PROPOSED RULES
SOCIAL AND HEALTH SERVICES
(Medical Assistance Administration)
Continuance of WSR 01-20-109.
Preproposal statement of inquiry was filed as WSR 01-13-070.
Title of Rule: Amending WAC 388-530-1050 Definitions and new section WAC 388-530-1260.
Purpose: To incorporate into rule section 210(14), chapter 1, Laws of 2000 2nd sp.s. (EHB 2487), which provides funds to develop a therapeutic consultation program.
Statutory Authority for Adoption: RCW 74.08.090, 74.04.050.
Statute Being Implemented: RCW 74.08.090, 74.04.050.
Summary: The rules describe MAA's therapeutic consultation service (TCS) that provides a process to manage drug therapies for a medical assistance client whose utilization of brand name prescription drugs exceeds an established monthly limit, or whose drug claim is for a nonpreferred drug within therapeutic classes. The rules also clarify terms used in the TCS process by providing definitions.
Reasons Supporting Proposal: It will encourage less costly alternatives to expensive medications, while continuing to make client quality of care the highest priority.
Name of Agency Personnel Responsible for Drafting: Kathy Sayre, P.O. Box 45533, Olympia, WA 98504, (360) 725-1342; Implementation and Enforcement: Johnna Dodge, P.O. Box 45506, Olympia, WA 98504, (360) 725-1570.
Name of Proponent: Department of Social and Health Services, governmental.
Rule is not necessitated by federal law, federal or state court decision.
Explanation of Rule, its Purpose, and Anticipated Effects: The new rules describe MAA's therapeutic consultation service (TCS), clarify and define terms used in the TCS process, and describe the requirements of the pharmacy provider, the prescriber, and the MAA designee in the TCS process. The purpose of the rules is to manage drug therapies for a client whose utilization of brand name prescription drugs exceeds an established monthly limit, or whose drug claim is for a nonpreferred drug within therapeutic drug classes. It is anticipated the TCS process will encourage less costly alternatives to expensive medications, while continuing to make client quality of care the highest priority.
Proposal Changes the Following Existing Rules: Adds several new definitions to WAC 388-530-1050 Definitions.
No small business economic impact statement has been prepared under chapter 19.85 RCW. The department has analyzed the new rules and concluded that no new costs will be imposed on businesses affected by them.
RCW 34.05.328 applies to this rule adoption. The department has analyzed the proposed rules and determined that they meet the definition of a "significant legislative rule." An analysis of the probable costs and benefits is available from the person listed in Name of Agency Personnel above.
Hearing Location: WestCoast Sea-Tac Hotel, Cascade Room, 18220 International Boulevard (Old Highway 99), Seattle, WA 98188 (Exit #152 off Interstate 5. Follow 188th Street west to International Boulevard, turn right, following signs to Sea-Tac International Airport. Hotel is located on the east side of International Boulevard, 1/2 block past the first stop light), on November 14, 2001, at 7:00 p.m.
Assistance for Persons with Disabilities: Contact Andy Fernando, DSHS Rules Coordinator, by November 13, 2001, phone (360) 664-6094, TTY (360) 664-6178, e-mail lindgBH@dshs.wa.gov.
Submit Written Comments to: Identify WAC Numbers, DSHS Rules Coordinator, Rules and Policies Assistance Unit, P.O. Box 45850, Olympia, WA 98504-5850, fax (360) 664-6185, by 5:00 p.m., November 15, 2001.
Date of Intended Adoption: Not sooner than November 16, 2001.
November 6, 2001
Brian Lindgren, Manager
Rules and Policies Assistance Unit