MedicaidAdministrativeMedium impact
Administrative Lock-In Emergency Services Process
Missouri Medicaid (MO HealthNet)·MO · Emergency Medicine·Provider Notice
Effective date
Jan 20, 2026
We identified it
Jun 20, 2026
Summary
MO HealthNet participants with administrative lock-ins can only receive services from authorized providers, except for emergency services which require paper claims marked 'EMERGENCY' with supporting medical records. Referrals from authorized providers require form PI-118 and are valid for only 30 days from date of service.
Action Required
Immediately: Billing team must identify MO HealthNet participants with administrative lock-ins via eMOMED eligibility verification. For emergency services to locked-in participants, submit paper claims marked 'EMERGENCY' with medical records to Wipro Infocrossing P.O. Box 5600, Jefferson City, MO 65102. For referrals, ensure authorized providers complete form PI-118 within 30 days of service date and submit via eMOMED or mail to P.O. Box 5900. Claims for locked-in participants without proper authorization or emergency documentation will be denied payment.