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Legislature passes prior authorization reform for medical procedures, drugs

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Legislature passes prior authorization reform for medical procedures, drugs

The Legislature has overwhelmingly passed a bill to regulate how insurance companies decide which prescription and medical procedures to for a consumer — a called prior authorization.

The Senate passed the proposal unanimously earlier this month, but the House had amended the Senate bill and sent it back. The Senate on Tuesday agreed to the House’s changes.

The proposal now heads to Republican Gov. Tate Reeves, who vetoed a similar measure last year, for consideration.

“The bill that we have will be a great improvement for the process,” Senate Insurance Committee Chairman Walter Michel said. “It’s great for the medical community, it’s great for the patient, and it’s an improvement for the insurance companies as well because they have a defined timetable to the prior authorization.”

Prior authorization is when physicians have to seek approval from an insurance company before the company will cover a prescribed procedure, service or medication that is not an emergency.

If an insurance organization denies a prior authorization claim, a consumer could be forced to pay for a prescription or medical procedure out of pocket.

Insurance companies typically believe prior authorization helps ensure provide only medically necessary services. Doctors argue the process is typically handled by clerical insurance staffers ill-equipped to understand medical procedures.

The bipartisan proposal would require insurance companies to create a “portal” or website by January 2025 for doctors to submit prior authorization applications.

For emergency services such as treating a stroke, prior authorization is not required under the new measure. For urgent services or procedures that can treat someone in intense pain, insurance companies have 48 hours to process requests. For non-urgent services, insurance companies have seven days to process requests.

The governor vetoed a similar measure last year, but a Reeves spokesperson previously told that the governor’s office has worked with “necessary stakeholders” to address some of his concerns in last year’s version of the bill.

“We made changes mainly to hopefully find something that the governor can agree with and go on and sign into ,” House Public Chairman Sam Creekmore IV said. “I think they were reasonable changes, and I hope it will make for a more efficient prior authorization process going forward.”

Insurance Commissioner Mike Chaney’s office will be responsible for enforcing the plan, and Michel told reporters on Tuesday that he intends to ask legislative to give more money to Chaney’s office to effectively enforce the program. 

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

Mississippi Today

On this day in 1875

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mississippitoday.org – Jerry Mitchell – 2024-11-02 07:00:00

Nov. 2, 1875

Pictured here are U.S. Sen. Hiram Revels of Mississippi, left, with six Black members of the U.S. House, Ben J.S. Turner of Alabama, Josiah T. Walls of Florida, Jefferson H. Long of Georgia, and Robert C. De Large, Joseph H. Rainy and R. Brown Elliot, all of South Carolina. Credit: Library of

The first Mississippi Plan, which included violence against Black Americans to keep them from , resulted in huge victories for white Democrats across the

A year earlier, the Republican Party had carried a majority of the votes, and many Black had been elected to office. In the wake of those victories, white leagues arose to Republican rule and began to use widespread violence and fraud to recapture control of the state. 

Over several days in September 1875, about 50 Black Mississippians were killed along with white supporters, a school teacher who worked with the Black community in Clinton. 

The governor asked President Ulysses Grant to intervene, but he decided against intervening, and the violence and fraud continued. Other Southern states soon copied the Mississippi plan. 

John R. Lynch, the last Black congressman for Mississippi until the 1986 election of Mike Espy, wrote: “It was a well-known fact that in 1875 nearly every Democratic club in the State was converted into an armed military company.” 

A federal grand jury concluded: “Fraud, intimidation, and violence perpetrated at the last election is without a parallel in the annals of history.”

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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Mississippi Today’s NewsMatch Campaign is Here: Support Journalism that Strengthens Mississippi

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mississippitoday.org – Mary Margaret White – 2024-11-01 12:34:00

High-quality journalism like ours depends on reader ; without it, we simply couldn’t exist. That’s why we’re proud to join the NewsMatch movement, a national initiative aimed at raising $50 million for nonprofit newsrooms that serve communities like ours here in Mississippi, where access to reliable information has often been limited.

In a time when trusted journalists and sources are disappearing, we believe the stakes couldn’t be higher. Without on-the-ground, trustworthy reporting, civic engagement suffers, accountability falters and corruption often goes unaddressed. But it doesn’t have to be this way.

Here at Mississippi Today we act as watchdogs, holding those in power accountable, and as storytellers, giving a platform to voices that have been ignored for too long. And we’re committed to keeping our stories for everyone because information should be accessible when it’s needed most.

Why NewsMatch and Why Now?

This year’s NewsMatch campaign runs from November 1 through December 31, giving us a special opportunity to make each dollar you give go even further. Through matching funds provided by local foundations like the Maddox Foundation, and national funders like the MacArthur Foundation, the Rural Partner Fund and the Hewlett Foundation, your gift will be matched dollar for dollar up to $1,000. Plus, if 100 new donors join us, we’ll unlock an additional $2,000 in funding, bringing us even closer to our goal. Boiled down: your donation goes four times as far.

Every dollar raised strengthens our ability to serve you with fact-based journalism on issues that impact your everyday —whether it’s covering local election issues or reporting on decisions affecting schools, safety and economic growth in Mississippi. Your support makes it possible for us to stay rooted in the community, offering nuanced perspectives that understand and engage with what’s happening around them.

Special Event: “Freedom of the Press: Southern Challenges, National Impact”

As part of the campaign, we’re to host a special virtual , “Freedom of the Press: Southern Challenges, National Impact.” Join Deep South Today newsrooms Mississippi Today and Verite News, along with national experts on press freedom, for an in-depth discussion on the unique challenges facing journalists in the Deep South. This one-hour session will explore the critical role local newsrooms play in holding power accountable, highlighting recent restrictions on press freedom such as Louisiana’s “25-foot ,” which affects journalists’ ability to report vital news.

We’ll examine what’s at stake if local newsrooms lose press freedoms and will discuss how you, as members of the public, can help protect it. This event is open to Mississippi Today and Verite News members as a special thank-you for supporting local journalism and standing with us in this mission. Donate today to RSVP!

How You Can Help

Make Your Gift Today

Together, let’s ensure Mississippi has the robust, independent journalism it needs to thrive. Your support fuels our ability to expose the truth, elevate marginalized stories and build a more informed Mississippi.

Thank you for believing in the power of journalism to strengthen the communities we love—not only during election season but year-round. With your help, we’ll keep Mississippi informed, engaged and connected for generations to .

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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Hinds County loses fight over control of jail

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mississippitoday.org – Mina Corpuz – 2024-11-01 12:57:00

The sheriff and Board of Supervisors have lost an appeal to prevent control of its jail by a court-appointed receiver and an injunction that orders the county to address unconstitutional conditions in the facility.   

Two members from a three-judge panel of the 5th U.S. Circuit Court of Appeals agreed with decisions by U.S. District Judge Carlton Reeves to appoint a receiver to oversee day-to-day jail operations and keep parts of a previous consent decree in place to fix constitutional violations, a failure to protect detainees from harm. 

However, the appeals court called the new injunction “overly broad” in one area and is asking Reeves to reevaluate the scope of the receivership.

The injunction retained provisions relating to sexual assault, but the appeals court found the provisions were tied to general risk of violence at the jail, rather than specific concerns about the Prison Rape Elimination Act. The court reversed those points of the injunction and remanded them to the district court so the provisions can be

The court also found that the receiver should not have authority over budgeting and staff salaries for the Raymond Detention Center, which could be seen as “federal intrusion into RDC’s budget” – especially if the receivership has no end date. 

Hinds County Board of Supervisors President Robert Graham was not immediately available for comment Friday. Sheriff Tyree Jones declined to comment because he has not yet read the entire court opinion. 

In 2016, the Department of Justice sued Hinds County alleging a pattern or practice of unconstitutional conditions in four of its detention facilities. The county and DOJ entered a consent decree with stipulated changes to make for the jail system, which people facing trial. 

“But the decree did not resolve the dispute; to the contrary, a yearslong battle ensued in the district court as to whether and to what extent the County was complying with the consent decree,” the appeals court wrote.  

This prompted Reeves to hold the county in contempt of court twice in 2022. 

The county argued it was doing its best to comply with the consent decree and spending millions to fix the jail. One of the they offered was building a new jail, which is now under construction in

The county had a to further prove itself during three weeks of hearings held in February 2022. Focuses included the of seven detainees in 2021 from assaults and suicide and issues with staffing, contraband, old and use of force. 

Seeing partial compliance by the county, in April 2022 Reeves dismissed the consent decree and issued a new, shorter injunction focused on the jail and removed some provisions from the decree.

But Reeves didn’t see improvement from there. In July 2022, he ordered receivership and wrote that it was needed because of an ongoing risk of unconstitutional harm to jail detainees and staff. 

The county pushed back against federal oversight and filed an appeal, arguing that there isn’t sufficient evidence to show that there are current and ongoing constitutional violations at the jail and that the county has acted with deliberate indifference. 

Days before the appointed receiver was set to take control of the jail at the beginning of 2023, the 5th Circuit Court ordered a stay to halt that receiver’s work. The new injunction ordered by Reeves was also stayed, and a three-person jail monitoring team that had been in place for years also was ordered to stop work. 

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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