New Provider Updates 01/08/2024

New Updates have been posted to MO HealthNet

January 08, 2024 Bulletins Pharmacy COVID-19 Vaccine Administration December 27, 2023 Applies to: Pharmacy Providers Effective date: November 29, 2023 Beginning November 29, 2023, thru September 30, 2024, pharmacy providers authorized to administer COVID-19 vaccines under the US Department of Health and Human Services (HHS) COVID-19 Public Readiness and Emergency Preparedness (PREP) Act declaration will be able to bill for COVID-19 vaccines regardless of whether the pharmacy provider is enrolled as a Vaccines for Children (VFC) Program provider or the age of the participant. Read more... Psychiatric Residential Treatment Facilities – Bed Hold Reimbursement December 28, 2023 Applies to: Psychiatric Residential Treatment Facilities Effective date: October 1, 2023 • Bed Hold Reimbursement • Medical Leave Days • Therapeutic Leave Days • Procedure Code, Limitation, Modifiers, and Maximum Allowable Rate • Notification Required Bed Hold Reimbursement Effective October 1, 2023, Psychiatric Residential Treatment Facilities (PRTFs) will receive reimbursement for medical and therapeutic leave days at 50% of the PRTF per diem rate. Medical Leave Days Medical leave days/bed hold days are reimbursed a maximum of five (5) days per treatment episode. A treatment episode is defined as an inpatient psychiatric care hospital admission or a medical/surgical hospital admission. Read more... Hot Tips MO HealthNet making the following changes to the Preferred Drug Listing for Insulin Agents December 20, 2023 Effective January 11, 2024, in response to various changes in the current marketplace, MO HealthNet will make the following changes to the Preferred Drug Listing for Insulin Agents. For further information, please reference the Pharmacy Clinical Edits and Preferred Drug Lists webpage at Missouri Pharmacy Clinical Edits and Preferred Drug Lists | Missouri Department of Social Services (mo.gov). Insulin, Long Acting PDL Edit Levemir® FlexPen®/FlexTouch®/Vial will be listed as a non-preferred agent based on Novo Nordisk's decision to discontinue Levemir in the United States. Participants compliant on non-preferred therapy will be allowed to continue therapy with the same non-preferred agent. Read more... Manuals Behavioral Health Youth Targeted Case Management Manual Name Change January 05, 2023 To be consistent with the Behavioral Health Adult Targeted Case Management Manual, the Youth Targeted Case Management Manual has been renamed Behavioral Health Youth Targeted Case Management Manual. Read more... Contact Us For questions about pharmacy or MORx, please email: MHD.PharmacyAdmin@dss.mo.gov. For questions about psychology, exceptions, or medical pre-certifications, please email: Clinical.Services@dss.mo.gov For all other questions or comments, please email: Ask.MHD@dss.mo.gov Our Mission: Empower Missourians to live safe, healthy, and productive lives.     Note: replies to this email address will not be monitored.

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