SB 2867 Mississippi Senate · 2025 Regular Session

Medicaid; make various amendments to the provisions of the program.

SB 2867 amends Mississippi's Medicaid program to update eligibility rules, including extending foster care eligibility to age 26 and modifying income criteria. It requires less frequent medical reviews for children with chronic conditions, mandates 100% Medicare-rate reimbursement for pediatric primary care, and expands coverage for non-opioid pain medications, autism services, and eye glasses (every two years instead of five). The bill also prohibits Medicaid reimbursement for gender transition procedures and updates reimbursement rates for hospitals, ambulance services, and outpatient care to align with federal standards. The bill was signed into law but later vetoed by the governor on March 27, 2025.

Issues: ✓ Healthcare

Bill status vetoed 4 of 5 stages cleared

Introduction

Feb 2025

Committee Review

Mar 2025

Senate Passage

Mar 2025

House Passage

Mar 2025

Vetoed

Mar 2025

Introduced Feb 17, 2025 Vetoed Mar 27, 2025

Maddy AI version diff · 3 comparisons

What changed between versions

As Introduced → Committee Substitute · 19 edits

MAJOR

This bill amends Mississippi's Medicaid law to expand eligibility for children in foster care until age 26, update reimbursement rates for various services, and implement new coverage requirements for postpartum depression screening and GLP-1 medications. It also modifies hospital payment systems, extends certain program deadlines, and adds provisions for maternal mental health services.

Scope change

The bill expands Medicaid eligibility to children in foster care until their 26th birthday and adds new service coverage requirements while modifying existing reimbursement methodologies.

ELIGIBILITY

Children in foster care remain eligible for Medicaid until their 26th birthday instead of the previous age limit.

Removes the requirement for pregnant women to provide proof of pregnancy and income documentation when seeking presumptive eligibility.

Removes age restriction for gender transition procedure coverage, now prohibiting all gender transition procedures regardless of age.

COVERAGE

Requires coverage and reimbursement for postpartum depression screening and prohibits step therapy protocols for FDA-approved postpartum depression medications.

Mandates reimbursement for FDA-approved GLP-1 agonist medications for chronic weight management.

Requires reimbursement for preparticipation physical evaluations and nonstatin medications that reduce cardiovascular event risk.

Authorizes reimbursement for neuromuscular tongue muscle stimulators and alternative treatments for snoring and obstructive sleep apnea.

FISCAL

Changes eyeglass reimbursement frequency from every five years to every two years for certain beneficiaries.

Requires reimbursement of pediatricians for certain primary care services at 100% of Medicare rates.

Allows reimbursement for ambulatory surgical care based on 100% of Medicare ASC payment system rates.

Eliminates the option for rural hospitals with 50 or fewer beds to opt out of APC reimbursement methodology.

Increases the quarterly hospital assessment limit to allow increases exceeding $3,750,000 to maximize federal funds.

TIMELINE

Extends the repeal date for border city university-affiliated pediatric teaching hospital provisions from 2024 to 2029.

Reduces legislative notice period for proposed Medicaid rate changes from 30 days to 15 days with expedite option.

REQUIREMENT

Requires hospitals providing birth services to distribute maternal mental health educational materials to new parents and women showing signs of maternal mental health disorders.

Requires healthcare providers offering postnatal care to provide postpartum depression screening and referrals.

Prohibits insurers from requiring step therapy protocols for FDA-approved postpartum depression medications.

DEFINITION

Creates new sections defining terms related to maternal mental health and establishing requirements for educational materials.

TECHNICAL

Updates various code sections to conform with federal law and make minor technical revisions.

As Passed the upper → Current version · 10 edits

MAJOR

This bill updates Mississippi's Medicaid program to align with federal requirements, modernize payment systems, and expand certain benefits. Key changes include extending eligibility for foster care children to age 26, allowing oral contraceptives in 12-month supplies, adjusting reimbursement rates for certain services, and clarifying hospital payment programs. The bill also extends the deadline for repealing certain hospital reimbursement provisions and adds new requirements for maternal mental health screening.

Scope change

The bill expands Medicaid eligibility for children in foster care to age 26 (previously 21), adds new medication coverage options, and modifies how certain hospital services are reimbursed while maintaining compliance with federal Medicaid rules.

ELIGIBILITY

Extended Medicaid eligibility for children in foster care from age 21 to age 26, aligning with federal law.

Added coverage for oral contraceptives that can be prescribed in 12-month supply increments under family planning services.

Added coverage for nonopioid medications approved by FDA for pain treatment and management.

Added eligibility for men of reproductive age under the Family Planning Program.

FISCAL

Changed Ambulatory Surgical Care (ASC) reimbursement from 100% of Medicare rates to 90% of Medicare rates.

REQUIREMENT

Added requirement for hospitals providing birth services to offer postpartum depression screening materials to new parents and women showing signs of maternal mental health disorders.

Modified hospital assessment rules to maximize federal funding for supplemental payment programs while maintaining existing methodologies for State Fiscal Year 2025.

Added requirement for the Division of Medicaid to submit a waiver by July 1, 2025 to CMS for less frequent medical redeterminations for children with chronic conditions.

Added requirement that pregnant women no longer need to provide proof of pregnancy or monthly income documentation for presumptive eligibility.

TIMELINE

Extended the repeal date for Border City University-affiliated pediatric teaching hospital reimbursement from July 1, 2024 to July 1, 2027.

Committee Substitute → As Passed the upper · 8 edits

MODERATE

This bill updates Mississippi's Medicaid program with several substantive changes including new coverage requirements, reimbursement rules, and administrative procedures. Key modifications include requiring a CMS waiver for less frequent medical redeterminations for children with chronic conditions, adding coverage for GLP-1 medications for weight management, prohibiting step therapy for postpartum depression treatments, and modifying appeal processes to eliminate certain court appeals. The bill also extends several existing programs and adjusts reimbursement rates for various healthcare services.

Scope change

The bill expands Medicaid coverage to include GLP-1 medications for chronic weight management and postpartum depression screening, while also adding new requirements for the Division of Medicaid to submit a waiver to CMS by July 1, 2025. It modifies appeal procedures by eliminating appeals to the Chancery Court of Hinds County and removes the option for certain hearings.

REQUIREMENT

Division of Medicaid must submit a waiver to CMS by July 1, 2025 to authorize less frequent medical redeterminations for children with long-term or chronic conditions that don't need annual reidentification.

Prohibits step therapy protocols for drugs approved by FDA for treating postpartum depression and requires coverage for postpartum depression screening.

Requires the Division to reimburse ambulance transportation service providers that provide assessment, triage, or treatment for eligible Medicaid beneficiaries.

Establishes new Medicaid Advisory Committee and Beneficiary Advisory Committee as required by federal regulations, with members serving until July 1, 2028.

Removed language authorizing the Division to tax the costs of certain administrative hearings to providers who do not succeed in their defense.

ELIGIBILITY

Added coverage for FDA-approved GLP-1 agonist medications for chronic weight management and additional conditions at the medical provider's discretion.

ENFORCEMENT

Eliminates appeals to the Chancery Court of the First Judicial District of Hinds County following administrative appeals and removes the option for certain hearings.

TECHNICAL

Several technical formatting changes and reorganization of sections, including moving some provisions and updating section numbering.

Floor votes · Senate Feb 12, 2025 · House Mar 12, 2025

How they voted

45–5

Passed · 1 other

Total votes 51

Feb 12, 2025

D Democratic16

16 Yea

100% Yea

R Republican35

29 Yea 5 Nay 1

82% Yea

Vote distribution

All Yea All Nay Mixed No data

Full legislative history

Actions timeline

Total actions

Key actions

Committee

Amendments

Mar 28, 2025

Committee

Veto Referred To Medicaid

upper

Mar 27, 2025

Vetoed

executive

Mar 18, 2025

Upper · Passed

Concurred in Amend From House

upper

Mar 12, 2025

Lower · Passed

Passed As Amended

lower

Mar 12, 2025

Lower · Passed

Amended

lower

Mar 4, 2025

Lower · Passed

Title Suff Do Pass As Amended

lower

Feb 17, 2025

Committee

Referred To Medicaid

lower

Feb 17, 2025

Introduced

Transmitted To House

upper

Feb 12, 2025

Upper · Passed

Passed As Amended

upper

Feb 12, 2025

Upper · Passed

Amended

upper

Feb 4, 2025

Upper · Passed

Title Suff Do Pass Comm Sub

upper

Jan 20, 2025

Committee

Referred To Medicaid

upper

0 primary · 1 co-sponsor