All MO HealthNet Division (MHD) providers are required by federal regulations, 42 CFR 455, and state regulations, 13 CSR 65-2.020, to disclose certain information to Missouri Medicaid Audit & Compliance (MMAC), during their initial enrollment
Missouri Medicaid Audit & Compliance (MMAC) is implementing new provider enrollment procedures, including provider revalidation. Any provider, whose address has changed since initial enrollment, should submit the updated information to MMAC by accessing the “Provider Update Request” form and submitting the changes to MMAC.
The Missouri Medicaid Audit and Compliance (MMAC) website posts information for MO HealthNet Division (MHD) providers and participants. On the MMAC website, the "Contact Us" tab allows users to contact MMAC with their questions. Please utilize this function to submit questions directly to MMAC.
Please protect and secure health information.
Tips for Protecting Protected Health Information (PHI):
On August 31, 2014, Current Procedural Terminology (CPT) code 90655 SL, Influenza virus vaccine, was made non-covered by MO HealthNet Division (MHD).
The Department of Health and Senior Services, (DHSS) is offering an additional vaccine to providers enrolled in the Vaccines for Children (VFC) Program.
MHD reimbursement for the administration of the additional vaccine is effective for dates of service September 12, 2014, and after. The additional vaccine provided through the VFC program is as shown below:
The Missouri Tobacco Quitline has expanded its eligibility for all tobacco users willing to set a quit date within 30 days. The Quitline is free to anyone in Missouri. The Quitline provides services to assist individuals who want to quit smoking or using other tobacco products. The services include:
On October 20, 2014, the MO HealthNet Division (MHD) Provider Manuals were consolidated to include the General Sections with the Program Sections into a single document for each specific provider manual.
MO HealthNet participants, who are eligible to receive Non-Emergency Medical Transportation (NEMT), should request for transportation at least five (5) calendar days in advance by calling (866) 269-5927. Requests may be made 24 hour a day, seven (7) days a week.
The MO HealthNet Division (MHD) provides weekly Hot Tips to providers to assist them in receiving timely reimbursement. Please share these weekly hot tips with billing staff.
If there is a topic that you would like to see covered, please send them by e-mail to: MHD.provtrain@dss.mo.gov.
Eligibility verification is essential to processing a claim for reimbursement. Providers shall check participant eligibility on the date of service (DOS) to verify the participant’s eligibility status and covered services.
