Provider 1099 Forms

Bulletins Provider 1099 Forms January 25,2024 MO HealthNet (MHD) has been made aware of an issue with provider 1099-MISC tax forms. The amounts inadvertently do not include the last check date in calendar year 2023. If the provider did not have any paid claims for the 12/22/2023 check date, the provider will receive a corrected 1099 with the same amount. Some providers may have also received two 1099 forms these will be combined in the corrected form. MHD is working on sending out corrected 1099-MISC forms as quick as possible. Pharmacy Program Reimbursement January 16, 2024 Applies to: Pharmacy Providers Effective date: January 1, 2024 •Professional Dispensing Fee Professional Dispensing Fee Due to the decrease in the Missouri Pharmacy Reimbursement Allowance (Pharmacy Tax), the adjustment to account for the Medicaid-reimbursed prescriptions will be decreased effective January 1, 2024. In-state pharmacy providers will continue to receive a professional dispensing fee of $12.22, plus an adjustment to account for the cost of the Missouri Pharmacy Reimbursement Allowance attributable to Medicaid-reimbursed prescriptions. The professional dispensing fee plus the current adjusted amount will total $12.65.Out-of-state pharmacy providers will continue to receive a professional dispensing fee of $8.85. Long-term care pharmacy providers supplying covered drugs to participants in long-term care facilities will continue to receive an additional $0.50 dispensing fee. Read More... Hot Tips Asthma Inhaler Update Hot Tip January 25, 2024 The MO HealthNet Pharmacy Program has become aware of a nationwide shortage of Asmanex® HFA inhalers. As brand name Flovent HFA® has also been discontinued by the manufacturer, this action has reduced access to maintenance medications for pediatric patients with asthma. In response to these changes in the marketplace, the following temporary changes in the Corticosteroids, Oral Inhaled PDL Edit will be effective 1/25/2024: • Fluticasone Propionate HFA (generic Flovent HFA®) is now a preferred agent. Arnuity® Ellipta® (fluticasone furoate) and Asmanex® Twisthaler® (mometasone furoate) remain preferred agents. Dulera® 50mcg/5mcg (mometasone furoate and formoterol fumarate dihydrate) and Asmanex® HFA (mometasone furoate) remain available to participants < 12 years of age as first-line therapy without any pre-requisite trial of a preferred agent. Please reference the full criteria at Corticosteroids Oral – Inhaled | mydss.mo.gov. MO HealthNet recommends using SMART therapy for all appropriate participants with asthma. Symbicort® and Dulera® 100mcg/5mcg remain preferred agents with no prior authorization required. More information on SMART therapy may be accessed here: Asthma SMART Therapy | mydss.mo.gov. Providers with questions may call MO HealthNet at 800-392-8030. Group Prenatal Care Billing Webinar January 18 ,2024 The MO HealthNet Division (MHD) and the St. Louis Integrated Health Network held a jointly sponsored event to launch Group Prenatal Care on January 12, 2024. As a follow up to this exciting launch, MHD will be hosting a webinar on February 1, 2024. The webinar will include a video of the launch event and its dynamic speakers, as well as an interactive discussion regarding how to bill for Group Prenatal Care and other questions providers may have on this benefit. To register for this Group Prenatal Care webinar, click here. For more information on Group Prenatal Care, review the Bulletin. Retrospective Inpatient Certification Due to Incarceration January 22, 2024 The MO HealthNet Division (MHD) requires all MO HealthNet enrolled hospitals in Missouri and bordering states to receive an admission certification. Retrospective (post-discharge) certification requests are only accepted when the participant has retroactive eligibility, or the hospital provider has a retroactive enrollment date. All other retrospective certifications will only be accepted on a case-by-case basis. The Inpatient Certification Request Form must be mailed with a copy of the patient’s medical record for days of the inpatient stay requiring review. When sending the retrospective requests, please indicate if the participant is “incarcerated, involuntarily confined to a state or federal prison, jail, detention facility or other penal facility” on the MO HealthNet inpatient request letter and attach (if applicable) the recoupment letter from Centurion. Mail Retrospective Inpatient Certifications to: CONDUENT P.O. Box 105110 3425 West Truman Blvd Jefferson City, MO 65110 This process will help streamline reviews and ensure requests are not dismissed due to participants' eligibility on admission. Inpatient hospital admissions must be certified as medically necessary and appropriate before MO HealthNet reimburses for inpatient services. For more information, please refer to the Inpatient Hospital Certification Reviews section of the Hospital Manual. Contact Us For questions about pharmacy or MORx, please email: MHD.PharmacyAdmin@dss.mo.gov. For questions about psychology, exceptions, or medical pre-certifications, please email: Clinical.Services@dss.mo.gov For all other questions or comments, please email: Ask.MHD@dss.mo.gov facebooktwitteryoutubelinkediin Our Mission: Empower Missourians to live safe, healthy, and productive lives. Note: replies to this email address will not be monitored. This newsletter is provided to you by the Missouri Department of Social Services This email was sent to charles.h.swartz@gmail.com using GovDelivery Communications Cloud on behalf of: Missouri Department of Social Services · Broadway State Office Building PO Box 1527 · Jefferson City, MO 65102 GovDelivery logo