INTERPRETIVE OR POLICY STATEMENT
Legal and Administrative Services
Subject: Prescription drug program - Authorization requirement for Symbyax¦.
Effective Date: April 14, 2012.
Effective for dates of service on and after May 14, 2012, the medicaid program of the HCA will require authorization for Symbyax¦. Symbyax will not require authorization if the HCA paid for the drug within the last six months.
For additional information, contact Amber Dassow, HCA, P.O. Box 45504, phone (360) 725-1349, TDD/TTY 1-800-848-5429, fax (360) 586-9727, e-mail email@example.com, web site http://www.hca.wa.gov/.