The Health Care Authority (HCA) Apple Health (Medicaid) released a new provider fact sheet with information about language access. 

Also in Washington, the 2025-27 Operating Budget directed the Health Care Authority (HCA) to reduce Apple Health (Medicaid) managed care organization (MCO) rates by 1 percent, or approximately $90 million, for calendar year 2026. HCA is implementing several specific reductions that combined will result in $90 million in reduced expenditures. HCA summarized the changes which take effect January 1, 2026. 

Also in Washington, HCA posted information about language access and interpreter services: 

• HCA language access page 

• HCA interpreter services provider page 

• Nondiscrimination statement 

Also in Washington, the Washington Health Care Privacy Toolkit was updated. 

Also in Washington, the Health Care Authority (HCA) launched a Naloxone Pilot Program for a one-time distribution of naloxone to behavioral health agencies (BHAs) in the state. This pilot is the result of efforts to expand access to opioid reversal medication and listening to feedback from community partners, which showed that BHAs have a high need for upfront funding to purchase the initial stock of naloxone before they can begin a "stock and replenish" model.  

Finally in Washington, the Pharmacy Quality Assurance Commission (PQAC) published its August newsletter. 

For more information, contact NACDS’ Mary Staples at 817-442-1155.

The Pharmacy Quality Assurance Commission (PQAC) will hold a regular business meeting beginning on August 14. They posted the agenda and meeting materials.

Also in Washington, PQAC released a draft rule for utilization of pharmacy ancillary personnel. The rules workshop will be held at the August 14 meeting. The draft rule language considers amending WAC 246-945-001, -315, and -317 and adding two new sections in chapter 246-945 WAC to provide clarification on the utilization of ancillary personnel and technology within the pharmacy.

Finally in Washington, the Prescription Drug Affordability Board (PDAB) Advisory Group will meet on August 12 to discuss these agenda items.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

The Health Care Cost Transparency Board analyzed healthcare spending from 2017 to 2023, using data from both public and commercial insurers in the All-Payer Claims Database. The analysis revealed that spending on retail pharmacies increased by 71 percent during this period, which is a significantly faster rate of growth compared to any other category of services. Rising prices were the primary driver of growth in spending on prescription drugs, with the number of prescriptions increasing by only three percent, compared to a 66 percent price increase. This study aligns with other studies that show that list prices set by manufacturers are the primary reason why costs are escalating. 

Also in Washington, the Health Care Authority's (HCA) 2025-27 Operating Budget was reduced for Apple Health (Medicaid) managed care organization (MCO) rates by one percent, or approximately $90 million, for calendar year 2026. HCA provided guidance and FAQ on the managed care rate reductions effective January 1, 2026.  

Also in Washington, the Health Care Authority (HCA) updated the substance use disorder (SUD) provider guide, clarifying state and federal laws that limit the use and disclosure of SUD information. 

Finally in Washington, starting August 1, submitting eligibility policy questions and data requests for Eligibility Policy Innovation and Community Support (EPICS) is transitioning from the email inboxes to the ServiceNow platform, renamed to Apple Health Policy.  

For more information, contact NACDS’ Mary Staples at 817-442-1155.

The Pharmacy Quality Assurance Commission collaborated with the Washington Medical Commission, the Washington State Board of Nursing, the Board of Osteopathic Medicine and Surgery and the Board of Naturopathy to create brief tip sheets for the ongoing Rite Aid closures. Download the Rite Aid Closures Tip Sheet for Clinicians and the Rite Aid Closures Tip Sheet for Patients. 

Also in Washington, the Department of Health Office of the Assistant Secretary announced policy, procedures and guidelines exercising enforcement discretion to permit pharmacists and pharmacy technicians to practice in the state without an active Washington state credential or certification under chapters 18.130, 18.64, or 18.64A RCW only for the purpose of assisting with prescription transfers due to the closures of Rite Aid and Bartell Drugs pharmacies in Washington.  

For more information, contact NACDS’ Mary Staples at 817-442-1155.

The Pharmacy Quality Assurance Commission collaborated with the Medical Commission, the Board of Nursing, the Board of Osteopathic Medicine and Surgery and the Board of Naturopathy to create brief tip sheets for the ongoing Rite Aid closures. Download the Rite Aid Closures Tip Sheet for Clinicians and the Rite Aid Closures Tip Sheet for Patients.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

Effective July 1, the Health Care Authority (HCA) Apple Health (Medicaid) added a new section to the audio-only behavioral health procedure code list for HCPCS codes billable for Reentry Targeted Case Management (rTCM). The revised list is posted online under "Billing guides and fee schedules"; click on "Reentry services". 

Also in Washington, Apple Health (Medicaid) announced changes to the State Maximum Allowable Costs (SMAC) list for the fee-for-service (FFS) Prescription Drug Program effective September 1. The full SMAC list can be found on the agency's Provider billing guides and fee schedules website under the Prescription Drug Program and applies to claims billed to FFS. 

Also in Washington, the Health Care Authority (HCA) Prescription Drug Program's third quarter Preferred Drug List has been posted. 

Also in Washington, the Health Care Authority (HCA) created a toolkit called Apple Health is Medicaid Communications Toolkit to assist providers, community leaders and advocates to help Washingtonians access care. 

Finally in Washington, in an effort to effort to help prevent opioid misuse and overdose deaths, Fred Meyer's 60 pharmacies partnered with the Health Care Authority (HCA) to provide free locking bags to patients to more safely store their opioid prescriptions. The HCA's Lock Up Your Meds safe storage program is part of the statewide Starts with One campaign to prevent opioid overdoses by increasing the safe use, storage and disposal of opioid prescriptions. 

For more information, contact NACDS’ Mary Staples at 817-442-1155.

Gov. Bob Ferguson (D) issued a joint statement with the California and Oregon governors to the US Health and Human Services Secretary Robert F. Kennedy Jr. condemning the dismissal of the 17 members of the Advisory Committee on Immunization Practices (ACIP) at the Centers for Disease Control and Prevention (CDC). 

Also in Washington, Gov. Bob Ferguson (D) appointed Ryan Moran as the director of the Washington State Health Care Authority, effective August 18. Moran currently serves as Deputy Secretary for Health Care Financing and Medicaid Director for the Maryland Department of Health. 

Also in Washington, the Health Care Authority announced that the Pharmacy Fax Server will be undergoing maintenance June 28 from 3:00 am-6:00 am and June 28 from 7:00 pm to 3:00 am  on June 29. During these times, providers will not be able to submit faxes. Pharmacy Point of Sale (POS) system maintenance activity will impact pharmacy claims requiring SmartPA. If you receive claim exception code 4677 with NCPDP Reject Code 75 – 'Prior Auth Required' during the maintenance window, please resubmit impacted claims after the maintenance period. 

Finally in Washington, due to the timing of the State Biennium End and the observance of Independence Day, payments to providers for the week of June 30, will be delayed and made the following week on July 8. Remittance Advices (RAs) and HIPAA 835 files will also be made available on July 8.  

For more information, contact NACDS’ Mary Staples at 817-442-1155.

Gov. Bob Ferguson (D) appointed Dennis Worsham as the new Secretary of Health, effective July 7. 

For more information, contact NACDS’ Mary Staples at 817-442-1155.