23 Miss. Code. R. 202-3.2

Current through December 10, 2024

Rule 23-202-3.2 - Certification of Providers/ Provider Enrollment

A. The Division of Medicaid requires any hospital certified for participation in the Medicare swing bed program who wants to participate in the Medicaid program to become a provider. A separate provider number from the hospital is required for the swing bed.

B. Hospital providers, including swing bed providers applying for enrollment into the Medicaid program must satisfy all requirements set forth in Part 200, Chapter 4, Rule 4.8 in addition to submitting the following provider type specific requirements:

1. National Provider Identifier (NPI), verification from National Plan and Provider Enumeration System (NPPES).

2. Written confirmation from the IRS confirming the provider's tax identification number and legal business name.

3. CLIA certificate and submit the completed certification form.

4. Joint Commission on Accreditation of Health Care Organization (JCAHO) for licensed hospitals.

5. Copy of current Medicare certification or Tie-In Notice. Explanation of Medicare Benefits (EOMB) is not acceptable.

6. Copy of outstanding claims, if applicable, for out-of state facility.

7. Copy of Hospital license:

a.Copy of license/certification, in effect during the claims period for which they are billing for out-of state facility.

b. In-state facility: A copy of letter from the Mississippi State Department of Health is acceptable for in-state facility.

c. License in effect for the new owner for Hospital undergoing a Change of Ownership (CHOW).

23 Miss. Code. R. 202-3.2

Miss. Code Ann. § 43-13-121