WSR 14-07-003

[Filed March 6, 2014, 10:41 a.m.]

Title or Subject: Medicaid State Plan Amendment (SPA) 14-0018, Removal of Excluded Drugs.

Effective Date: January 1, 2014.

Description: The health care authority (agency) intends to submit medicaid SPA 14-0018 to reflect the new federal requirement to remove barbiturates, benzodiazepines, and agents used to promote smoking cessation from the list of drugs a state medicaid program may exclude from coverage or otherwise restrict. For Washington medicaid beneficiaries, these drugs were not excluded from coverage under the medicaid program. The federal requirements result in no change in coverage for Washington medicaid beneficiaries.

For medicaid beneficiaries who also have medicare (dual eligible beneficiaries), benzodiazepines, barbiturates and prescription smoking cessation products already qualified as Part D drugs effective January 1, 2013, and are not covered under medicaid.

Nonprescription smoking cessation products will continue to be available to both dual eligible and nondual eligible medicaid clients through participation in an agency approved smoking cessation program, and for pregnant clients (both dual eligible and nondual eligible) receiving smoking cessation counseling from their prescribing practitioner.

There is no change in benefits for Washington medicaid clients or payments to providers as a result of these changes in federal requirements, because Washington already exercised its right to optionally provide these benefits under the medicaid program. There will be no change in annual expenditures.

For additional information, contact Charles Agte, Pharmacy, 626 8th Avenue S.E., Olympia, WA 98504-5506, phone (360) 725-1301, TDD/TTY 800-848-5429, fax (360) 725-2141, e-mail charles.agte@hca.wa.gov.