MississippiHB 9252026 Regular SessionHouseWALLET

Creating Logic for Efficiency and Accountability Reform (CLEAR) Act; create.

Sponsored By: Sponsor information unavailable

Signed by Governor

Accountability, Efficiency, Transparency

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Bill Overview

Analyzed Economic Effects

12 provisions identified: 7 benefits, 1 costs, 4 mixed.

No new Medicaid groups without law

The Division cannot add new eligibility groups or new covered services without a new state law. A court order is the only exception. This can delay or stop future expansions.

Easier access to home health care

Nurse practitioners, physician assistants, and clinical nurse specialists can order and certify home health care. All home health visits must be precertified. Total home health costs cannot exceed prevailing nursing home costs. These steps make it easier to start needed care while managing costs.

Medicaid pay rates for doctors

For services covered only by Medicaid, doctors are paid 90% of the Medicare‑based rate set January 1, 2018. Pay can be up to 100% for after‑hours care and some primary care. Certain OB/GYN primary care services are paid at 100%. These rules aim to keep doctors seeing Medicaid patients.

Pay changes for hospitals and clinics

Medicaid can use APR‑DRG to pay hospitals for inpatient care. Rural hospitals with 50 or fewer beds may skip APC and get 101% of the Medicare outpatient rate for two years. Federally qualified and rural clinics are paid for telehealth as both the patient site and the doctor site. The state can run supplemental payment programs and assess hospitals, nursing homes, and ambulance providers to fund the state share. These steps aim to keep local hospital and clinic access.

Medicaid drug list and pharmacy fees

The law sets a mandatory preferred drug list. Drugs not on the list need prior authorization. Medicaid pays for the cheapest equally effective generic instead of a brand drug. Pharmacies get at least $3.91 per prescription as a dispensing fee. Any restock fee is capped at $7.82. The state can team with other states, and, if federal law allows, other countries to lower drug costs. For people with Medicare and Medicaid, drug claims must be billed to Medicare first.

Nursing home pay and leave days

Medicaid pays the full nursing home rate for up to 42 home‑leave days each year, plus listed Thanksgiving and Christmas days. The state uses a case‑mix system for payments and quality checks and can pay some leave days at the lower of the case‑mix rate or 1.000. State‑owned nursing homes are paid their full reasonable costs.

Paid prison work with savings rules

Starting July 1, 2026, prisons run paid work programs, with up to 25 inmates per initiative. Only inmates with two years or less left, no recent escape conviction, and no listed sex offense may join. Employers must pay at least the prevailing wage and never less than the federal minimum wage. After deductions, pay is split: 25% to dependents and fines, 15% for program administration, 50% saved until release, and 10% for incidentals. Participants must keep a bank account and provide pay stubs.

Higher Medicaid payments to dentists

Medicaid raises dental fees by 5% per year for diagnostic and preventive services in FY2022–FY2024. It raises restorative dental fees by 5% per year in FY2023–FY2025. The program is reviewed each year by the advisory committee.

More Medicaid help for moms and kids

The state runs a Perinatal High Risk program for pregnant people and infants on Medicaid. The Health Department certifies early‑intervention funds each year to draw Medicaid match for more case management for children with special needs. Medicaid covers eyeglasses after eye surgery that changed vision within six months, and one pair every five years when prescribed.

Stronger guardrails on Medicaid plans

Managed care plans cannot pay less than standard Medicaid rates or add stricter prior auth or drug rules. Plans cannot override hospital ER doctors or block hemophilia center access. The Division must give lawmakers 30 days’ notice before rate changes and meet if chairs object. PEER must review nonemergency transport by January 1, 2027, and every three years.

New board to oversee health professions

The law creates a State Board of Health Professions to review health jobs, recommend regulation, and resolve scope‑of‑practice issues. The Health Department must budget for and support the board’s work. The board promotes competency standards and fair enforcement.

Rules and reporting for prison work

The Corrections Department oversees the work programs; sheriffs oversee regional ones. The corporation must issue rules within six months and include work‑release safety protections. Detailed program data must be reported every six months, with the first report due six months after July 1, 2026. PEER issues an annual effectiveness report by January 1 each year. Leaving an assigned work area without permission is escape, and a conviction ends eligibility during the current term.

Sponsors & Cosponsors

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 337 • No: 3

Senate vote • 4/1/2026

Conference Report Adopted

Yes: 52 • No: 0

House vote • 3/31/2026

Conference Report Adopted

Yes: 116 • No: 0

Senate vote • 3/10/2026

Passed As Amended

Yes: 50 • No: 2

House vote • 2/5/2026