Washington Administrative Code
Title 182 - Health Care Authority
WASHINGTON APPLE HEALTH
Chapter 182-501 - Administration of medical programs-General
Section 182-501-0055 - Health care coverage - How the agency determines coverage of services for its health care programs using health technology assessments

(1) The medicaid agency uses health technology assessments to determine whether a new technology, new indication, or existing technology approved by the Food and Drug Administration (FDA) is a covered service under agency health care programs. The agency only uses health technology assessments when coverage is not mandated by federal or state law. A health technology assessment may be conducted by or on behalf of:

(2) The agency reviews available evidence relevant to a medical or dental service or health care-related equipment and uses a technology evaluation matrix to:

(3)The agency may determine the technology, device, or technology-related supply is:

(4)The agency may periodically review existing technologies, devices, or technology-related supplies and reassign authorization requirements as necessary using the provisions in this section for new technologies, devices, or technology-related supplies.

(5) The agency evaluates the evidence and criteria from HTACC to determine whether a service is covered under WAC 182-501-0050(9) and (10) and this section.