Apple Health has updated its Hepatitis C treatment policy for immune modulators and anti-viral medications to treat chronic active Hepatitis C virus (HCV) infection. Clients whose requests for authorization were initially denied may now qualify for treatment.
Medication Assisted Treatment (MAT)
- As of October 1, 2015 all medications prescribed as medication assisted treatment (MAT) to clients enrolled in an Apple Health Managed Care Organization (MCO) must be billed directly to the client's plan.
- Please visit Apple Health (Medicaid) Drug Coverage Criteria for current and updated treatment policy, guidelines and forms for all Medication Assisted Treatments (MAT).
Unintentional overdose deaths are associated with methadone and other opioids. The Pharmacy and Therapeutics Committee has asked the Health Care Authority (HCA) to distribute a special health advisory to pharmacists and prescribers.
Note: For information on billing and rates, the Apple Health preferred drug list, and expedited authorization codes, please visit the Prescription Drug Program on our provider billing guide and rates web page.
- Become an endorsing practitioner for the Washington Preferred Drug List
- Opioid dosing guidelines
- Apple Health (Medicaid) Drug Coverage Criteria
- Request a pharmacy prior authorization
- Emergency fill policy
- NCPDP D.O. payer specification sheet
- Participating drug rebate manufacturers
Supplemental rebate offers
- Electronic submission is required.
- Send offers to Contracts@hca.wa.gov with a subject line "WA Medicaid Supplemental Rebate Offers".
- Faxes or written submissions will not be accepted.
- No bids will be entertained until the drug class is evaluated per the Pharmacy and Therapeutics (P&T) Committee schedule.
- Direct any questions about the supplemental rebate bid process to Allison Campbell at 360-725-2028.