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Pharmacists required to provide license and permit renewal information

The Mississippi Division of Medicaid (DOM) requires enrolled providers to be in good standing with all applicable regulatory authorities. Pharmacists are required to update their provider information with license renewal information, received from the Mississippi Board of Pharmacy, with the DOM fiscal agent, Conduent. Many Mississippi Board of Pharmacy permits are set to expire on Dec. 31, 2017.

Fax the following to Conduent’s Provider Enrollment at 888-495-8169 and not to DOM:

  • Cover sheet with name of pharmacy and/or pharmacy DME, MS Medicaid provider identification number(s), NPI(s), and a copy of the license renewal(s)/permit renewal(s).
  • Include the servicing pharmacy’s email address, telephone number and facsimile number on the cover sheet.
  • If you fax these documents to DOM, they will be returned to you.

For questions or additional information, please contact Conduent at 1-800-884-3222.
As of the date of this notice, many pharmacy providers have not updated their information with Conduent.

To ensure uninterrupted beneficiary access to care, DOM will allow a one (1) month grace period, from Jan. 1, 2018, through Jan. 31, 2018, during which time pharmacy providers must provide their updated license information to Conduent.

Prescriptions filled by pharmacy providers with records which still reflect permit expiration dates of Dec. 31, 2017 will NOT DENY until Feb. 1, 2018.