Section 182-530-6000. Mail-order services.

The medicaid agency provides a contracted mail-order pharmacy service for client use. The mail-order contractor is selected as a result of a competitive procurement process.

(1) The contracted mail-order pharmacy service is available as an option to all Washington apple health clients, subject to the:

(a) Scope of the client's medical care program;

(b) Availability of services from the contracted mail-order provider; and

(c) Special terms and conditions described in subsection (2) and (3) of this section.

(2) The mail-order prescription service may not dispense medication in a quantity greater than authorized by the prescriber. (See RCW 18.64.360(5), Nonresident pharmacies.)

(3) Prescribed medications may be filled by the mail-order pharmacy service within the following restrictions:

(a) Drugs available from mail-order in no more than a ninety-day supply include:

(i) Preferred drugs (see WAC 182-530-4100);

(ii) Generic drugs; and

(iii) Drugs that do not have authorization requirements (see WAC 182-530-3000 through 182-530-3200).

(b) Drugs available in no more than a thirty-four-day supply:

(i) Controlled substances (schedules II through V); and

(ii) Drugs having authorization requirements (see WAC 182-530-3000).

(c) Other pharmacy restrictions (chapter 182-530 WAC Prescription drugs (outpatient)) continue to apply.

(4) The contracted mail-order pharmacy services are reimbursed at levels lower than those established for the regular outpatient pharmacy services.

[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 16-01-046, § 182-530-6000, filed 12/9/15, effective 1/9/16. WSR 11-14-075, recodified as § 182-530-6000, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.04.050, 74.08.090, 74.09.530, and 74.09.700. WSR 07-20-049, § 388-530-6000, filed 9/26/07, effective 11/1/07.]

RCW 41.05.021 and 41.05.160. WSR 16-01-046, § 182-530-6000, filed 12/9/15, effective 1/9/16. WSR 11-14-075, recodified as § 182-530-6000, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.04.050, 74.08.090, 74.09.530, and 74.09.700. WSR 07-20-049, § 388-530-6000, filed 9/26/07, effective 11/1/07.

Rules

182-530-4100,182-530-3000,182-530-3200,182-530-3000,182-530,