MedicaidAdministrativeMedium impact
Reimbursement Issues – Pricing Inquiry Process
Missouri Medicaid (MO HealthNet)·MO · Family Medicine, Internal Medicine, General Practice +1 more·Provider Notice
Effective date
Oct 5, 2017
We identified it
Jun 20, 2026
Summary
MO HealthNet providers must now contact Pharmacy and Clinical Services at (573) 751-6963 before dispensing medications with reimbursement issues. If additional review is needed, providers must submit a MAC Pricing Inquiry Worksheet on the same day as dispensing if choosing to dispense below cost.
Action Required
Immediately: Pharmacy staff must call (573) 751-6963 before dispensing any MO HealthNet medications with reimbursement issues. If instructed to submit MAC Pricing Inquiry Worksheet, it must be faxed the same day medication is dispensed if dispensing below cost. Confirm worksheet receipt by phone on day of faxing. Providers are not required to dispense medications below cost.