The Care Authority (HCA) Director Sue Birch selected Dr. Charissa Fotinos, who has been the interim state Medicaid Director since August of 2021, as the new state Medicaid Director. Dr. Fotinos will also continue to serve as HCA behavioral health medical director.
Also in Washington, effective July 1, 2022, the Health Care Authority (HCA) is publishing quarterly updates to many of the Apple Health billing guides. Billing guides are located on HCA’s Provider billing guides and fee schedules webpage.
Finally in Washington, the State Health Care Authority (HCA) is beginning the first step of making its Medicaid Management Information System (MMIS), known as ProviderOne, more flexible and modifiable. First, HCA is working to replace the existing Pharmacy Point of Sale (POS) system. The new Pharmacy POS solution will offer the latest functionality, features, and technologies to better meet the needs of Washington’s Medicaid clients.
On the day of go‐live, fee‐for‐service pharmacy claims will no longer be billable using our current processor control number (PCN) and bank identification number (BIN). HCA will provide the new PCN/BIN as the project gets closer to go‐live. After the initial implementation, HCA will be adding functionality for pharmacies and prescribers to submit prior authorization requests through a new, secure online portal.
Sign up for the Health Care Authority’s email list to receive future updates on this project, including the go‐live date and PCN/BIN changes. If you have questions, contact pharmacyposproject@hca.wa.gov.
For more information, contact NACDS’ Mary Staples at 817-442-1155.