WSR 12-09-007

INTERPRETIVE OR POLICY STATEMENT

HEALTH CARE AUTHORITY


[ Filed April 5, 2012, 10:22 a.m. ]


Notice of Interpretive or Policy Statement


     In accordance with RCW 34.05.230(12), following is a list of policy and interpretive statements issued by the department of social and health services.


Health Care Authority (HCA)

Legal and Administrative Services



     Document Title: Provider Notice #12-18.

     Subject: The medicaid program of the health care authority (the agency) will change the coverage status of Benlysta¦ when administered in an outpatient hospital setting.

     Effective Date: April 1, 2012.

     Description: Effective for dates of service on and after April 1, 2012, the medicaid program of the agency will change the coverage status of Benlysta¦ when administered in an outpatient hospital setting from noncovered to covered with prior authorization. See table below for procedure code and coverage status [no further information supplied by agency].

     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 dassoal@hca.wa.gov, web site http://www.hca.wa.gov/.

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