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

11 provisions identified: 4 benefits, 4 costs, 3 mixed.

More Medicaid care and treatment options

Medicaid covers services at licensed birthing centers and certain biomarker tests. The state must add billing codes for covered biomarker tests within 60 days after July 1, 2026. The law protects medically appropriate, doctor-prescribed treatment for people with terminal conditions when they or an authorized decision-maker agree. Covered substance-use treatment does not count toward physician visit limits, and teens ages 10 through 18 can get vaccines at pharmacies. Medicaid can also pay for specified community health worker services after federal approval; the state must tell OB-GYN providers that Vaccines for Children is available at no charge.

Medicaid cuts possible after budget shortfalls

When Medicaid spending is expected to exceed its yearly budget, the Governor must consult the Medicaid director and take cost-cutting steps. These steps can include reducing optional services, lowering provider rates, or adding provider assessments. Federal law limits some cuts, and the law sets no reduction amount.

Medicaid therapy plans capped at six months

Each Medicaid therapy plan and its certification period can cover no more than six months of treatment. The plan must state the treatment period, rely on medical need, and be updated when revised. Any reduction in therapy must follow the federal appeal process.

Medicaid checkups and care coordination

The Medicaid agency must encourage members to get a checkup during eligibility reviews, but members do not have to get one. People found ineligible must receive information about local medical care. The agency can also create case management services for beneficiaries it considers high-cost, but the law does not require a specific service or start date.

Medicaid payments support care providers

The state can make enhanced Medicaid payments related to trauma care using health department funds set aside for federal matching. Participating home-care case management districts must receive the maximum rate approved by federal officials. The Medicaid agency can share savings with providers in its emergency-room redirection program and with health centers that accept referrals. Hospital payments and service allowances are protected while the hospital assessment is in effect, with exceptions for changes tied to admissions, audits, specified payment models, or managed care.

More protections in Medicaid managed care

Covered Medicaid managed-care plans cannot require people to use a pharmacy that ships, mails, or delivers their prescriptions. Plans must follow Medicaid payment and care-review rules, including protections for emergency care and access to federally funded hemophilia centers. Contractors must meet provider credentialing and claim-decision deadlines; a claim is approved and must be paid if a contractor misses the 60-day deadline for a final denial. The Medicaid agency can make one emergency extension, of up to one year, for contracts in effect July 1, 2021.

Limits on future Medicaid expansion

Mississippi cannot add new Medicaid recipient groups or types of care without approval from the Legislature. A court can order an addition without that approval. Managed-care enrollment is limited to groups eligible on January 1, 2021, CHIP, and certain approved waivers operating on that date. The law does not remove existing eligibility groups or covered services.

Medicaid copayments may be added

The Medicaid agency can add copayments or coinsurance only for services where federal rules allow them. The law does not set a charge or name which services will have one, so any new cost depends on the agency’s choices.

New Medicaid pediatric hospital payment rules

Medicaid now treats qualifying pediatric long-term acute care hospitals as a separate service category for eligible people under 21. These hospitals must be freestanding, Medicare-certified, have average stays longer than 25 days, and mainly serve children and young people with long-term medical needs. A separate payment authority for one qualifying border-city pediatric teaching hospital ended July 1, 2024; it had required federal approval and other strict hospital conditions.

New board reviews health professions

Beginning July 1, 2026, Mississippi has an 11-member State Board of Health Professions. Six members represent health regulatory boards, and the Governor appoints five at-large members who cannot hold licenses in those professions. The board reviews how professions are regulated, considers scope-of-practice changes and board conflicts, and advises state officials and the Legislature.

Prison work pays wages and sets limits

Beginning July 1, 2026, work initiatives operate at four named state prisons, with no more than 25 inmates in each initiative. Eligible inmates must have two years or less remaining on their sentence and no specified recent escape conviction or qualifying sex-offense sentence; training participants get priority, but placement is not guaranteed. Employers must pay at least the prevailing wage and never less than the federal minimum wage. After required deductions, 25% of wages goes to court-ordered support and costs, 15% to administration, 50% is saved for parole or release, and 10% is available for incidental expenses. Leaving the work area or travel route without authority or just cause counts as escape; facility leaders may also approve education or rehabilitation programs, and program rules must include work-release protections.

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 • Other: 1

Senate vote • 3/10/2026

Passed As Amended

Yes: 50 • No: 2

House vote • 2/5/2026