MedicaidPrior AuthMedium impact
RSV Prophylaxis
Missouri Medicaid (MO HealthNet)·MO · Pediatrics, Pulmonology, Neonatology·Provider Notice
Effective date
Oct 30, 2023
We identified it
Jun 20, 2026
Summary
MO HealthNet will begin reviewing Synagis (palivizumab) requests starting October 30, 2023, allowing up to two doses for November and December 2023 due to Beyfortus supply constraints. Prior authorization will be required based on clinical edit requirements and age restrictions.
Action Required
By October 30, 2023: Billing team must begin obtaining prior authorization for all Synagis (palivizumab) requests through MO HealthNet. Providers should coordinate with pharmacies to ensure scheduled appointments exist before medication is dispensed to reduce waste. Contact MO HealthNet at 800-392-8030 for questions.