Rule 23-302-2.2 - Program OversightA. The Division of Medicaid's Office of Program Integrity: 1. Manages the Beneficiary Health Management (BHM) program, 2. Screens beneficiaries against criteria designed to identify drug seeking behavior and inappropriate use of prescription drugs, and 3. Reviews claims and pharmacy point-of-sale data to identify patterns of inappropriate, excessive or duplicative use of pharmacy services. B. The Division of Medicaid will require the Mississippi Coordinated Access Network (MSCAN) contractor to lock-in beneficiaries who have had prior lock-ins with the Medicaid fee-for-service program or other Medicaid-participating Coordinated Care Organizations (CCOs). 23 Miss. Code. R. 302-2.2
42 C.F.R. § 431.54; Miss. Code Ann. §§ 43-13-117, 43-13-121.