MO HealthNet will reimburse any medication for a MO HealthNet participant dispensed within the eligibility period shown on a MO HealthNet Presumptive Eligibility Authorization (PE-3) form.
MO HealthNet will also reimburse any medication for a MO HealthNet participant dispensed within the eligibility period shown on a Show Me Healthy Babies Presumptive Eligibility (SMHB-PE) Authorization form.
Both of these forms serve as proof of presumptive eligibility. Pharmacy providers should check the dates of eligibility on the authorization forms to ensure the presumptive eligibility period is active, and make a photocopy of the form and maintain it in the pharmacy file.
Missouri Medicaid Audit and Compliance (MMAC) considers this adequate documentation.
Pharmacies may contact Pharmacy Administration at (573) 751-6963 if they have questions.
Please follow the bellow link to see the March 30, 2017 bulletin which contains sample copies of the forms that participants will be presenting.
https://dss.mo.gov/mhd/providers/pdf/bulletin39-49_2017March30.pdf