Washington Administrative Code
Title 182 - Health Care Authority
WASHINGTON APPLE HEALTH
Chapter 182-530 - Prescription drugs (outpatient)
REIMBURSEMENT
Section 182-530-7300 - Reimbursement-Requesting a change
Current through Register Vol. 24-18, September 15, 2024
Upon request from a provider, the medicaid agency may reimburse at the provider's actual acquisition cost AAC) for a drug that would otherwise be reimbursed at maximum allowable cost (MAC) when:
(1) The availability of lower cost equivalents in the marketplace is severely curtailed and the price disparity between AAC for the drug and the MAC reimbursement affects clients' access; and
(2) An invoice documenting AAC relevant to the date the drug was dispensed is provided to the agency.
11-14-075, recodified as §182-530-7300, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.04.050, 74.08.090, 74.09.530, and 74.09.700. 07-20-049, § 388-530-7300, filed 9/26/07, effective 11/1/07.