Current through October 31, 2024
Rule 23-206-1.4 - Non-Covered ServicesA. The Division of Medicaid does not cover community mental health services that: 1. Are not medically necessary,2. Are not prior authorized by the Division of Medicaid, Utilization Management/Quality Improvement Organization (UM/QIO) or designee, if required, and3. Are not part of a plan of care or treatment plan approved by a team member qualified to approve the service being provided.B. The Division of Medicaid does not cover the following activities and/or services:1. Time spent completing paperwork,2. Telephone contacts, unless included in the service definition,3. Recreational activities,4. Educational interventions,6. Missed or canceled appointments,7. Room and board, and/or 8 Services provided to a beneficiary during an inpatient stay, unless included in the service definition.C. The Division of Medicaid does not cover services and/or programs that do not meet the standards of the licensing/certifying agency when applicable.23 Miss. Code. R. 206-1.4
42 C.F.R. §§ 440.130, 440.169; Miss. Code Ann. §§ 43-13-117, 43-13-121.