Bill Text: MS HB1517 | 2010 | Regular Session | Introduced
Bill Title: Medicaid; provide for an optional arbitration hearing for a provider to resolve a dispute regarding a reimbursement decision.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Failed) 2010-02-02 - Died In Committee [HB1517 Detail]
Download: Mississippi-2010-HB1517-Introduced.html
MISSISSIPPI LEGISLATURE
2010 Regular Session
To: Medicaid
By: Representative Holland
House Bill 1517
AN ACT TO GIVE MEDICAID PROVIDERS THE OPTION OF HAVING AN ARBITRATION HEARING TO RESOLVE A DISPUTE WITH THE DIVISION OF MEDICAID ABOUT A DECISION OF THE DIVISION THAT ADVERSELY AFFECTS THE PROVIDER'S MEDICAID REIMBURSEMENT; TO PROVIDE FOR THE APPOINTMENT OF THE ARBITRATOR; TO PROVIDE THAT THE FINAL DECISION OF THE ARBITRATOR SHALL BE BINDING ON BOTH PARTIES; AND FOR RELATED PURPOSES.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:
SECTION 1. (1) When the Division of Medicaid has made a final administrative decision that adversely affects the reimbursement of a Medicaid provider, the provider has the option of having the dispute resolved through arbitration instead of using the administrative hearing procedure set forth in the Medicaid Provider Policy Manual.
(2) Any provider whose reimbursement has been adversely affected by a final administrative decision of the division may request an arbitration hearing to resolve the dispute by filing with the division a written notice of request for arbitration. The notice must be filed within thirty (30) calendar days after the date of the final administrative decision of the division. The notice shall contain a statement setting forth the nature of the dispute, the amount involved and remedy sought by the provider. The division may file an answer to the notice within twenty (20) days after receipt of the notice. Failure of the division to file an answer will not operate to deny the arbitration hearing.
At the time of filing the notice, the provider shall execute a bond in the amount of Five Thousand Dollars ($5,000.00) with a surety company authorized to do business in Mississippi to cover the cost of the arbitration hearing.
(3) After the expiration of
the time for the division to file an answer, the parties shall request the
Mississippi Attorney General to submit the names of three (3) arbitrators from
the Mississippi Arbitrator Directory or The Mississippi Bar's Alternative
Dispute Resolution Section. The provider and the division shall jointly agree
on one (1) arbitrator from the names provided by the Attorney General. If the
provider and the division are unable to agree on an arbitrator, then the third
name on the list shall be the arbitrator. If an arbitrator who has been
appointed fails or is unable to act and his successor has not been agreed upon,
then the Attorney General shall appoint the arbitrator.
(4) The arbitrator shall conduct the hearing within twenty (20) days
after his appointment. Within five (5) days after completion of the hearing,
the arbitrator shall send a copy of the recording of the hearing to the
division and the provider. Within twenty (20) days after the completion of the
hearing, the arbitrator shall prepare his final decision in the matter and send
it in writing to the parties, together with the written record of the hearing.
The final decision of the arbitrator shall be binding on both parties and shall
not be subject to review.
SECTION 2. This act shall take effect and be in force from and after July 1, 2010.
