WSR 25-21-060

HEALTH CARE AUTHORITY

[Filed October 11, 2025, 8:33 a.m.]

Title or Subject: Medicaid State Plan Amendment (SPA) 25-0027 Outpatient Pharmacy Payment Methodology Update.

Effective Date: January 1, 2026.

Description: The health care authority (HCA) intends to submit SPA 25-0027 to update the payment methodology for certain pharmaceuticals provided in outpatient hospital settings. SPA 25-0027 will clarify that certain pharmaceuticals will be paid using the pharmacy fee schedule.

SPA 25-0026 [25-0027] is expected to have no effect on the annual aggregate expenditures/payments.

HCA is in the process of developing the SPA. HCA would appreciate any input or concerns regarding this SPA. To request a copy of the SPA when it becomes available or submit comments, you may contact the person named below (please note that all comments are subject to public review and disclosure, as are the names of those who comment).

CONTACT: Abigail Cole, Hospital Finance, P.O. Box 45501, Olympia, WA 98508, TRS 711, email abby.cole@hca.wa.gov.