Pharmacy Point of Sale Replacement Project

Project overview

The current Pharmacy Point of Sale (POS) system encompasses the automated functions necessary to receive and adjudicate all pharmacy Fee-for-Service (FFS) claims, managed care organization encounters and process drug rebate invoicing. The future solution will build on these features and include a cloud- hosted architecture that is flexible and scalable to meet future Washington State business needs and federal requirements.

Additional features include a secure web portal for drug labelers to retrieve quarterly invoices and claim level detail, more robust prior authorization workflow processes for state staff and rules-engine driven functionality to assist with easy Washington program updates. 

Project status

We are testing the new system to offer improved functionality, features, and technologies to better meet the needs of Apple Health (Medicaid) clients.

User acceptance testing continues in the new system with great progress.

The current targeted go-live date is Saturday, June 8, 2024.

Details will be shared via email (see links below) as we get closer to the targeted go-live date.

For managed care organizations

Changes are coming to the companion guide for encounter submissions. Review the draft encounter companion guide and frequently asked questions to prepare for the changes.

Testing has begun with managed care organizations (MCO). Details are being shared directly with MCO contacts.

As a result of integrating the preferred drug list (PDL) into the new system, some necessary drug status and class changes were identified. HCA will ensure all changes to the PDL will be provided to the MCOs in the updated file layout 90 days before required implementation by the MCOs.

Submit questions to HCA managed care programs.

For providers and pharmacies

There will be minor changes for pharmacies, including the BIN/PCN and Group they bill for Apple Health FFS pharmacy claims as well as the fax number for prior authorizations. Those new numbers will be provided as we get closer to go-live.

View the payer sheet effective June 8, 2024.

Updates and detailed information will be shared through the pharmacy email list.

For drug manufacturers

Drug rebate invoices will be changing from mailed-in paper to an online application called RebateWeb where you will be able to access your invoice with claim-level detail.

If you are not registered for RebateWeb with other states:

• Register for RebateWeb.
• View the recorded training from Conduent.

If you are already registered for RebateWeb in other states, you will see Washington available as a program to view your invoices for 1Q2024.

Use the Manufacturer Contact Change Form to make any changes to legal, invoice, and technical contact information.

Stay informed

Pharmacy Point of Sale Replacement Project: frequently asked questions. 

Stay informed on the Pharmacy POS project by signing up for notifications. 

• Drug manufacturers: subscribe to the point of sale manufacturer email list.
• All others: subscribe to our pharmacy email list.