MedicaidPrior AuthHigh impact
Third Party Vendor Requesting Drug Prior Authorization
Missouri Medicaid (MO HealthNet)·MO·Prior Authorization
Effective date
Apr 26, 2019
We identified it
Jun 20, 2026
Summary
MO HealthNet (Missouri Medicaid) no longer accepts drug prior authorization requests from third-party vendors like CoverMyMeds and ZAPPRX. All drug prior authorization requests must now originate directly from the prescriber's office or pharmacy.
Action Required
Immediately: Stop using third-party vendors (CoverMyMeds, ZAPPRX, etc.) for MO HealthNet drug prior authorization requests. Billing team and providers must submit all drug prior authorization requests directly from prescriber's office or coordinate with pharmacy for direct submission. Update workflow procedures to ensure compliance. Contact MO HealthNet Pharmacy Administration at (573) 751-6963 with questions.