Rule 23-208-2.10 - ReimbursementA. Claims must be based on services that have been rendered to waiver persons as authorized by the Plan of Services and Supports (PSS), accurately billed by qualified waiver providers, and in accordance with the approved waiver. B. The Division of Medicaid conducts financial audits of waiver providers. If warranted, immediate action is taken to address compliance or financial discrepancies. C. The Division of Medicaid denies payment for services when a waiver person or applicant is not Medicaid eligible on the date of service. D. The Division of Medicaid conducts post utilization reviews to ensure the services provided were on the person's approved PSS. E. Records documenting the provision of services must be maintained by the operating agency (if applicable) and providers of waiver services for a minimum of five (5) years. F. Payment for all waiver services is made through an approved Medicaid Management Information System (MMIS). 23 Miss. Code. R. 208-2.10
Miss Code Ann. §§ 43-13-117, 43-13-121.