208.201. Mo HealthNet division established--director, how appointed, powers and duties--powers, duties and functions of division.

Mo HealthNet division established--director, how appointed, powers andduties--powers, duties and functions of division.

208.201. 1. The "MO HealthNet Division" is hereby established withinthe department of social services. The director of the MO HealthNetdivision shall be appointed by the director of the department. Where thetitle "division of medical services" is found in the Missouri Revisedstatutes it shall mean "MO HealthNet division".

2. The MO HealthNet division is an integral part of the department ofsocial services and shall have and exercise all the powers and dutiesnecessary to carry out fully and effectively the purposes assigned to it bylaw and shall be the state agency to administer payments to providers underthe MO HealthNet program and to carry out such other functions, duties, andresponsibilities as the MO HealthNet division may be transferred by law, orby a departmental reorganizational plan pursuant to law.

3. All powers, duties and functions of the family support divisionrelative to the development, administration and enforcement of the medicalassistance programs of this state are transferred by type I transfer asdefined in the Omnibus State Reorganization Act of 1974 to the MO HealthNetdivision. The family support division shall retain the authority todetermine and regulate the eligibility of needy persons for participationin the MO HealthNet program.

4. All state regulations adopted under the authority of the divisionof medical services shall remain in effect unless withdrawn or amended byauthority of the MO HealthNet division.

5. The director of the MO HealthNet division shall exercise thepowers and duties of an appointing authority under chapter 36, RSMo, toemploy such administrative, technical, and other personnel as may benecessary, and may designate subdivisions as needed for the performance ofthe duties and responsibilities of the division.

6. In addition to the powers, duties and functions vested in the MOHealthNet division by other provisions of this chapter or by other laws ofthis state, the MO HealthNet division shall have the power:

(1) To sue and be sued;

(2) To adopt, amend and rescind such rules and regulations necessaryor desirable to perform its duties under state law and not inconsistentwith the constitution or laws of this state;

(3) To make and enter into contracts and carry out the duties imposedupon it by this or any other law;

(4) To administer, disburse, accept, dispose of and account forfunds, equipment, supplies or services, and any kind of property given,granted, loaned, advanced to or appropriated by the state of Missouri orthe federal government for any lawful purpose;

(5) To cooperate with the United States government in matters ofmutual concern pertaining to any duties of the MO HealthNet division or thedepartment of social services, including the adoption of such methods ofadministration as are found by the United States government to be necessaryfor the efficient operation of state medical assistance plans required byfederal law, and the modification or amendment of a state medicalassistance plan where required by federal law;

(6) To make reports in such form and containing such information asthe United States government may, from time to time, require and complywith such provisions as the United States government may, from time totime, find necessary to assure the correctness and verification of suchreports;

(7) To create and appoint, when and if it may deem necessary,advisory committees not otherwise provided in any other provision of thelaw to provide professional or technical consultation with respect to MOHealthNet program administration. Each advisory committee shall consultwith and advise the MO HealthNet division with respect to policies incidentto the administration of the particular function germane to theirrespective field of competence;

(8) To define, establish and implement the policies and proceduresnecessary to administer payments to providers under the MO HealthNetprogram;

(9) To conduct utilization reviews to determine the appropriatenessof services and reimbursement amounts to providers participating in the MOHealthNet program;

(10) To establish or cooperate in research or demonstration projectsrelative to the medical assistance programs, including those projects whichwill aid in effective coordination or planning between private and publicmedical assistance programs and providers, or which will help improve theadministration and effectiveness of medical assistance programs.

(L. 1987 H.B. 579, A.L. 2007 S.B. 577)