Title 83, Insurance

(1) Each licensee shall notify the commissioner as promptly as possible but in no event later than three (3) business days from a determination that a cybersecurity event involving nonpublic information that is in the possession of a licensee has occurred when either of the follo…

(1) The commissioner shall have power to examine and investigate into the affairs of any licensee to determine whether the licensee has been or is engaged in any conduct in violation of this article. This power is in addition to the powers which the commissioner has under Section…

(1) Any documents, materials or other information in the control or possession of the department that are furnished by a licensee or an employee or agent thereof acting on behalf of a licensee pursuant to Section 83-5-807(9), Section 83-5-811(2)(b), (c), (d), (e), (h), (j) and (k…

(1) The following exceptions shall apply to this article:(a) A licensee meeting any of the following criteria is exempt from Sections 83-5-807, 83-5-809(3) and 83-5-811(4)(a) and (b):(i) Fewer than fifty (50) employees, excluding any independent contractors;(ii) Less than Five Mi…

In the case of a violation of this article, a licensee may be penalized in accordance with Section 83-5-85.

The commissioner may issue such regulations as shall be necessary to carry out the provisions of this article.

If any provisions of this article or the application thereof to any person or circumstance is for any reason held to be invalid, the remainder of the article and the application of such provision to other persons or circumstances shall not be affected thereby.

Licensees shall have one (1) year from July 1, 2019, to implement Section 83-5-807 and two (2) years from July 1, 2019 to implement Section 83-5-807(6).

This article shall be known as the “Mississippi Insurance E-Commerce Model Act.”

The purpose of this article is to provide consumers more choice, convenience and flexibility in managing their insurance.

(a) As used in this article, the following definitions apply:(a) “Delivered by electronic means” means either of the following:(i) Delivery to an electronic mail address at which a party has consented to receive notices or documents; or(ii) Posting on an electronic network or sit…

(1) Subject to the requirements of this section, any notice to a party or any other document required by law in an insurance transaction or that is to serve as evidence of insurance coverage may be delivered, stored, and presented by electronic means if the electronic means meet …

(a) After the consent of a party is given, in the event a change in the hardware or software requirements needed to access or retain a notice or document to be delivered by electronic means creates a material risk that the party will not be able to access or retain the notice or …

(1) The provisions of this section shall not be construed to affect requirements related to content or timing of any notice or document required by any other provision of law. (2) If a provision of this title or other applicable law requiring a notice or document to be provided t…

The legal effectiveness, validity or enforceability of any contract or policy of insurance executed by a party shall not be denied solely because of the failure of the insurer to obtain electronic consent or confirmation of consent of the party in accordance with the provisions o…

(1) A withdrawal of consent by a party shall not affect the legal effectiveness, validity or enforceability of a notice or document delivered by electronic means to the party before the withdrawal of consent is effective. (2) A withdrawal of consent by a party shall be effective …

(a) If the consent of a party to receive certain notices or documents in an electronic form is on file with an insurer before July 1, 2022, and an insurer intends to deliver additional notices or documents to the party in an electronic form pursuant to this article, then prior to…

(a) An insurer shall deliver a notice or document by any other delivery method permitted by law other than electronic means if either of the following occurs:(a) The insurer attempts to deliver the notice or document by electronic means and has a reasonable basis for believing th…

An insurance producer shall not be subject to civil liability for any harm or injury that occurs because of a party’s election to receive any notice or document by electronic means or by an insurer’s failure to deliver or a party’s failure to receive a notice or document by elect…

(1) An insurance policy and an endorsement that does not contain personally identifiable information may be mailed, delivered, or, if the insurer obtains separate, specific consent, posted on the insurer’s website. If the insurer elects to post an insurance policy and an endorsem…

All claims brought by insureds, workers’ compensation claimants, or third parties against an insurer shall be paid by check or draft of the insurer or, if offered by the insurer and the claimant consents, electronic transfer of funds to the order of the claimant to whom payment o…

The Commissioner of Insurance may adopt rules to implement the provisions of this article.

This article shall be known and may be cited as the “Mississippi Prior Authorization Reform Act.”

(a) The Mississippi Legislature finds and declares that:(a) The health care professional-patient relationship is paramount and should not be subject to unreasonable third-party interference;(b) Prior authorization programs may be subject to member coverage agreements and medical …

This article applies to every health insurance issuer and all health benefit plans, as both terms are defined in Section 83-9-6.3, and all private review agents and utilization review plans, as both terms are defined in Section 41-83-1, with the exception of employee or employer …

(a) For purposes of this article, unless the context requires otherwise, the following terms shall have the meanings as defined in this section:(a) “Adverse determination” means a determination by a health insurance issuer that, based on the information provided, a request for a …

(1) A health insurance issuer shall maintain a complete list of services for which prior authorization is required, including for all services where prior authorization is performed by an entity under contract with the health insurance issuer. (2) A health insurance issuer shall …

(1) If any health insurance issuer requires prior authorization of a health care service, the insurer or its designee utilization review organization shall, by January 1, 2025, make available a standardized electronic prior authorization request transaction process using an inter…

If a health insurance issuer requires prior authorization of a health care service, the health insurance issuer must make an approval or adverse determination and notify the enrollee, the enrollee’s health care professional, and the enrollee’s health care provider of the approval…

(1) If requested by a treating health care provider or health care professional for an enrollee, a health insurance issuer must render an approval or adverse determination concerning urgent health care services and notify the enrollee, the enrollee’s health care professional and …

(a) If a health insurance issuer makes an adverse determination, the health insurance issuer shall include the following in the notification to the enrollee, the enrollee’s health care professional, and the enrollee’s health care provider:(a) The reasons for the adverse determina…

(1) A health insurance issuer must ensure that all appeals are reviewed by a physician when the request is by a physician or a representative of a physician. The physician must:(a) Possess a current and valid nonrestricted license to practice medicine in any United States jurisdi…

(a) A health insurance issuer shall periodically review its prior authorization requirements and consider removal of prior authorization requirements:(a) Where a medication or procedure prescribed is customary and properly indicated or is a treatment for the clinical indication a…

(1) A health insurance issuer may not revoke or further limit, condition or restrict a previously issued prior authorization approval while it remains valid under this article. (2) Notwithstanding any other provision of law, if a claim is properly coded and submitted timely to a …

(1) A prior authorization approval shall be valid for the lesser of six (6) months after the date the health care professional or health care provider receives the prior authorization approval or the length of treatment as determined by the patient’s health care professional or t…

(1) If a health insurance issuer requires a prior authorization for a recurring health care service or maintenance medication for the treatment of a chronic or long-term condition, including, but not limited to, chemotherapy for the treatment of cancer, the approval shall remain …

(1) On receipt of information documenting a prior authorization approval from the enrollee or from the enrollee’s health care professional or health care provider, a health insurance issuer shall honor a prior authorization granted to an enrollee from a previous health insurance …

A failure by a health insurance issuer to comply with the deadlines and other requirements specified in this article shall result in any health care services subject to review to be automatically deemed authorized by the health insurance issuer or its contracted private review ag…

(1) In addition to the enforcement powers granted to it by law to enforce the provisions of this article, the department is granted specific authority to issue a cease-and-desist order or require a private review agent or health insurance issuer to submit a plan of correction for…

(1) By June 1, 2025, and each June 1 after that date, a health insurance issuer shall report to the department, on a form issued by the department, the following aggregated trend data, de-identified of protected health information, related to the insurer’s practices and experienc…

If a health insurance issuer has clear and convincing evidence that a health care professional or health care provider has knowingly and willingly submitted false or fraudulent requests for prior authorization to the health insurance issuer, the issuer shall notify and provide th…

(a) As used in this chapter the following terms have the respective meanings herein set forth unless the context shall require otherwise:(a) An “affiliate of” or person “affiliated” with a specific person means a person that directly, or indirectly through one or more intermediar…

(1) The commissioner is required to terminate the registration of any insurer which demonstrates that it no longer is a member of an insurance holding company system. (2) The commissioner may require or allow two (2) or more affiliated insurers subject to registration hereunder t…

The commissioner may allow an insurer which is authorized to do business in this state and which is part of an insurance holding company system to register on behalf of any affiliated insurer which is required to register under Section 83-6-3 and to file all information and mater…

The provisions of Sections 83-6-3 through 83-6-19 do not apply to any insurer, information or transaction if and to the extent that the commissioner, by rule, regulation or order, exempts the same from the provisions of Sections 83-6-3 through 83-6-19.

Any person may file with the commissioner a disclaimer of affiliation with any authorized insurer or such a disclaimer may be filed by such insurer or any member of an insurance holding company system. The disclaimer shall fully disclose all material relationships and bases for a…