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HB 1565

Medicaid; seek federal waiver to provide for presumptive eligibility for persons who need mental health or substance use disorder services.

2025 Regular Session Introduced by Becky Currie

Mississippi seeks federal waiver to let mental health and substance abuse patients receive immediate Medicaid services while eligibility applications are processed.

Died In Committee
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Bill Summary · HB 1565

Legislative bill overview

HB 1565 would authorize Mississippi to seek a federal waiver from CMS to implement presumptive eligibility for individuals seeking mental health or substance use disorder services under Medicaid. Presumptive eligibility allows patients to receive services immediately while their Medicaid application is being processed, rather than waiting for formal approval. This mechanism would streamline access to treatment for vulnerable populations experiencing mental health crises or addiction.

Why is this important

Mental health and substance use disorder crises often require immediate intervention, and delays in Medicaid eligibility determination can result in untreated conditions, emergency department use, or worse outcomes. Presumptive eligibility removes administrative barriers to timely care access and could reduce the burden on emergency services and crisis intervention resources. This approach has been used successfully in other states for other medical conditions.

Potential points of contention

  • Cost concerns: The state must absorb costs for services provided under presumptive eligibility if applicants are later determined ineligible, raising budgetary questions about fiscal impact
  • Federal waiver uncertainty: Obtaining CMS approval is not guaranteed, and the bill provides no contingency plan if the waiver is denied
  • Program administration: Implementation requires training providers and Medicaid staff on new eligibility procedures, retroactive coverage rules, and potential claim denials/recoupments

Compiled from official sources — confirm details with the bill’s official record.

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