WASHINGTON STATE REGISTER

WSR 11-23-016

INTERPRETIVE OR POLICY STATEMENT

HEALTH CARE AUTHORITY

[ Filed November 7, 2011, 2:19 p.m. ]

Notice of Interpretive or Policy Statement

Title or Subject: 11-61 Synagis (2011-2012 Respiratory Syncytial Virus (RSV) Season): Administration and Authorization Requirements.

Effective Date: December 1, 2011.

Description: Effective for dates of service on and after December 1, 2011, the medicaid program of the health care authority (the agency) will:

• Establish the RSV/Synagis¦ Season as beginning December 1, 2011, through April 30, 2012.

• Require providers to follow the 2009 American Academy of Pediatrics (AAP) guidelines for the administration of Synagis¦.

• Require the use of agency-approved forms when submitting requests for authorization of Synagis.

For additional information, contact Amber Dassow, Health Care Authority, P.O. Box 45504, phone (360) 725-1349, TDD/TTY 1-800-848-5429, fax (360) 586-9727, e-mail dassoal@hca.wa.gov, web site http://www.hca.wa.gov/.

•	Establish the RSV/Synagis¦ Season as beginning December 1, 2011, through April 30, 2012.
•	Require providers to follow the 2009 American Academy of Pediatrics (AAP) guidelines for the administration of Synagis¦.
•	Require the use of agency-approved forms when submitting requests for authorization of Synagis.

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