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Apple Health Second Opinion Program
The Health Care Authority (HCA) requires a review by an agency-designated mental health specialist from the Second Opinion Network when drugs used to treat mental health conditions are prescribed outside of the established guidelines set by the pediatric children’s mental health workgroup.
As mandated by the legislator in RCW 74.09.490, HCA has developed the second opinion program to improve prescribing practices in children. In collaboration with The Pediatric Mental Health Advisory Group and the Drug Utilization Review Board, HCA has established pediatric mental health guidelines to identify children who may be at high risk due to off-label use of prescription medication, use of multiple medications, high medication dosage, or lack of coordination among multiple prescribing providers.
The guidelines include:
- Alpha-agonist age and dose limits
- Antidepressant therapy duplications
- Antipsychotic age and dose limits
- Antipsychotic therapy duplications
- Attention deficit hyperactivity disorder (ADHD) age and dose limits
- ADHD therapy duplications
- Insomnia medications
- Mental health polypharmacy (medication therapy includes five or more mental health drugs)