Washington Administrative Code
Title 182 - Health Care Authority
WASHINGTON APPLE HEALTH
Chapter 182-530 - Prescription drugs (outpatient)
REIMBURSEMENT
Section 182-530-7900 - Drugs purchased under the Public Health Service (PHS) Act

(1) Providers registered and approved as PHS-qualified covered entities participate in the 340B program under their medicaid provider number or NPI listed on the quarterly medicaid exclusion file (MEF).

(2) PHS-qualified covered entities participating in the 340B program must follow federal and state 340B program requirements and applicable medicaid agency rules including, but not limited to, this chapter, chapters 182-501 and 182-502 WAC, and agency billing instructions.

(3) All claims submitted to Washington apple health through fee-for-service (FFS) or managed care for outpatient drugs purchased, dispensed, or administered by PHS-qualified covered entities participating in the 340B program:

(4) With the exception of claim types identified in subsection (5) of this section, all drugs purchased, dispensed, or administered by a PHS-qualified covered entity participating in the 340B program must be billed at the actual acquisition cost (AAC) when submitted through FFS to the agency.

(5) Exceptions to the AAC billing requirement are only made for:

(6) As part of participation in the 340B program, providers must submit a completed annual attestation form (HCA 13-0047) to the agency acknowledging that all claims for Washington apple health clients in both FFS and managed care are subject to all applicable 340B rules. Providers who fail to submit a completed attestation form to the agency may receive a compliance audit and be at risk of duplicate discounts.