25% of managed care enrollment; extends automatic repealer date for hospital assessment provisions from July 1, 2018 to July 1, 2021.