Effective April 1, 2025, MO HealthNet will no longer cover LifeScan products as the preferred diabetic testing supply. Participants currently using LifeScan products must transition to one of the new Preferred Diabetic Supplies. Please note that the new preferred products will not be payable before April 1, 2025, and LifeScan products will not be payable after this date.
Effective April 3, 2025, Cinvanti® will once again be a non-preferred agent in the Antiemetic 5-HT3 and NK1 Agents, Injectable PDL Edit. Cinvanti was temporarily changed to a preferred agent last fall during the shortage on IV fluids following the effects of Hurricane Helene in North Carolina. Baxter stated in their February 17, 2025 update that manufacturing has now returned to pre-hurricane levels.
All MO HealthNet providers and professional community partners are invited to join the MO HealthNet Division, our Managed Care health plans, Show-Me ECHO, and the Office of Oral Health for a unique in-person networking opportunity in cities across Missouri.
Attendees will learn about valuable benefits, incentives, and resources available to pregnant women and their families, including individualized case management, Doula coverage, Non-Emergency Medical Transportation, and more.
It is crucial to use the latest version of the drug prior authorization form to ensure that your requests are processed as quickly and efficiently as possible. Providers can access all drug prior authorization forms here.
MHD Education and Training has posted the 2nd Quarter Provider Training Schedule. These program specific live webinars can also be found on the Provider Training Calendar located at Education and Training.
The Healthy Moms Healthy Babies website offers information for moms and providers. A new addition to the site is the American Heart Association (AHA) information for moms to review during their pregnancy.
Instantly Check PA Fax Status on the MHD Pharmacy and Medical Pre-Certification Helpdesk
MO HealthNet has introduced a convenient self-service feature on the MHD Pharmacy and Medical Pre-Certification Helpdesk IVR. Pharmacies and providers can now quickly check the status of their drug prior authorization (PA) fax requests using the National Provider Identifier (NPI), Participant’s Designated Client Number (DCN), and Fax Date.
Before requesting prior authorization (PA) from the MO HealthNet Division (MHD) for any medication, please verify whether the participant has any other third-party liability (TPL). Providers must utilize all available third-party benefits, including exploring therapeutic alternatives, pursuing prior authorization through the third-party payer, and utilizing a preferred pharmacy before MHD will consider reviewing PAs for participants with TPL.
