MEMORANDUM

2009 Memorandums

IM-#78      10/05/09

DEPARTMENT OF SOCIAL SERVICES
FAMILY SUPPORT DIVISION
P.O. BOX 2320
JEFFERSON CITY, MISSOURI
TO:
ALL COUNTY OFFICES
FROM:
ALYSON CAMPBELL, DIRECTOR
SUBJECT:
SUBJECT:
MO HEALTHNET MANAGED CARE CONTRACTS AWARDED AND PHARMACY, DENTAL, AND OPTICAL COVERAGE CHANGES

DISCUSSION:

Effective October 1, 2009 new Managed Care contracts have been awarded in the Eastern, Central, and Western regions of the State. The new contracts include the following changes to services:

MO HEALTHNET MANAGED CARE PHARMACY CHANGES

Effective October 1, 2009 Managed Care Plans are no longer providing pharmacy services for their members. MO HealthNet recipients will obtain pharmacy benefits through fee for service coverage.

MO HEALTHNET MANAGED CARE DENTAL AND OPTICAL CHANGES

Effective October 1, 2009 Managed Care Plans covers dental services for adult participants age 21 and over, when the absence of dental treatment would adversely affect a pre-existing medical condition.

Managed Care Plans are responsible for one pair of eyeglasses every two years (during any 24 month period of time) for adult participants age 21 and over.

Managed Care Plans are responsible for optical services for Adult Pregnant Women (age 21 and over) when related to trauma or treatment of disease/medical condition (including eye Prosthetics) and one pair of eyeglasses per year.

Review the Managed Care Changes Bulletin attachment for further details regarding Managed Care Plans available by region and benefit changes.

NECESSARY ACTION:

TM

ATTACHMENT:


2009 Memorandums