How to start a hospice in Mississippi

Mississippi requires a Hospice license (per site/location) from Mississippi State Department of Health, Bureau of Health Facilities Licensure and Certification to operate a hospice. Fee: $1,000.

License required

Yes

License

Hospice license (per site/location)

Issuing agency

Mississippi State Department of Health, Bureau of Health Facilities Licensure and Certification

Fee

$1,000

Fee details

Statute: $1,000 per site or location at application and at each renewal, plus $18 per bed for review of inpatient hospice care (increases follow Miss. Code § 41-3-65). Fingerprinting fee up to $50 per rule.

Renewal

Every year · Licenses expire automatically on June 30 each year; the renewal packet must be returned with the current annual licensure fee.

Survey and inspection

MSDH conducts annual licensure inspections, which may be combined with the annual Medicare certification inspection.

Moratorium or freeze

Miss. Code § 41-85-7(3) bars MSDH from processing new hospice license applications or issuing new licenses (renewals excepted), apart from limited past exception windows (up to 5 licenses in 2017; up to 2 pediatric palliative care licenses through 2021-07-01). As amended by 2021 HB 294, the moratorium subsection stands repealed on July 1, 2027. Reinstatement after an HHS-OIG audit closed without penalty is exempt.

Medicare certification

Medicare certification is separate from the state license (state survey or CMS-approved accreditor). CMS imposed a nationwide 6-month moratorium on new Medicare hospice enrollments (including new practice locations) effective 2026-05-13, extendable in 6-month increments; applications received by the Medicare contractor before that date are still processed, accreditation cannot be used for deemed-status entry during the moratorium, and a hospice undergoing a non-exempt ownership change within 36 months of enrollment must re-enroll as new and is therefore blocked. The federal notice leaves Medicaid/CHIP hospice moratoria to each state.

Regulation

Miss. Code Ann. § 41-85-1 et seq. (§ 41-85-7 fees and moratorium); 15 Miss. Admin. Code Pt. 16, Subpt. 1, Ch. 1 (Minimum Standards of Operation for Hospices)

1. Check the statutory moratorium: MSDH may not process new hospice license applications (renewals excepted) while Miss. Code § 41-85-7(3) is in force
2. If eligible, file the MSDH application with the per-site fee
3. Pass the licensure inspection (annual inspections may coincide with Medicare certification inspections)
4. Renew annually before June 30 with the renewal packet and fee

Program

Mississippi Medicaid (Mississippi Division of Medicaid, DOM)

Enrollment portal

Medicaid Enterprise System Assistance (MESA) Provider Portal

Fiscal agent

Gainwell Technologies (DOM fiscal agent; sends recredentialing notices and does revalidation site visits)

Application fee

DOM charges institutional provider taxonomies on its list (e.g., home health, hospice, ASCs, ESRD, FQHCs, mental health centers, rehab facilities) $750 for 2026. The fee applies at initial enrollment, reactivation, revalidation or re-enrollment, ownership changes and new practice locations, and is paid by check to the Division of Medicaid (marked with the application tracking number) and mailed to Gainwell. Providers that already paid Medicare or another state are exempt. Federal rule (42 CFR 455.460): the state must collect the CMS application fee from institutional providers that are newly enrolling or re-enrolling; individual physicians and non-physician practitioners are exempt, as are providers already enrolled in (or that already paid the fee to) Medicare or another state's Medicaid/CHIP. CMS set the fee at $750 for calendar year 2026.

Fingerprinting

Revalidating providers may have to submit fingerprints as part of screening. Federal rule (42 CFR 455.434, 455.450(c)): providers the state places in the 'high' categorical risk level, and anyone owning 5% or more of such a provider, must submit fingerprints for a criminal background check.

Site visit

Revalidating providers may need a site visit, done by Medicaid's fiscal agent. Federal rule (42 CFR 455.432, 455.450(b)-(c)): the state must do site visits before and after enrollment for providers in the 'moderate' or 'high' risk levels, and any enrolled provider must allow unannounced on-site inspections.

Revalidation

DOM restarted revalidation on October 1, 2023, mailing notices to providers enrolled five years or more; revalidation is done in the MESA Provider Portal. DOM published a Medicaid Provider Revalidation Roadmap in August 2026. Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.

Full Mississippi Medicaid enrollment guide →

CON program

Yes

Program

Certificate of Need

Agency

Mississippi State Department of Health, Office of Health Policy and Planning (Health Planning & Resource Development)

Services covered

• nursing home care services (skilled nursing and ICF)
• ICF/IID and nursing care for persons with developmental disabilities
• pediatric skilled nursing facilities
• acute psychiatric, chemical dependency and psychiatric residential treatment beds
• obstetrical and neonatal special care services
• comprehensive medical rehabilitation
• ambulatory surgery
• home health agencies / home health services
• end stage renal disease facilities
• general acute care hospitals and beds, swing beds, long-term care hospitals
• MRI, PET, digital angiography, therapeutic radiation, stereotactic radiosurgery, cardiac catheterization, open-heart surgery
• major medical equipment and capital expenditures above indexed thresholds; changes of ownership

Moratoria

Long-standing legislative moratoria (first imposed in 1990) bar new or expanded nursing home beds, ICF and ICF/IID beds, and new home health agencies. Effective April 17, 2026, the Legislature re-enacted and reaffirmed the nursing facility / ICF / ICF-IID moratorium (HB 1622, 2026 Regular Session, §2) and the home health agency moratorium.

Mississippi certificate of need details →

State minimum wage

$7.25 an hour

Effective

2009-07-24

Scheduled increases

No scheduled change found in the official sources reviewed.

HCBS 80/20 rule

Federal baseline: 42 CFR 441.302(k) requires the state to show that each provider spends at least 80% of Medicaid payments for homemaker, home health aide and personal care services under 1915(c) waivers on direct care worker pay and benefits. Compliance starts 2030-07-09 (for managed care, the first rating period starting on or after that date); annual payment-adequacy reporting under 441.311(e) starts 2028-07-09. A state may set a lower share for state-defined small providers and exempt providers facing hardship, each only through a public notice-and-comment process. The eCFR text has not changed since 2024-07-09. No state-published 80/20 implementation step (small-provider criteria, hardship exemption or reporting guidance) was found for this state in the official sources reviewed.

Hospice agencies (community based) — active organization NPIs (NPPES)

314 (as of Sep 13, 2026)

Medicare-certified hospices (CMS Care Compare)

84 (as of Aug 19, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

584,125 (as of Jun 1, 2026)

All Mississippi Hospice Medicaid rates, ranked →