Mississippi Code Title 83. Insurance § 83-5-909

(a) When prior authorization became required for policies issued or health benefit plan documents delivered in Mississippi, including the effective date or dates and the termination date or dates, if applicable, in Mississippi;

(b) The date the Mississippi-specific requirement was listed on the health insurance issuer's, health benefit plan's, or private review agent's website;

(c) Where applicable, the date that prior authorization was removed for Mississippi; and

(d) Where applicable, access to a standardized electronic prior authorization request transaction process.

(a) Be based on nationally recognized, generally accepted standards except where state law provides its own standard;

(b) Be developed in accordance with the current standards of a national medical accreditation entity;

(c) Ensure quality of care and access to needed health care services;

(d) Be evidence-based;

(e) Be sufficiently flexible to allow deviations from norms when justified on a case-by-case basis; and

(f) Be evaluated and updated, if necessary, at least annually.

(a) An associated health care service has received prior authorization; or

(b) Prior authorization for the health care service is not required.

(a) The health insurance issuer has identified fraudulent or abusive practices related to the health care service;

(b) The health care service is unavailable or scarce which necessitates the use of an alternative health care service;

(c) The health care service is newly introduced to the health care market and a delay in providing coverage for the health care service and would not be in the best interests of enrollees;

(d) The health care service is the subject of a clinical trial authorized by the United States Food and Drug Administration; or

(e) Changes to the health care service or its availability are otherwise required by law to be made by the health insurance issuer in less than sixty (60) days.

(a) A list of all health care services, including medications, that are subject to prior authorization;

(b) The percentage of standard prior authorization requests that were approved, aggregated for all items and services;

(c) The percentage of standard prior authorization requests that were denied, aggregated for all items and services;

(d) The percentage of prior authorization requests that were approved after appeal, aggregated for all items and services;

(e) The percentage of prior authorization requests for which the timeframe for review was extended, and the request was approved, aggregated for all items and services;

(f) The percentage of expedited prior authorization requests that were approved, aggregated for all items and services;

(g) The percentage of expedited prior authorization requests that were denied, aggregated for all items and services;

(h) The average and median time that elapsed between the submission of a request and a determination by the payer, plan or health insurance issuer, for standard prior authorization, aggregated for all items and services;

(i) The average and median time that elapsed between the submission of a request and a decision by the payer, plan or health insurance issuer, for expedited prior authorizations, aggregated for all items and services; and

(j) Any other information as the department determines appropriate.