Section 182-553-400. Home infusion therapy and parenteral nutrition program—Provider requirements.

(1) Eligible providers of home infusion supplies and equipment and parenteral nutrition solutions must:

(a) Have a signed core provider agreement with the medicaid agency; and

(b) Be one of the following provider types:

(i) Pharmacy provider;

(ii) Durable medical equipment (DME) provider; or

(iii) Infusion therapy provider.

(2) The agency pays eligible providers for home infusion supplies and equipment and parenteral nutrition solutions only when the providers:

(a) Are able to provide home infusion therapy within their scope of practice;

(b) Have evaluated each client in collaboration with the client's physician, pharmacist, or nurse to determine whether home infusion therapy and parenteral nutrition is an appropriate course of action;

(c) Have determined that the therapies prescribed and the client's needs for care can be safely met;

(d) Have assessed the client and obtained a written physician order for all solutions and medications administered to the client in the client's residence or in a dialysis center through intravenous, epidural, subcutaneous, or intrathecal routes;

(e) Meet the requirements in WAC 182-502-0020, including keeping legible, accurate, and complete client charts, and providing the following documentation in the client's medical file:

(i) For a client receiving infusion therapy, the file must contain:

(A) A copy of the written prescription for the therapy;

(B) The client's age, height, and weight; and

(C) The medical necessity for the specific home infusion service.

(ii) For a client receiving parenteral nutrition, the file must contain:

(A) All the information listed in (e)(i) of this subsection;

(B) Oral or enteral feeding trials and outcomes, if applicable;

(C) Duration of gastrointestinal impairment; and

(D) The monitoring and reviewing of the client's lab values:

(I) At the initiation of therapy;

(II) At least once per month; and

(III) When the client, the client's lab results, or both, are unstable.

[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 15-15-152, § 182-553-400, filed 7/21/15, effective 8/21/15; WSR 15-08-103, § 182-553-400, filed 4/1/15, effective 5/2/15. WSR 11-14-075, recodified as § 182-553-400, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090. WSR 10-19-057, § 388-553-400, filed 9/14/10, effective 10/15/10. Statutory Authority: RCW 74.08.090, 74.09.530. WSR 04-11-007, § 388-553-400, filed 5/5/04, effective 6/5/04.]

RCW 41.05.021 and 41.05.160. WSR 15-15-152, § 182-553-400, filed 7/21/15, effective 8/21/15; WSR 15-08-103, § 182-553-400, filed 4/1/15, effective 5/2/15. WSR 11-14-075, recodified as § 182-553-400, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090. WSR 10-19-057, § 388-553-400, filed 9/14/10, effective 10/15/10. Statutory Authority: RCW 74.08.090, 74.09.530. WSR 04-11-007, § 388-553-400, filed 5/5/04, effective 6/5/04.

Rules

182-502-0020,