Are out-of-state providers permitted to enroll in the MO HealthNet program?
MO HealthNet participants are required to obtain services from Missouri or bordering state providers. MO HealthNet will consider enrollment of an out of state provider if at least one of the following conditions is met: • Services were a result of a medical emergency (including ambulance). Emergency services are defined as those services provided in a hospital, clinic, office or other facility that is equipped to furnish the required care, after sudden onset of medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) that the absence of immediate medical attention could reasonably be expected to result in: • placing the patient’s health in serious jeopardy; • serious impairment to bodily functions; or • a serious dysfunction of any body organ or part. • Services were provided to a Medicare/MO HealthNet participant with Medicare as primary payor; • Provider of service is located in a bordering state of Missouri; • Services were provided to a
