MedicaidCoverageLow impact
Reimbursement for Specialized Formulas for WIC Enrolled Participants
Missouri Medicaid (MO HealthNet)·MO · Pediatrics, Family Medicine, Gastroenterology·Provider Bulletin
Effective date
May 5, 2026
We identified it
Jun 20, 2026
Summary
New policy establishes reimbursement guidelines for specialized infant formulas for participants enrolled in the WIC (Women, Infants, and Children) program. This affects billing for specialized nutritional products prescribed for infants with specific medical conditions who are also WIC participants.
Action Required
By May 5, 2026: Billing team should review WIC enrollment status for pediatric patients requiring specialized formulas. Update billing workflows to ensure proper coordination of benefits between Medicaid and WIC programs. Verify specialized formula coverage rules and documentation requirements for dual-enrolled patients.