CurrentMississippi Division of MedicaidPolicy N/A

Administrative Procedures Notice Filing — Part 300 (Appeals)

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Notice of filing to update and reformat Part 300 (Appeals) of the Mississippi Medicaid Administrative Code, adding standard of review language for provider appeals, revising timely filing requirements, and making technical corrections affecting providers, beneficiaries, and stakeholders involved in Medicaid appeals procedures within Mississippi Division of Medicaid.

Policy Summary

PayerMississippi Division of Medicaid

PolicyPart 300 (Appeals) administrative procedures notice filing

Policy CodePolicy N/A

Change TypeRevisions and additions to appeals rules

Effective DateN/A

Next Review DateN/A

Key ActionProviders should note updated appeals procedures including new standard of review language and a revised timely filing requirement and follow updated timelines when submitting appeals.

SourceLink

POLICY UPDATE CHANGES

Final file changes made to add standard of review language for provider appeals, revise the timely filing requirement for appeals, and minor technical corrections.

Chapters 3.1-3.8 and Rule 4.2 are listed as (NEW) in the filing.

Part 300sections filed/updated

Rules 1.1-4.2rules repealed/amended/added

Jan 26 2023

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CurrentMississippi Division of MedicaidPolicy N/A

Administrative Procedures Notice Filing — Part 300 (Appeals)

Customize your policy alerts

Sign up for all Mississippi Division of Medicaid policy alerts

Know when Mississippi Division of Medicaid releases new policies or updates existing guidance.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Policy Summary

PayerMississippi Division of Medicaid

PolicyPart 300 (Appeals) administrative procedures notice filing

Policy CodePolicy N/A

Change TypeRevisions and additions to appeals rules

Effective DateN/A

Next Review DateN/A

Key ActionProviders should note updated appeals procedures including new standard of review language and a revised timely filing requirement and follow updated timelines when submitting appeals.

SourceLink

POLICY UPDATE CHANGES

Final file changes made to add standard of review language for provider appeals, revise the timely filing requirement for appeals, and minor technical corrections.

Chapters 3.1-3.8 and Rule 4.2 are listed as (NEW) in the filing.

Part 300sections filed/updated

Rules 1.1-4.2rules repealed/amended/added

Jan 26 2023

Actions and Provider-Facing Changes

Documentation Required

Appeals procedures changed — follow updated Part 300 rules

Final file changes to Part 300 (Appeals) update appeals procedures by adding "standard of review" language for provider appeals and by revising the timely filing requirement for appeals. Providers should note these procedural revisions and follow the updated Part 300 rules when filing or pursuing appeals with the Division of Medicaid.

Standard of review language for provider appeals has been added to Part 300.
The timely filing requirement for appeals has been revised.
Chapters 3.1–3.8 and Rule 4.2 are newly listed in the filing; multiple rules in Chapters 1–4 are amended or repealed as indicated.

Definitions and Process Notes

Part 300 Appeals update

Scope of changeUpdate and reformat of Title 23, Part 300 (Appeals), Chapters 1–4; Rules 1.1–1.5, 2.1–2.23, 3.1–3.8 (NEW), 4.1, 4.2 (NEW) listed as repealed/amended/added.

Key substantive revisionsAddition of standard of review language for provider appeals and revision of the timely filing requirement for appeals; also minor technical corrections.

Legal authority cited42 C.F.R. Part 431 Subpart E; 42 C.F.R. Part 438 Subpart F; 42 C.F.R. Part 455 Subpart E; Miss. Code Ann. §§ 43-13-116, 43-13-117, 43-13-121.

Document type and filing infoAdministrative Procedures Notice Filing submitted to Mississippi Secretary of State; file stamp Jan 26 2023.

Affected stakeholdersProviders, beneficiaries, and other stakeholders involved in Mississippi Medicaid appeals procedures.

Oral proceeding / public comment process

When an oral proceeding is requiredAn oral proceeding must be held if a written request is submitted by a political subdivision, an agency, or ten (10) or more persons within twenty (20) days after filing the notice of proposed rule adoption.

How to request an oral proceedingSubmit a written request to the agency contact person at the address in the filing and include name, address, email, and telephone number of requester; if agent/attorney, include contact info for represented parties.

Public comment period for written submissionsWritten submissions (arguments, data, views) may be submitted at any time within the twenty-five (25) day public comment period following filing.

If no proceeding initially scheduledIf an oral proceeding is not scheduled at filing, the written-request rule above triggers a proceeding when timely requested.

Policy Summary

PayerMississippi Division of Medicaid

PolicyPart 300 (Appeals) administrative procedures notice filing

Policy CodePolicy N/A

Change TypeRevisions and additions to appeals rules

Effective DateN/A

Next Review DateN/A

Key ActionProviders should note updated appeals procedures including new standard of review language and a revised timely filing requirement and follow updated timelines when submitting appeals.

SourceLink

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