WAC 296-20-03023: When may the department or self-insurer deny payment of opioid medications used to treat chronic, noncancer pain?

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WACs > Title 296 > Chapter 296-20 > Section 296-20-03023

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296-20-03022 << 296-20-03023 >> 296-20-03024

WAC 296-20-03023	Agency filings affecting this section
When may the department or self-insurer deny payment of opioid medications used to treat chronic, noncancer pain?

  Payment for opioid medications may be denied in any of the following circumstances:

     Absent or inadequate documentation;

     Noncompliance with the treatment plan;

     Pain and functional status have not substantially improved after three months of opioid treatment; or

     Evidence of misuse or abuse of the opioid medication or other drugs, or noncompliance with the attending physician's request for a drug screen.

[Statutory Authority: RCW 51.04.020 and 51.04.030. 00-01-040, § 296-20-03023, filed 12/7/99, effective 1/20/00.]