PDFWAC 182-554-525

Covered orally administered enteral nutrition products, equipment and related suppliesThickeners.

(1) The medicaid agency covers, with prior authorization (PA) thickeners for clients with dysphagia who are younger than age one. The request for PA must include:
(a) Proof the client has dysphagia as documented by a speech therapist or an occupational therapist that specializes in dysphagia;
(b) A dysphagia diet plan and assessment for the client from a registered dietitian; and
(c) Documented medical necessity. The report recommending a thickener must be in the client's chart in the prescriber's office.
(2) The agency covers, with expedited prior authorization (EPA), thickeners for clients with dysphagia who are older than age one. The provider must keep the following in the client's file:
(a) Proof the client has dysphagia as documented by a speech therapist or an occupational therapist that specializes in dysphagia;
(b) A dysphagia diet plan and assessment for the client from a registered dietitian; and
(c) Documented medical necessity. The report recommending a thickener must be in the client's chart in the prescriber's office.
[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 17-08-009, § 182-554-525, filed 3/24/17, effective 5/1/17.]