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).