Notwithstanding language to the contrary elsewhere contained herein, if a licensed physician certifies in writing to an insurer within seventy-two (72) hours of an admission that the insured person admitted was in need of immediate hospital care, such shall constitute a prima facie case of the medical necessity of the admission. To overcome this, the entity requesting the utilization review and/or the private review agent must show by clear and convincing evidence that the admitted person was not in need of immediate hospital care.
Structure Mississippi Code
Chapter 83 - Utilization Review of Availability of Hospital Resources and Medical Services
§ 41-83-5. Certificate requirement for general in-house utilization review; exemptions
§ 41-83-9. Submission of information in conjunction with application
§ 41-83-15. Reporting requirements to evaluate and determine compliance
§ 41-83-17. Disclosure or publication of information; consent or authorization; court order
§ 41-83-19. Penalties for violations
§ 41-83-21. Certification of need of immediate hospital care; prima facie evidence