AN ACT TO AMEND SECTION 43-13-117, MISSISSIPPI CODE OF 1972, TO PROVIDE THAT THE DIVISION OF MEDICAID SHALL REIMBURSE FOR VAGUS NERVE STIMULATION (VNS) SURGICAL IMPLANT PROCEDURES PERFORMED IN HOSPITALS ON AN OUTPATIENT BASIS AND IN AMBULATORY SURGICAL FACILITIES AND TO PRESCRIBE THE RATES OF REIMBURSEMENT; TO PROVIDE THAT CONTRACTS ENTERED INTO OR RENEWED ON OR AFTER THE EFFECTIVE DATE OF THIS ACT BETWEEN THE DIVISION AND A MANAGED CARE ORGANIZATION MUST CONTAIN A REQUIREMENT THAT THE MANAGED CARE ORGANIZATION COMPLY WITH PROVISION REGARDING REIMBURSEMENT RATES FOR VNS SURGICAL IMPLANT PROCEDURES FOR FEE-FOR-SERVICE PROVIDERS; AND FOR RELATED PURPOSES.
Summary
SB 2674 amends Mississippi’s Medicaid statute to require the Division of Medicaid to reimburse for vagus nerve stimulation (VNS) surgical implant procedures when performed in hospitals on an outpatient basis and in ambulatory surgical facilities. The bill sets specific reimbursement amounts for two CPT codes: $45,000 for CPT 64568 and $35,000 for CPT 61885, beginning July 1, 2026. It also directs the division to seek to align managed care organization contracts with this reimbursement requirement so that managed care plans comply with the same VNS payment rules that apply in fee-for-service Medicaid.
Beyond the VNS-specific change, the bill is largely an amendment to the broader Medicaid reimbursement statute and leaves the existing structure of covered services, managed care authority, and payment oversight in place. It adds VNS implants to the list of covered Medicaid services, and it requires managed care contracts entered into or renewed on or after the effective date to include compliance with the new VNS reimbursement mandate. The section containing these Medicaid rules is set to repeal on July 1, 2028, while the act itself takes effect July 1, 2026.
Impact
The bill would amend Section 43-13-117 of the Mississippi Code to create a new Medicaid reimbursement obligation for outpatient VNS implant procedures in hospitals and ambulatory surgical facilities, with fixed payment rates for the specified CPT codes. It would also affect managed care contracts by requiring compliance with the new reimbursement provision, thereby extending the policy beyond fee-for-service Medicaid into capitated or managed care arrangements. The bill does not otherwise restructure Medicaid eligibility or benefits, but it does expand the list of reimbursable services and adds a targeted payment rule for providers performing these procedures.
Sentiment
The available context shows no committee debate, votes, or recorded opposition, so there is no documented split in sentiment. Based on the bill’s narrow focus and the absence of recorded controversy, the measure appears to be a targeted Medicaid reimbursement bill rather than a broader policy fight. The caption and text suggest a generally supportive, technical approach aimed at ensuring payment for a specific medical procedure.
Contention
The main potential point of contention is fiscal: the bill mandates relatively high fixed reimbursement amounts for VNS implant procedures, which could raise Medicaid spending and affect managed care payment arrangements. Another possible issue is whether the required rates are appropriate for all settings and whether managed care organizations should be bound to the same fee-for-service reimbursement terms. No specific objections, amendments, or stakeholder concerns are recorded in the provided context, so any contention is inferred from the policy design rather than from documented debate.