Washington Administrative Code (Last Updated: November 23, 2016) |
Title 182. Health Care Authority |
Chapter 182-530. Prescription drugs (outpatient). |
Section 182-530-1000. Outpatient drug program—General. |
Section 182-530-1050. Definitions. |
Section 182-530-1075. Requirements—Use of tamper-resistant prescription pads. |
Section 182-530-2000. Covered—Outpatient drugs, devices, and drug-related supplies. |
Section 182-530-2100. Noncovered—Outpatient drugs and pharmaceutical supplies. |
Section 182-530-3000. When the medicaid agency requires authorization. |
Section 182-530-3100. How the medicaid agency determines when a drug requires authorization. |
Section 182-530-3200. The medicaid agency's authorization process. |
Section 182-530-4000. Drug use review (DUR) board. |
Section 182-530-4050. Drug use and claims review. |
Section 182-530-4100. Washington preferred drug list (PDL). |
Section 182-530-4125. Generics first for a client's first course of treatment. |
Section 182-530-4150. Therapeutic interchange program (TIP). |
Section 182-530-5000. Billing requirements—Pharmacy claim payment. |
Section 182-530-5050. Billing requirements—Point-of-sale (POS) system/prospective drug use review (Pro-DUR). |
Section 182-530-5100. Billing requirements—Unit dose. |
Section 182-530-6000. Mail-order services. |
Section 182-530-7000. Reimbursement. |
Section 182-530-7050. Reimbursement—Dispensing fee determination. |
Section 182-530-7100. Reimbursement—Pharmaceutical supplies. |
Section 182-530-7150. Reimbursement—Compounded prescriptions. |
Section 182-530-7200. Reimbursement—Out-of-state prescriptions. |
Section 182-530-7250. Reimbursement—Miscellaneous. |
Section 182-530-7300. Reimbursement—Requesting a change. |
Section 182-530-7350. Reimbursement—Unit dose drug delivery systems. |
Section 182-530-7400. Reimbursement—Compliance packaging services. |
Section 182-530-7500. Drug rebate requirement. |
Section 182-530-7600. Reimbursement—Clients enrolled in managed care. |
Section 182-530-7700. Reimbursement—Dual eligible clients/medicare. |
Section 182-530-7800. Reimbursement—Clients with third-party liability. |
Section 182-530-7900. Drugs purchased under the Public Health Service (PHS) Act. |
Section 182-530-8000. Reimbursement method—Estimated acquisition cost (EAC). |
Section 182-530-8050. Reimbursement—Federal upper limit (FUL). |
Section 182-530-8100. Reimbursement—Maximum allowable cost (MAC). |
Section 182-530-8150. Reimbursement—Automated maximum allowable cost (AMAC). |