- Drug Prior Authorization Committee
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Thank you for your interest in the MO HealthNet Drug Prior Authorization Committee. The Committee was created by State Regulation 13 CSR 70-20.300.
The Committee is responsible for review of the MO HealthNet Division’s clinical recommendations for inclusion in the MO HealthNet Pharmacy Program and for review of product recommendations for prior authorization, clinical edit or Preferred Drug List (PDL) status. Prior to making coverage recommendations to the Drug Utilization Review (DUR) Board and the MO HealthNet Division (MHD), the Committee will hold quarterly public hearings. Committee nominations are made by the Director of the MO HealthNet Division. Interested parties may submit their CV to MHD.PharmacyAdmin@dss.mo.gov.
Committee Information
- Drug Utilization Review Board
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Thank you for your interest in the MO HealthNet Drug Utilization Review (DUR) Board. The DUR Board was created by State Statute 208.175 as required by the Omnibus Reconciliation Act of 1990. The Board is charged with review and research of the MO HealthNet Division’s clinical recommendations which are ratified through the Drug Prior Authorization Committee. After review by both advisory groups these recommendations are scheduled for implementation by the Department of Social Services/MO HealthNet Division.
For additional information please see 13 CSR 70-20.300. In addition the Board monitors participant drug use, prescribing and dispensing practices for MO HealthNet providers through retrospective and prospective DUR. Applications to serve on the DUR Board may be made online at the Governor’s Web site. Nominations for membership are referred for final appointment by the Governor and are subject to Senate confirmation.
Committee Information
- Advisory Council on Rare Diseases and Personalized Medicine
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Thank you for your interest in the Advisory Council on Rare Diseases and Personalized Medicine. The Council was created by State Statute 208.183.
The advisory council shall serve as an expert advisory committee to the drug utilization review board, providing necessary consultation to the board when the board makes recommendations or determinations regarding beneficiary access to drugs or biological products for rare diseases, or when the board itself determines that it lacks the specific scientific, medical, or technical expertise necessary for the proper performance of its responsibilities and such necessary expertise can be provided by experts outside the board. “Beneficiary access”, as used in this section, shall mean developing prior authorization and reauthorization criteria for a rare disease drug, including placement on a preferred drug list or a formulary, as well as payment, cost-sharing, drug utilization review, or medication therapy management. Council nominations are made by the Director of Social Services. Interested parties may submit their CV to MHD.PharmacyAdmin@dss.mo.gov.
For the purpose of this advisory council a “rare disease drug” shall mean a drug used to treat a rare medical condition, defined as any disease or condition that affects fewer than two hundred thousand persons in the United States, such as cystic fibrosis, hemophilia, and multiple myeloma.
Committee Information
- MO HealthNet Advisory Committees
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There are a number of other MO HealthNet advisory committees including: the MO HealthNet Oversight Committee, the Dental Advisory Committee, the Durable Medical Equipment Advisory Committee, the Non-Pharmaceutical Mental Health Services Prior Authorization Advisory Committee, and the Specialty Health Plan for Children & Youth in the Care & Custody of the State Stakeholder Advisory Committee. For information, please visit the MO HealthNet Advisory Committee page.