House Bill 1383 Summary

• Authorizes the Division of Medicaid to establish a three-year pilot program beginning on or before January 1, 2021, to evaluate an alternative managed care payment model for medically complex children.

• Pilot program covers beneficiaries under 19 years of age with cardiac conditions requiring inpatient care or surgery, behavioral or developmental issues, or significant chronic conditions affecting two or more body systems.

• Division shall select one Mississippi-licensed children's hospital to deliver services; provider may implement innovative payment models in addition to or instead of fee-for-service reimbursement to share savings with the state.

• All pilot program participants retain the right to choose from available providers in their managed care organization's network; the selected provider may release beneficiaries if determined to be in their best interest.

• Division must report comparative program results to legislative committees in December 2020 and annually thereafter, evaluating health outcomes, administrative costs, and beneficiary satisfaction against other plans.