23 Miss. Code. R. 306-1.7

Current through December 10, 2024
Rule 23-306-1.7 - Coordination of Benefits
A. Coverage available through the Mississippi Medicaid program is secondary to any third party benefits to which a beneficiary may be entitled. If a beneficiary has other insurance, the primary insurance should be used before billing Medicaid. Benefits available from insurance or other third party liability are used to reduce costs to the Medicaid program. To be eligible for Medicaid reimbursement, all Division of Medicaid policies including prior authorization requirements must be followed.
B. Policies that provide wage or income supplementation for lost income due to disability are not considered third party resources. However, policies, including indemnity policies that provide for payment while the beneficiary receives medical care and services such as during a period of hospitalization covered by Medicaid, are considered third party resources. The assignment of third party medical payments is a condition of eligibility for Medicaid per federal and state laws.

23 Miss. Code. R. 306-1.7

42 CFR §§433.138, 433.145; Miss. Code Ann. § 43-13-121.
Amended 6/1/2015