MedicaidAdministrativeHigh impact
Reprocessing Fee-for-Service (FFS) Claims Paid Erroneously should have denied with Edit 2017/EOB 0287
Mississippi Medicaid (DOM)·MS · Pharmacy·Prior Authorization
Effective date
Jul 1, 2024
We identified it
Jun 21, 2026
Summary
Mississippi Medicaid has transitioned to a single Pharmacy Benefit Administrator (Gainwell Technologies) for all pharmacy claims processing, including prior authorizations, effective July 1, 2024. All pharmacy providers must update their billing systems with new BIN/PCN values and submit prior authorization requests through new channels.
Action Required
Immediately: Pharmacy providers must update billing software to submit all Medicaid pharmacy claims (FFS, MSCAN, MSCHIP) with dates of service 7/1/2024 and after using BIN 025151 and PCN DRMSPROD to Gainwell Technologies. Update prior authorization submission process to use MESA Portal or fax to 866-644-6147. For retroactive claims before 7/1/2024, determine member's CCO enrollment and submit to appropriate PBM. Update pharmacy help desk contact to 833-660-2402.