INTERPRETIVE OR POLICY STATEMENT
Legal and Administrative Services
Subject: Medicaid program of the HCA is publishing a revised Physician-Related Services Medicaid Provider Guide.
Effective for dates of service on and after November 1, 2012, the medicaid program of the HCA will no longer pay for hemophilia- and von Willebrand-related products when dispensed by a retail or specialty pharmacy. The HCA will pay for hemophilia- and von Willebrand-related products shipped to fee-for-service clients only when the products are dispensed by a qualified hemophilia center of excellence per WAC 182-531-1625. This policy applies only when medicaid is the primary payer. If medicaid is the secondary payer, the HCA will continue to pay for products when dispensed by a retail or specialty pharmacy.
For additional information, contact Amber Lougheed, 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/.