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    • June 4, 2018

    Several sections in the Provider Manuals have been updated. Please see below for details: Section 1 had several updates; old terminology was replaced with current terminology, all of the language was updated to match the description of the ME Codes, and changes to the eligibility and presumptive eligibility processes.  Also, all of the... more

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    • November 27, 2017

    On November 30, 2017, a new state rule (13 CSR 65-3.050) will be effective for electronic signatures in the MO HealthNet Program.  The new rule establishes the basis on which health care providers and participants under Missouri Title XIX programs may use electronic signatures when validating services rendered and received. All providers are... more

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    • July 28, 2017

    Effective for dates of services on or after July 1, 2017, the MO HealthNet Division (MHD) Fee-For-Service maximum allowable rates are reduced by approximately three percent (3%) for the Physician Program. These changes are due to reductions included in the Fiscal Year 2018 budget. The MHD will reimburse the lower of the provider’s billed charge or... more

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    • July 28, 2017

    Effective for dates of services on or after July 1, 2017, the MO HealthNet Division (MHD) Fee-For-Service maximum allowable rates are reduced by approximately three percent (3%) for the Physician Program. These changes are due to reductions included in the Fiscal Year 2018 budget. The MHD will reimburse the lower of the provider’s billed charge or... more

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    • August 31, 2012

    Effective September 1, 2012, the MO HealthNet Division will begin covering the multigene expression assay procedure called Oncotype DX Breast Cancer Assay. This assay predicts outcomes for patients with early stage estrogen receptor (ER)-positive, lymph node-negative breast cancer by examining the tumor at a molecular level. This information is... more

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    • November 22, 2010

    This informational bulletin is to notify you of two policies that CMS and the Medicaid Integrity Group (MIG), Program Integrity is implementing to improve the process whereby Audit Medicaid Integrity Contractors (Audit MICs) conduct audits of Medicaid providers. CMS has developed national standards for: • Look-Back period for... more

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    • January 31, 2011

    MO HealthNet timely filing guidelines for claims and adjustments can be found in Section 4 of Provider Original claims must be filed by the provider and received by the state agency within twelve (12) months from the date of service. Any claims that originally were submitted and received within twelve (12) months from the date of service, but were... more

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    • June 27, 2011

    If you have medical or billing records that have been lost due to a natural disaster, an Attestation of Medical Record Loss or Destruction form should be filled out and kept in your records, in place of the records that have been lost. This form will serve as the replacement for all records lost or destroyed to the point in time of the loss or... more

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