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
- Albuterol Limit for Prescribers
- Pharmacy Billing Webinar
- Pharmacy Provider Resource Guide
- Pharmacy Billing Medical Claims
- MO HealthNet Education & Training
- Opioid Policy Update
- Pharmacy Prior Authorization Process
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
- Cystic Fibrosis Treatment Request
- Diabetic Supplies Prior Authorization
- Drug Prior Authorization
- GLP-1 Receptor Agonists & Combination Agents 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
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 |
|---|---|---|---|---|
| 02/26/2024 | Optimizing Missouri’s Managed Care Plan Benefits for Maternal and Infant Health | Hot Tips | All MO HealthNet Providers | |
| 02/20/2024 | 46-43 | 2024 HCPCs | Bulletins | All MO HealthNet Providers |
| 02/20/2024 | GLP-1 Shortage | Hot Tips | Pharmacy | |
| 02/01/2024 | Telemedicine Billing Resource | Hot Tips | All MO HealthNet Providers | |
| 01/30/2024 | Diagnosis Code Requirement on Certain Pharmacy Claims | Hot Tips | Pharmacy | |
| 01/30/2024 | Master Plan on Aging – Upcoming Town Halls | Hot Tips | All MO HealthNet Providers | |
| 01/26/2024 | Asthma Inhaler Update | Hot Tips | Pharmacy | |
| 01/25/2024 | 46-39 | Provider 1099 Forms | Bulletins | All MO HealthNet Providers |
| 01/25/2024 | General Provider Resource | Hot Tips | All MO HealthNet Providers | |
| 01/16/2024 | 46-38 | Pharmacy Program Reimbursement Bulletin 46-38 | Bulletins | Pharmacy |
| 01/11/2024 | Inhalers Update | Hot Tips | Pharmacy | |
| 12/28/2023 | Prior Authorization for Your Patient’s Medications | Hot Tips | All MO HealthNet Providers | |
| 12/27/2023 | 46-34 | Pharmacy COVID-19 Vaccine Administration | Bulletins | Pharmacy |
| 12/20/2023 | New Missouri Tobacco Quitline Services in 2024 | Hot Tips | All MO HealthNet Providers | |
| 12/20/2023 | MO HealthNet making the following changes to the Preferred Drug Listing for Insulin Agents | Hot Tips | All MO HealthNet Providers |