Date

The MO HealthNet Division (MHD) reimburses providers for long-acting reversible contraception (LARC) devices for dual eligible participants even if their Medicare benefit does not cover it. The MHD currently has a Fiscal Edit in place to prevent duplicate billing of non-oral contraceptive products. Providers are responsible for checking criteria to confirm their patient’s eligibility for a LARC device prior to billing MHD. The criteria for non-oral contraceptive products are available at: http://dss.mo.gov/mhd/cs/pharmacy/pdf/non-oral-contraceptives.pdf. Once a provider has determined a dual eligible participant meets the criteria for a LARC, they must submit a claim to MHD, then contact the Pharmacy Administration Unit at 573-751-6963 or MHD.PharmacyAdmin@dss.mo.gov to obtain an override.