MO HealthNet Division

The MO HealthNet Division administers the state’s Medicaid program for low-income Missourians, including the elderly, the disabled, children, parents and pregnant women. While states must meet certain minimum criteria to receive federal Medicaid funding, each state can establish eligibility guidelines, benefit packages, and provider payment rates for its program. The division engages in health care provider claims adjudication; care management through contracted health plans and health homes; and establishing edits and prior authorization policies to ensure quality care are focal to the Medicaid program’s work.