Section 182-554-400. Enteral nutrition—Provider requirements.

(1) The following providers are eligible to enroll/contract with the department to provide orally administered enteral nutrition products and tube-delivered enteral nutrition products, equipment, and related supplies:

(a) Pharmacy provider; or

(b) Durable medical equipment (DME) provider.

(2) To receive payment for orally administered enteral nutrition products and tube-delivered enteral nutrition products, equipment and related supplies, a provider must:

(a) Meet the requirements in chapters 388-501 and 388-502 WAC;

(b) Provide only those services that are within the scope of the provider's license;

(c) Obtain prior authorization from the department, if required, before delivery to the client and before billing the department;

(d) Deliver enteral nutritional products in quantities sufficient to meet the client's authorized needs, not to exceed a one-month supply;

(e) Confirm with the client or the client's caregiver that the next month's delivery of authorized orally administered enteral nutrition products is necessary and document the confirmation in the client's file. The department does not pay for automatic periodic delivery of products;

(f) Furnish clients with new or used equipment that includes full manufacturer and dealer warranties for at least one year; and

(g) Notify the client's physician if the client has indicated the enteral nutrition product is not being used as prescribed and document the notification in the client's file.

[WSR 11-14-075, recodified as § 182-554-400, filed 6/30/11, effective 7/1/11. Statutory Authority: 2009 c 564 § 1109, RCW 74.04.050, and 74.08.090. WSR 10-01-138, § 388-554-400, filed 12/21/09, effective 1/21/10. Statutory Authority: RCW 74.08.090, 74.09.530 and chapter 74.09 RCW. WSR 05-04-059, § 388-554-400, filed 1/28/05, effective 3/1/05.]

WSR 11-14-075, recodified as § 182-554-400, filed 6/30/11, effective 7/1/11. Statutory Authority: 2009 c 564 § 1109, RCW 74.04.050, and 74.08.090. WSR 10-01-138, § 388-554-400, filed 12/21/09, effective 1/21/10. Statutory Authority: RCW 74.08.090, 74.09.530 and chapter 74.09 RCW. WSR 05-04-059, § 388-554-400, filed 1/28/05, effective 3/1/05.

Rules

388-501,388-502,