Missouri
LLC
Website link to register:
https://sos.mo.gov/business
Naming conventions
Cannot mislead the public about the nature of the LLC. Must include “Limited Liability Company,” “LLC,” or “L.L.C.” PLLCs are required for medical practices.
Licensing Requirements
Submit proof of licensure from the Missouri Board of Healing Arts. Malpractice insurance mandatory. Additional permits for on-site pharmacies may be required.
Required documentation for medical practices
Articles of Organization, On-Site Pharmacy Permits, Professional Licenses, Malpractice Insurance
Filing Fee: $50
Annual/Biennial Fee: None
Additional Notes: No annual report requirement for LLCs.
Medicaid
Program Name: MO HealthNet
Official Website: https://mydss.mo.gov/mhd
Legislation: Missouri passed HB 769 in 2015, defining DPC agreements as not being insurance and exempting them from state insurance laws.
Private Contracting
Explicitly permitted; DPC agreements are recognized and not subject to state insurance laws.
Restrictions
No explicit restrictions for DPC providers; compliance with federal and state regulations is required.
Medicaid Program
Missouri Medicaid, known as MO HealthNet, provides health coverage to eligible low-income residents.
Notification Requirements
Notification recommended for clarity in patient agreements.
Provider Enrollment Requirements
Providers must enroll with MO HealthNet to serve beneficiaries directly or offer reimbursable services.
Enrollment Options
"Ordering and Referring Only" status available.
Ordering, Referrals, and Testing
Non-enrolled providers may face challenges with Medicaid recognition for orders and referrals.
Designated PCP Restrictions
DPC physicians cannot serve as Medicaid PCPs.
Billing and Reimbursement
DPC practices typically do not bill Medicaid for services covered under private agreements.
Managed Care Plan Exemptions
Not specified.
Billing Clarity
Cannot bill Medicaid patients for covered services without a pre-agreed contract.
CMS Guidance
CMS supports the use of streamlined enrollment for non-billing providers.
Opportunities for Collaboration
Opportunities may exist to collaborate with Medicaid Managed Care Organizations (MCOs) or state healthcare initiatives.
State-Specific Notes
Collaboration opportunities exist with Missouri HealthNet for innovative primary care models.
Dispensing Medication
Board of Pharmacy Official Link: https://pr.mo.gov/pharmacists.asp
State Licensing
Physicians must register with the Missouri Board of Pharmacy for dispensing medications and controlled substances.
Scope of Practice
Dispensing is allowed within a physician’s scope of practice; controlled substances require additional registration.
Inventory Management
Inventory logs must be detailed and storage secure for controlled substances.
Record-Keeping
Records must comply with Missouri state and federal HIPAA regulations.
Dispensing Standards
Labels must meet Missouri pharmacy board requirements, including patient name, dosage, and prescriber details.
Controlled Substances
DEA registration and mandatory reporting to Missouri’s PMP are required for controlled substances.
Billing and Reimbursement
Billing practices must comply with federal and state-specific regulations.
Federal Compliance
Adherence to federal DEA, FDA, and OSHA standards is required.
State Pharmacy Laws
Physicians must comply with Missouri Board of Pharmacy rules for controlled substances dispensing.
Patient Consent
Patient consent must be obtained before medications are dispensed.
Insurance and Liability
Liability insurance must explicitly cover risks associated with dispensing practices.
Training Requirements
Continuing education is encouraged for compliance with Missouri’s controlled substances regulations.
Audits and Inspections
Inspections are conducted by the Missouri Board of Pharmacy to ensure compliance; penalties apply for violations.