MedicaidAdministrativeHigh impact
Managed Care Goes Statewide on May 1, 2017
Missouri Medicaid (MO HealthNet)·MO·Provider Notice
Effective date
May 1, 2017
We identified it
Jun 20, 2026
Summary
Effective May 1, 2017, Missouri expanded its MO HealthNet Managed Care program statewide, transitioning approximately 240,000 participants from Fee-For-Service to Managed Care plans. Providers must now contract with the three MO HealthNet Managed Care health plans separately, as these plans may have different prior authorization requirements, timely filing rules, and reimbursement rates than the original Fee-For-Service program.
Action Required
Immediately: Contact the three MO HealthNet Managed Care health plans directly to establish contracts. Review and understand each plan's specific prior authorization requirements, timely filing rules, and reimbursement rates as they may differ from the MO HealthNet Fee-For-Service program. Maintain enrollment with MO HealthNet FFS program. Update billing team on new managed care requirements and patient eligibility verification procedures.