Mississippi Medicaid Billing Boosters April 2015

New Medicaid Cards: Blue and Yellow!

Have you noticed new Medicaid Identification Cards?  Last year, Mississippi Medicaid issued either a new blue card or a yellow card.

• Medicaid beneficiaries were issued new blue ID cards to replace the former green ID cards

• Family Planning Waiver beneficiaries were issued yellow ID cards to replace their old yellow card

So, if a patient presents a yellow card it is for Family Planning Services and NOT regular Medicaid services.

Effective 1/1/2015, women and men between the ages of 13-44 became eligible for the Family Planning Waiver Program. The program is for women and men who receive Medicaid benefits LIMITED to family planning services and family planning related services. This includes one annual visit and subsequent visits related to their birth control methods and family planning services.  Beneficiaries cannot exceed a total of 4 visits per federal fiscal year (October 1-September 30). They are NOT eligible to receive ANY OTHER Medicaid benefits.  The requirements are:

• Family income is at or below 194% of the federal poverty level (FPL)

• Must be capable of reproducing

• Must not have had a procedure that prevents them from reproducing

• Must not have Medicare, CHIP, or any other health insurance or third party medical coverage.

See the Covered diagnosis and procedure codes for Family Planning Waiver visits here.

At each and every Medicaid or Medicaid Family Planning Waiver beneficiary visit, the provider is required to:

1. Compare the Medicaid card with a picture ID or similar form of identification to confirm their identity.

2. Verify the patient’s current eligibility benefits.  Possession of a card does not guarantee eligibility.

Medicaid to Transition Children Into MississippiCAN Managed Care Program

Mississippi Medicaid is in the process of transitioning all Medicaid-eligible children up to the age of 19 (with the exception of those who are on Medicare, waivers, or reside in institutions) into its managed-care program, Mississippi Coordinated Access Network (MississippiCAN), between May and July 31, 2015.

This transition does not change their coverage or benefits; however, unlike fee-for-service Medicaid, MississippiCAN is administered by two coordinated-care organizations.  Beneficiaries will choose between Magnolia Health or United Healthcare as their health plan.  If the beneficiary does not choose, one will be automatically assigned.  Those who are automatically assigned will have 90 days to switch plans.  If they don’t, any changes will have to wait until the annual open enrollment period in October, for an effective date of January 1. 

Now, more than ever, verifying the eligibility for each Medicaid patient at each and every visit is of maximum importance.