WSR 12-11-004

INTERPRETIVE OR POLICY STATEMENT

HEALTH CARE AUTHORITY


[ Filed May 2, 2012, 4:42 p.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 health care authority (HCA).

HCA

Legal and Administrative Services



     Document Title: Provider Notice #12-28.

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

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