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Pharmacy Point-of-Sale Drugs: Prior Authorization Requirements
Effective date
Jan 1, 2027
Identified
Sep 29, 2026
Summary
Effective January 1, 2027, Mississippi Medicaid is transitioning all pharmacy prior authorization submissions to mandatory electronic submission through the MESA Provider Portal, replacing paper and phone submission methods. Providers must register for portal access and train staff immediately to avoid claim denials starting in the new year.
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What to do
Action · 1 steps
01REQUIREMENTS:
By December 31, 2026 (before effective date):
- Billing team and clinic administrators must register for MESA Provider Portal access if not already registered at https://medicaid.ms.gov/ (select 'Register Now' on MESA Portal page)
- Clinic administrator must grant delegate portal access to all staff members responsible for submitting pharmacy prior authorization requests
- All personnel who submit pharmacy PAs must confirm they have been granted delegate access and can log into the portal
- Billing team must test electronic PA submission process through MESA Provider Portal in advance of January 1, 2027
- Update internal workflow documentation to reflect mandatory electronic PA submission only (discontinue paper and phone methods)
IMMEDIATELY:
- Contact Gainwell Provider Enrollment Call Center at 800-884-3222 for assistance with portal registration, delegate access setup, or password resets
- Identify and train all staff who will submit pharmacy PAs on MESA Portal PA submission procedures
- Participate in training opportunities offered by DOM and Gainwell throughout remainder of 2026 (additional details will be announced)
CONSEQUENCES:
- Pharmacy prior authorization requests submitted by non-electronic methods after January 1, 2027 will not be accepted
- Claims submitted without required electronic prior authorization will be denied
- Failure to obtain portal access before the effective date may cause significant delays in claim processing and payment
Original notice
Pharmacy Point-of-Sale Drugs: Prior Authorization Requirements
medicaid.ms.gov · Always check the source before changing claims.
Related changes
See all Mississippi Medicaid (DOM) changes →Medicaid to implement single Pharmacy Benefit Administrator for all pharmacy claims on July 1MediumEffective Jul 1, 2024 · Prior AuthorizationInitial Provider Notice – Transition to Mandatory Electronic Pharmacy Prior Authorization SubmissionHighNo effective date · Prior AuthorizationMedicaid to implement single Pharmacy Benefit Administrator for all pharmacy claims on July 1, 2024HighEffective Jul 1, 2024 · Prior AuthorizationBrowse every Mississippi Medicaid (DOM) change in the policy list