Missouri HealthNet Update

Representatives from the Missouri Chiropractic Physicians Association Legal Committee, along with our Bill Sponsor Rep. John Wiemann and MCPA Lobbyist Lynne Schlosser, met with MO HealthNet last month to discuss the progress of our the implementation of the HB 1516 that became law the end of August. This new law allows MO HealthNet patients to see a chiropractic physician practicing within their scope for up to 20 visits per year.

Although this law is currently in effect, unfortunately, that does not mean that the state is currently ready for this to occur. We were told that they are working on getting their computer program set up to allow chiropractic physicians to enroll and set a fee schedule for codes that chiropractors bill. They expect to have this done by sometime in January, but no later than February. MO HealthNet will send out an announcement when enrollment is open. Since they do not currently have chiropractic physicians in their database, you are encouraged to go to their website and sign up to receive notices. Go to https://dss.mo.gov/mhd/ and sign up for email updates located on the right side. Once enrollment opens, you will first need to apply to be a MO HealthNet provider with the State of Missouri. Following that, you will be able to sign up with MCO's that cover MO HealthNet recipients. Currently, there are three MCO's: Home State Health Plan, Wellcare, and UHC Community Plan.

As is true with all laws, the new law is subject to a funding mechanism. Since we will be providing services already covered, it is not an increase in the dollar amount appropriated, but rather an authorization is needed to transfer appropriated funds from one provider group to another. The department will be requesting enabling language to permit the transfer establishing a funding mechanism. This funding mechanism will be included in the departments budget request to the Governor that was due October 1, 2018 and be a part of the appropriations ask during the 2019 legislative session. Once approved, it would go into effect the beginning of fiscal year 2020 which begins July 1, 2019.

There was a rumor that prior authorization would be required. After meeting with the department, they stated it is their preference to not require prior authorization for recipients, but each MCO you contract with could develop their own requirements.

We will continue to work with MO HealthNet as they implement the rules that will govern the program and will send out more information as it becomes available.