ms-28975: Title 23: Medicaid, Part 202: Hospital Services, Chapter 1: Inpatient Services, New Rule 1.19: Potentially Preventable Hospital Returns (PPHR).

1. Briefly summarize the benefits that may result from this regulation and who will benefit:

Allows the Division of Medicaid to reduce payments to hospitals for potentially preventable hospital returns,

3. Briedly describe the effect the proposed action will have on the public health, safety. and

welfare: Eliminates unnecessary renon visits.

4. Estimated Cost of implementing proposed action:

a. To the agency Nothing (1) Minimat (J Moderate (1 Substantial 1] Excessive b. ‘To other state or local government entities El Nothing [] Minimal [J Moderate [1] Substantial [] Excessive 5, Estimated Cost andor economic benclfit to all persons directly affected by the proposed tule: ec. Cost: ONothing KX Minimal (J Moderate (] Substantial (J Excessive d. Economic Benefit: Nothing (] Minimal (7 Moderate [] Substantial (J Excessive 6. Estimated impact on small businesses: Ed Nothing [] Minimal [J Moderate (J Substantial [7] Excessive a. Estimate of the number of small businesses subject to the proposed regulation: N/A. a. Estimate of the number of small businesses subject te the proposed regulation: N/A. b. Projected costs for smal] businesses 10 comply: N/A c. Statement of probable effect on impacted small businesses: N/A 7. The cost of adopting the rule compared to not adopting the rule or signilicantly amending the existing rule (check option): gq substantially less than Oo moderately less than [XJ minimally less than UJ the same as (J minimally more than (1 moderately more than LU substantially more than _] excessively more than 8. The benefit of adopting the rule compared to not adopting the rule or significantly amending the existing rule (check option): O stibstantially less than Oo moderately less than 0 minimally less than UC the same as J minimally more than ([] moderately more than U1 substantially mare than [1] excessively more than

L. Other than adopting this rule, are there less costly or less intrusive methods for achieving the

purpose of the propased rule? Dyes no 2. ifyes, please briefly describe available, reasonable alternative(s) and the reasons for rejecting those alternatives in favor of the proposed rule. (Please sce §25-43-4.104 for factors you must consider.) N/A

C. Data and Methodology

4. Please briefly describe the data and methodology you used in making the estimates required by this form. Taking all PPHR chains from the Vl PPHR Statewide report, getting their Paid Amount fram the claims data, and applying the reduction percentage to the paid amount ifthe claim was the index admission, If the claim is not an initial admission, then we are using the base paid amount front the claim.

1. Where. when. and how may someane present their views on the proposed rule and

request an oral proceeding on the proposed rule if one is not already scheduled? Written conunents will be received by the Division of Medicaid. Office af the Governor, Office of Policy. P.O. Ba: Jackson. Md ippi 39. or emailed to DOMPoliey Qmedicaid. ms. gov for thirty (30) days from the date of publication of this notice. Comments will be available for public review at the above address and on the Division of Medicaid's website at www. medicaid ms.gov. SIGNAJSIRE TITL Metheh wed Executive Director DATE PROPOSED EFFECTIVE DATE OF RULE ()) /0~ 19~ orp : UAL O1 2027 SOS APA Form 003 Rev. 6/12 Michael Watson SECRETARY OF STATE ECONOMIC IMPACT STATEMENT. An Economie Impact Statement is required for this proposed rute by Section 25-43-3.105 of the Administrative Procedures Act. An Economic Impact Statement must be attached to this Form and address the factors below. A PDF document containing this executed Form and the Economic Impact Statement must be filed with any proposed Fula, if required by the aforementioned statute. AGENCY NAME iT HONE, MS Division of Medicaid NUMBER _ 603-359-2081 ADDRESS CITY STATE ZIP ‘S50 High Street Jackson MS: 39201 EMAIL DESCRIPTIVE TITLE OF PROPOSED RULE DOMPolicy “i mediciad as gow ‘Tithe 23; Medienid, Port 202: Hospital Services, Chapter 1: Inpatient Services, New Rule t.19: Putentially Preventable Hospital Reluras (PPHR). ‘Specific Legal Authority Authorizing the promulyation of Reference to Rules repealed, amended or suspended by the Proposed Rute: AD CHR.§ 447.253. 19 (new) “SIGNATERE TITLE Tob, Executive Director DATE «/ PROPOSED EFFECTIVE DATE OF RULE, /0-/?~ Bdaw JAN 0 1 2027 |, Describe the need for the proposed action: reyuires Aospuats to perform the requireit discharge planning steps

2. Describe the benefits which will likely accrue as the result of the proposed action: dans the Dives of

Meideuid to rechece payments to inspitals for potennalle preventable hospital retarns,

4. Estimate the cost to the agency and to any other state or local government entities, of implementing

and enforcing the proposed action, including the estimated amount of paperwork, and any anticipated effect on state or loval revenues: No cos: to sie agency

J. Estimate the cost or economic benefit to all persons directly affected by the proposed action: the «

would be aresioal 6. Pravide an analysis of the impact of the proposed rule on small business: na a. Identify and estimate the number of small businesses subject to the proposed regulation: wa b. Provide the projected reporting. recordkeeping. and other administrative costs required for compliance with the proposed regulation, including the type of professional skills necessary for preparation of the report or record: sia c. State the probable effect on impacted small businesses: xa d. Describe any less intrusive or less costly alternative methods of achieving the purpose of the proposed regulation including the following regulatory flexibility analysis: iil. iv. ve The establishment of less stringent compliance or reporting requirements for small] businesses; The establishment of less stringent schedules or deadlines for compliance or reporting requirements for small businesses; The consolidation or simplification of compliance or reporting requirements for small businesses; The establishment of performance standards for small businesses to replace design or operational standards required in the proposed regulation; and The exemption of some or all small businesses from all or any part of the requirements contained in the proposed regulations: wa 7. Compare the costs and benefits of the proposed rule to the probable costs and benefits of not adopting the proposed rule or significantly amending an existing rule: Minimally less than. 8. Determine whether less costly methods or less intrusive methods exist for achieving the purpose of the proposed rule where reasonable alternative methods exist which are not precluded by law: nva 9. Describe reasonable alternative methods, where applicable, for achieving the purpose of the proposed action which were considered by the agency: N/A 10. State reasons for rejecting alternative methods that were described in #9 above: wa 11. Provide a detailed statement of the data and methodology used in making estimates required by this subsection: Taking all PPHR chains from the V41 PPHR Statewide report, getting their Paid Amount from the claims data, and applying the reduction percentage to the paid amount if the claim was the index admission. If the claim is not an initial admission, then we are using the base paid amount from the claim.