WSR 13-09-060



(Medicaid Program)

[ Filed April 16, 2013, 1:27 p.m. ]

     Subject of Possible Rule Making: WAC 182-501-0070 Health care coverage -- Noncovered services, 182-501-0160 Exception to rule -- Request for a noncovered health care service, 182-502-0160 Billing a client, 182-530-2100 Noncovered -- Outpatient drugs and pharmaceutical supplies, 182-530-2200 How the medicaid agency develops and maintains the formulary, 182-530-2300 The medicaid agency's nonformulary justification process, and 182-531-0100 Scope of coverage for physician-related and health care professional services -- General.

     Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 41.05.021.

     Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: The health care authority (HCA) has concluded that implementing a drug formulary for fee-for-service medicaid client[s] who remain after the transition of SSI clients to managed care is not the most effective use of state resources at this time.

     Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: None.

     Process for Developing New Rule: HCA welcomes the public to take part in developing this rule. If interested, contact the person identified below to receive an early rule draft to review. After the early review, HCA will send a notice of proposed rule making (CR-102) to everyone receiving this notice and anyone who requests a copy.

     Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Kevin Sullivan, P.O. Box 42716, Olympia, WA 98504-2716, phone (360) 725-1344, fax (360) 586-9727, TTY 1-800-848-5429, e-mail

April 16, 2013

Kevin M. Sullivan

Rules Coordinator