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Chapter 388-530 WAC

 Last Update: 2/5/09

Prescription drugs (outpatient)

WAC Sections

388-530-1000 Outpatient drug program--General.
388-530-1050 Definitions.
388-530-1075 Requirements -- Use of tamper-resistant prescription pads.
COVERAGE
388-530-2000 Covered--Outpatient drugs, devices, and drug-related supplies.
388-530-2100 Noncovered--Outpatient drugs and pharmaceutical supplies.
AUTHORIZATION
388-530-3000 When the department requires authorization.
388-530-3100 How the department determines when a drug requires authorization.
388-530-3200 The department's authorization process.
QUALITY OF CARE
388-530-4000 Drug use review (DUR) board.
388-530-4050 Drug use and claims review.
388-530-4100 Washington preferred drug list (PDL).
388-530-4150 Therapeutic interchange program (TIP).
BILLING
388-530-5000 Billing requirements--Pharmacy claim payment.
388-530-5050 Billing requirements--Point-of-sale (POS) system/prospective drug use review (Pro-DUR).
388-530-5100 Billing requirements--Unit dose.
MAIL-ORDER SERVICES
388-530-6000 Mail-order services.
REIMBURSEMENT
388-530-7000 Reimbursement.
388-530-7050 Reimbursement--Dispensing fee determination.
388-530-7100 Reimbursement--Pharmaceutical supplies.
388-530-7150 Reimbursement--Compounded prescriptions.
388-530-7200 Reimbursement--Out-of-state prescriptions.
388-530-7250 Reimbursement--Miscellaneous.
388-530-7300 Reimbursement--Requesting a change.
388-530-7350 Reimbursement--Unit dose drug delivery systems.
388-530-7400 Reimbursement--Compliance packaging services.
388-530-7500 Drug rebate requirement.
388-530-7600 Reimbursement--Clients enrolled in managed care.
388-530-7700 Reimbursement--Dual eligible clients/medicare.
388-530-7800 Reimbursement--Clients with third-party liability.
388-530-7900 Drugs purchased under the Public Health Service (PHS) Act.
REIMBURSEMENT METHODOLOGY
388-530-8000 Reimbursement method--Estimated acquisition cost (EAC).
388-530-8050 Reimbursement--Federal upper limit (FUL).
388-530-8100 Reimbursement--Maximum allowable cost (MAC).
388-530-8150 Reimbursement--Automated maximum allowable cost (AMAC).