MedicaidAdministrativeMedium impact
Missouri Medicaid Audit and Compliance Notification to Providers
Missouri Medicaid (MO HealthNet)·MO · Palliative Care·Provider Notice
We identified it
Jun 20, 2026
Summary
Missouri Medicaid is conducting targeted audits through Recovery Audit Contractors (RAC) and Medicaid Integrity Contractors (MIC). Hospice providers are currently being audited by MIC for eligibility documentation, while pharmacy and durable medical equipment providers will be audited by RAC for proper billing and duplicate payment prevention.
Action Required
Immediately: If you receive communication from Missouri Medicaid Audit and Compliance (MMAC), Health Integrity LLC, Cognosante LLC, or their subcontractors, verify legitimacy by calling MMAC at (573) 751-3399. Hospice providers must prepare eligibility documentation for ongoing audits. Pharmacy providers should organize prescription records, dispensing records, counseling documentation, and delivery records. DME providers must maintain precertification forms, prior authorization documentation, prescriptions, physician orders, invoices, delivery proof, and certificates of medical necessity.