Welcome to the MO HealthNet Pharmacy Program. The MO HealthNet Pharmacy Program oversees reimbursement for outpatient, fee-for-service prescription drugs, over-the-counter products and devices. The program is responsible for pharmacy program and policy development and uses best practices and evidence-based medicine to drive clinical policy development. Pharmacy Administration is responsible for the pharmacy program and policy development for MHD. Contact Pharmacy Administration at MHD.PharmacyAdmin@dss.mo.gov or call (573) 751-6963.
Education & Training
- Alcohol Use Disorder Treatment Options
- Albuterol Limit for Prescribers
- MO HealthNet Education & Training
- Opioid Policy Update
- Opioid Reversal Agents
- Pharmacy Billing Medical Claims
- Pharmacy Prior Authorization Process
- Pharmacy Provider Resource Guide
- Proper Drug Billing Course
Forms
- Provider Forms
- ADHD Medication Prior Authorization Children Less than 6 Years Old
- Antipsychotic Children less than 9 years old Prior Authorization
- Benzodiazepine Prior Authorization
- Compound Prior Authorization
- Continuous Glucose Monitoring Device Tubeless Insulin Pump Prior Authorization
- Diabetic Supplies Prior Authorization
- Drug Prior Authorization
- GLP-1 Receptor Agonists for All Indications Prior Authorization
- Growth Hormone Somatropin Agents Prior Authorization
- Hepatitis C Treatment Prior Authorization
- Opioid Prior Authorization
- Psychotropic Medication Polypharmacy Prior Authorization
- Request for Brand Name Drug Prior Authorization
- Synagis Prior Authorization
- Targeted Immune Modulators Prior Authorization Misc Allergy and Asthma-related Monoclonal Antibodies
Provider Manual
Resources
- Claims & Billing
- Drugs Carved Out of Inpatient Per Diem
- Drugs Carved Out of 340B Reimbursement
- Drugs with Coverage Limitations and New Drug Review
- FAQs
- Fee Schedules
- Missouri Maximum Allowable Cost For Specific Drug Products
- New Drug AMCP Guidelines (Abbr.) and Cover Letter - 9.1.19
- New Drug Review Process - 11.26.19
- Provider Information
MO HealthNet News
The table below provides general information and updates that are relevant to this program page, as well as all MO HealthNet providers. To find information for all other MO HealthNet programs, or to search by date, program or keyword, visit the MO HealthNet News page. If you would like to receive updates in your inbox, subscribe to MO HealthNet News!
| Date | Volume Number | Subject | Type | Program |
|---|---|---|---|---|
| 02/13/2025 | 47-33 | 2025 HCPCs | Bulletins | All MO HealthNet Providers |
| 02/04/2025 | MO HealthNet Participant's with Third Party Liability Coverage | Hot Tips | All MO HealthNet Providers | |
| 01/06/2025 | 47-40 | Drugs Carved Out of 340B Reimbursement | Bulletins | All MO HealthNet Providers |
| 01/06/2025 | All MO HealthNet Providers Responsible for Updates | Hot Tips | All MO HealthNet Providers | |
| 01/06/2025 | Syphilis: A Provider’s Guide to Treatment and Prevention | Hot Tips | All MO HealthNet Providers | |
| 01/02/2025 | 2025-1 | Provider Newsletter 1st Quarter 2025 | Newsletters | All MO HealthNet Providers |
| 12/30/2024 | Notice of Pregnancy and Risk Screening Update | Hot Tips | All MO HealthNet Providers | |
| 12/27/2024 | Healthy Children and Youth Program Information | Hot Tips | All MO HealthNet Providers | |
| 12/26/2024 | New Practical Guide on Advising Patients on Using 988 vs 911 | Hot Tips | All MO HealthNet Providers | |
| 12/23/2024 | 47-39 | Notification of Pregnancy Revised | Bulletins | All MO HealthNet Providers |
| 12/17/2024 | Free Virtual Training on Substance Use Disorders in the Perinatal Period | Hot Tips | All MO HealthNet Providers | |
| 12/17/2024 | Provider Training Schedule Posted, January – March 2025 | Hot Tips | All MO HealthNet Providers | |
| 12/09/2024 | MO HealthNet Provider Enrollment Electronic Signatures | Hot Tips | All MO HealthNet Providers | |
| 12/09/2024 | 47-35 | Notification of Pregnancy | Bulletins | All MO HealthNet Providers |
| 10/15/2024 | Notification of Pregnancy and Risk Screening Webinars | Hot Tips | All MO HealthNet Providers |