Rule 23-215-1.2 - Provider Enrollment Requirements Home health providers, including out-of-state providers, must satisfy all requirements set forth in Part 200, Rule 4.8 in addition to the following provider type specific requirements:
A. National Provider Identifier (NPI), verification from National Plan and Provider Enumeration System (NPPES).B. Written confirmation from the Internal Revenue Service (IRS) confirming the provider's tax identification number and legal business name.C. A copy of the provider's current Medicare certification or Tie-In Notice from the Medicare Intermediary. An Explanation of Medicare Benefits (EOMB) is not acceptable.D. A copy of License from the Mississippi State Board of Health, Health Facilities Licensure and Certification. If parent entity is an out-of-state facility with a servicing location in Mississippi, a copy of the respective State's license is required.23 Miss. Code. R. 215-1.2
42 C.F.R. § 440.70, 42 C.F.R. Part 455, Subpart E; 42 C.F.R. Part 484; Miss. Code Ann. § 43-13-121.