The Department of Health’s Pharmacy Quality Assurance Commission (PQAC) filed a rulemaking inquiry to consider possible amending language on prescription transfers requested by the patient.

Also in Washington, the Health Care Authority (HCA) published a new Medicaid program integrity training for providers which includes pharmacy, COVID-related issues and general program integrity overview and activities. The information provided in this educational intervention is not intended to be a comprehensive detailed account of all legal requirements relevant to compliance with Medicaid program integrity laws and regulations and satisfies the law requiring annual training in RCW 74.09.195.

Also in Washington, the HCA updated the Prescription Drug Program Billing Guide, effective for dates of service on and after December 1, 2023. Revisions include added vaccines that can be billed through the point-of-sale pharmacy system, updated pharmacy billing information for vaccines and vaccine administration, and updated professional dispensing fee allowances for pharmacies to align with recently filed emergency rules.

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

CMS approved the Washington State SPA (State Plan Amendment), implementing the new updated July 1, 2023, dispensing fees based on the Oregon dispensing fee tiers. Washington Medicaid will soon be paying pharmacies the higher dispensing fees as well as making retroactive payments.  

Also in Washington, the Pharmacy and Family Planning Programs within the Clinical Quality Care Transformation division at the Health Care Authority is requesting pharmacy staff complete this pharmacy contraceptive access survey about barriers and solutions in prescribing and dispensing contraception. 

Also in Washington, in observance of Thanksgiving, the Health Care Authority’s offices will be closed on November 23 and 24. Provider payments for the week of November 20 will be made on November 22, including the delivery of Remittance Advices (RAs) and HIPAA (Health Insurance Portability and Accountability) 835 remittance files. 

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

Since the settlement and dismissal of our six-year-old lawsuit against the State of Washington for its below cost dispensing fees, NACDS, NCPA (National Community Pharmacists Association) and the Washington State Pharmacy Association have been monitoring the state’s compliance with its obligations. In terms of the state’s obligation to pursue a cost of dispensing study, the state issued a “work request” for a vendor to do the study on September 19, with the deadline for responses due October 21. The cost of dispensing study is supposed to start November 1. In terms of the retroactive payments to pharmacies for April 2017 through June 2023, the state reports that the process is in place and payments should be starting very soon. As for implementing the adjusted dispensing fees effective July 2023, the state needs CMS’ approval of the state plan amendment (SPA) pending before CMS with those new dispensing fees first. The state anticipates such approval to be forthcoming.  

Also in Washington, the State Department of Health Office of Health Professions is hosting a Vaccine Fatigue Webinar on November 3.  

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

The five-member Prescription Affordability Board (PDAB) held its first hybrid meeting on October 20.  

Also in Washington, the State Chief Science Officer Dr Tao Sheng Kwan-Gett signed an updated statewide standing order to dispense naloxone. 

Also in Washington, the Department of Health (DOH) Immunization Division is hosting a COVID-19 and RSV Vaccine Updates Webinar (online registration) on Tuesday, October 24 from 12:00 PM – 1:00 PM Pacific. Topics will include COVID-19 vaccine updates and RSV vaccine recommendations for older adults and pregnant persons, as well as recommendations for infants. The online seminar will be recorded. 

Finally in Washington, the Health Care Authority’s Health Care Cost Transparency Board met on October 18. 

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

Six years of litigation challenging the state’s below cost dispensing fees resulted in a stunning settlement agreement with an unprecedented windfall for Washington State pharmacies. In exchange for dismissal of our state lawsuit challenging Washington State’s failure to adopt cost-based dispensing fees in April 2017 as required by federal law, the three pharmacy groups, NACDS, NCPA and the Washington State Pharmacy Association (WSPA) secured a commitment from Washington State to conduct its belated cost of dispensing study, the results of which are expected to update Washington State’s illegally inadequate dispensing fees ranging from $4.24-$5.25. Additionally, as a part of the settlement, the state will make over $60 million in retroactive payments to fee-for-service pharmacies that have been victim of Washington’s unlawfully low dispensing fees.

Also in Washington, the Pharmacy Quality Assurance Commission (PQAC) created a new rule, implementing the optional unexpired prescription drug donation program law.

Finally in Washington, in an effort to improve patient outcomes and better contain healthcare costs, the state Health Care Authority (HCA) is embracing Value Based Care (VBC) quality performance measures within the Medicaid managed care contracts. HCA is working with Comagine Health to conduct annual reviews of the current performance measures and their results. Beginning in 2024, HCA will move toward outcomes-based measures, rather than continuing to use process of care measures.

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

The Department of Health Pharmacy Commission held a Board meeting on August 24 and 25. 

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

The Department of Health Pharmacy Commission held a Board meeting on August 24 and 25. 

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

The State Health Care Authority (HCA) announced that the Centers for Medicare & Medicaid Services (CMS) renewed the Section 1115 Medicaid Transformation Project (MTP) waiver for five years effective July 1, 2023. 

Also in Washington, the third quarter Preferred Drug List (PDL) has been posted.

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

The Department of Health (DoH) and the Health Care Authority (HCA) are hosting a webinar on July 18th for pharmacy staff to discuss barriers in prescribing and dispensing contraception. 

Also in Washington, starting on July 1st, the HCA will be publishing quarterly updates to the Apple Health billing guides and fee schedules. 

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