MedicaidPrior AuthMedium impact
RSV Prophylaxis Update
Missouri Medicaid (MO HealthNet)·MO · Pediatrics, Family Medicine, Pulmonology·Provider Notice
Effective date
Nov 8, 2023
We identified it
Jun 20, 2026
Summary
Due to supply shortages of the new RSV prophylaxis agent Beyfortus, MO HealthNet will now allow up to five doses of Synagis (palivizumab) for the 2023-2024 RSV season instead of the usual two doses. Previously approved authorizations from 10/31/2023-11/7/2023 will be automatically extended to cover five doses.
Action Required
Immediately: Billing team should verify that patients with existing Synagis prior authorizations approved between 10/31/2023-11/7/2023 now have coverage for up to five doses instead of two. Coordinate with providers to ensure scheduled appointments exist before requesting medication shipments to avoid waste. Contact MO HealthNet at 800-392-8030 with questions about RSV prophylaxis authorization changes.