MS HB32

Requires managed care organizations and coordinated care programs under Mississippi Medicaid to provide written explanation letters when denying coverage of procedures ordered or requested by health care providers.

Letters must include detailed reasons for denial, the name and credentials of the person who denied coverage, and must be signed by that person.

Letters must be sent to health care providers in both physical and electronic format.

Applies to all health maintenance organizations, coordinated care organizations, provider-sponsored health plans, and other capitated organizations contracting with the Division of Medicaid.