- Opioid Dosing Guidelines
- WA Health Care Authority Washington State PDL, Prescription Assistance Program Information
- Washington Preferred Drug List
- State Maximum Allowable Cost (SMAC) list effective November 1, 2009
Pharmacy Information
NEW!
Instructions for requesting a 12 month patient history of prescriptions, emergency and other services
December 1, 2009, the Department has updated the Medicaid Covered Over the Counter (OTC) Drug List.
September 1, 2009, the Department will restrict coverage of drugs used to treat cough and colds to those listed on the Covered Cough/Cold Product List. The memo will be distributed in August 1, 2009.
Effective August 1, 2009, Limitations on Blood Glucose Test Strips and Lancets. See Memo 09-54.
Effective July 1, 2009, DSHS will automatically authorize lamotrigine (Lamictal) for FDA-approved indications using Expedited Authorization (EA) codes. Prior authorization will be required for all off-label use. See fact sheet. In addition, DSHS will require prior authorization for prescriptions of Seroquel/Seroquel XR dosed daily at 50mg or less. See fact sheet.
Effective July 1, 2009, the Department implemented a rate change to AWP-16. See Memo 09-22.
On May 1, 2009, the Department of Social and Health Services (DSHS) implemented step therapy for inhaled long-acting beta agonist/corticosteroid combination drugs. See Memo 09-11.
On April 1, 2009, the Department implemented limits on duration of use for all Proton Pump Inhibitors (Memo 09-08; Fact Sheet 009-004); made changes to the Washington Preferred Drug List (PDL); and made changes and additions to the Expedited Authorization (EA) List.
On March 1, 2009, the Department developed an Antipsychotic Drug Initiative. DSHS required authorization and a DSHS-approved second opinion for clients who exceeded the antipsychotic drug age and dosing limits. For more information, see Memo 09-04.
For dates of service on and after January 1, 2009, the Department raised the maximum copayment for Medicare Part D copayments to $6.00 per prescription for clients who have a prescription benefit through Medicaid AND are eligible for Medicare Part D (dual eligible clients). See Memo 08-88.
Where can I find?
- Pharmacy News and Announcements. Information on new drugs, Healthy Options clients that self refer, Second Opinion Network Providers list, Fair Hearings, information on transportation for clients, Medicare Part D, Preferred Drug List (PDL), Mental Health Pharmaceutical News, and Reports.
- Pharmacy Prior Authorization. Prior Authorization fax forms, PDL drug list, and list of limits.
- Prescription Billing. Current Expedited Authorization (EA) list, Prescription Drug Program Billing Instructions, HRSA Preferred Drug Lists (PDL), Numbered Memorandums.
- WA Preferred Drug List (PDL). List of preferred drugs. Link on how to become an endorsing prescriber.
- Pharmacy Reimbursement. Request to Change Reimbursement fax form, current SMAC list, AWP-50% exclusions, Federal Upper Limits and NCPDP Billing Standards.
- HRSA Criteria For Authorization of Suboxone.
- Current List of Participating Drug Rebate Manufacturers (Excel spreadsheet).
- List of Drugs Requiring a 90-Day Supply.
For comments or questions regarding Health and Recovery Services Administration: contact us.
Page modified: November 2009
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