The Health Care Authority announced that the University of Washington Pain and Opioid Provider Consultation Hotline is a free telephone consultation service for health care providers caring for patients with chronic pain issues. Any health care provider in Washington State can receive consultation and recommendations from a pharmacist or physician with specialized expertise in chronic pain care.

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

The Health Care Authority (HCA) revised the Apple Health (Medicaid) COVID-19 vaccine clinical policy and the Emergency COVID-19 fee schedules. 

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

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.

The Health Care Authority (HCA) revised the Emergency COVID-19 Fee Schedule provider billing guidelines under COVID-19 for Apple Health.  

Also in Washington, the Pharmacy and Therapeutics (P&T) Committee and Drug Utilization Review (DUR) Board will be meeting on June 15th to review drug classes for the Washington PDL, and for the DUR Board to review drug classes for the Apple Health (Medicaid) PDL. This meeting will be held by Zoom webinar only. You will need to register for the webinar to receive the meeting link.  

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

The Health Care Authority’s recently approved second quarter preferred drug list is now available. 

Also in Washington, the Pharmacy and Therapeutics (P&T) Committee and Drug Utilization Review (DUR) Board meeting is scheduled for June 15, 2022, to review drug classes for the Washington PDL (Preferred Drug List), and the drug classes for the Apple Health (Medicaid) PDL. This meeting will be held by Zoom online seminar only and you will need to register in advance to receive the meeting link. 

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

The State Health Care Authority’s (HCA) emergency provisions for in-person interpreting allowing over the phone interpreting has ended. Now the Health Care Authority and Universal Language Service (ULS) signed the new spoken language contract to provide over-the-phone and video remote interpreting services. Providers must register under the new contract to have access to the over-the-phone and video remote interpreting contract. To register, email accounts@ulsonline.net. Pharmacists interested in providing interpreting services under the over-the-phone and video remote contract also must register via email at interpreter@ulsonline.net. 

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

The Health Care Authority (HCA) is publishing quarterly updates to many of the Apple Health billing guides and fee schedules, effective April 1, 2022. 

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

Effective March 12th, Gov. Jay Inslee (D) issued Proclamation 20-25 rescinding face covering requirements in most places except healthcare settings including pharmacies, long-term care facilities, correctional facilities, and jails.

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

The 60-day legislative session ended its regular session on March 10. Prior to adjournment, NACDS chain pharmacy lobbyists, independent pharmacists, the Washington State Pharmacists Association (WSPA), the Northwest Grocers Association (NWG) and the Washington Retail Association (WRA) successfully stopped ESHB 1852 from advancing, legislation that would have required directions for use and auxiliary warnings on prescription labels in both English and at least 15 languages. Rather than have this issue defined by the Legislature, the coalition will be working with the Pharmacy Quality Assurance Commission (PQAC) to adopt rules establishing requirements for the translation of prescription drug information.  

Also in Washington, on March 4, Gov. Jay Inslee (D) signed into law legislation capping insulin at $35. (Chapter 10, 2022/SSB 5546)  

Also in Washington, the Health Care Authority (HCA) will submit to the Centers for Medicare & Medicaid Services by July 15th a request to renew the Section 1115 Medicaid demonstration waiver, called the Medicaid Transformation Project (MTP), which will allow the state to create and continue to develop projects, activities and services that improve Washington’s health care system using federal Medicaid funding. The new proposals include: continuous Medicaid enrollment for children; extending coverage for postpartum services; re-entry services for individuals who are exiting jail, prison, or other correctional facility and enhancements to long-term services and supports (LTSS). 

Finally in Washington, HCA efforts aimed at increasing health care cost transparency and controlling health care cost growth include: 

• The Health Care Cost Transparency Board is focusing on reducing health care cost growth and increasing price transparency.
• Prescription drug price transparency focuses on creating an annual report on how prescription drugs affect health care costs. 
• The Washington State All Payer Claims Database (WA-APCD) is a tool used to collect health care claims data for reporting and analytics and to help the public make their health care decisions. The WA-APCD supports health care and payment reform while addressing the need for cost, quality and utilization transparency. 
• Value-based purchasing (VBP) helps us achieve a healthier Washington by containing costs while improving outcomes, patient and provider experience and equity. 

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