Current through Register Vol. 24-18, September 15, 2024
(1) To
receive home infusion therapy and parenteral nutrition, subject to the
limitations and restrictions in this section and other applicable WAC, a person
must be eligible for one of the Washington apple health programs listed in the
table in WAC
182-501-0060.
(2) Persons enrolled in an agency-contracted
managed care organization (MCO) are eligible for home infusion therapy and
parenteral nutrition through that plan.
(3) Persons eligible for home health program
services may receive home infusion related services according to WAC
182-551-2000 through
182-551-3000.
(4) To receive home infusion therapy, a
person must:
(a) Have a written physician
order for all solutions and medications to be administered.
(b) Be able to manage their infusion in one
of the following ways:
(i)
Independently;
(ii) With a
volunteer caregiver who can manage the infusion; or
(iii) By choosing to self-direct the infusion
with a paid caregiver (see WAC 388-71-0580).
(c) Be clinically stable and have a condition
that does not warrant hospitalization.
(d) Agree to comply with the protocol
established by the infusion therapy provider for home infusions. If the person
is not able to comply, the person's care-giver may comply.
(e) Consent, if necessary, to receive
solutions and medications administered in the home through intravenous,
enteral, epidural, subcutaneous, or intrathecal routes. If the person is not
able to consent, the person's legal representative may consent.
(f) Reside in a residence that has adequate
accommodations for administering infusion therapy including:
(i) Running water;
(ii) Electricity;
(iii) Telephone access; and
(iv) Receptacles for proper storage and
disposal of drugs and drug products.
(5) To receive parenteral nutrition, a person
must meet the conditions in subsection (4) of this section and:
(a) Have one of the following that prevents
oral or enteral intake to meet the person's nutritional needs:
(i) Hyperemesis gravidarum; or
(ii) An impairment involving the
gastrointestinal tract that lasts three months or longer.
(b) Be unresponsive to medical interventions
other than parenteral nutrition; and
(c) Be unable to maintain weight or
strength.
(6) A person
who has a functioning gastrointestinal tract is not eligible for parenteral
nutrition program services when the need for parenteral nutrition is only due
to:
(a) A swallowing disorder;
(b) Gastrointestinal defect that is not
permanent unless the person meets the criteria in subsection (7) of this
section;
(c) A psychological
disorder (such as depression) that impairs food intake;
(d) A cognitive disorder (such as dementia)
that impairs food intake;
(e) A
physical disorder (such as cardiac or respiratory disease) that impairs food
intake;
(f) A side effect of
medication; or
(g) Renal failure or
dialysis, or both.
(7) A
person with a gastrointestinal impairment that is expected to last less than
three months is eligible for parenteral nutrition only if:
(a) The person's physician or appropriate
medical provider has documented in the person's medical record the
gastrointestinal impairment is expected to last less than three
months;
(b) The person meets all
the criteria in subsection (4) of this section;
(c) The person has a written physician order
that documents the person is unable to receive oral or tube feedings;
and
(d) It is medically necessary
for the gastrointestinal tract to be totally nonfunctional for a period of
time.
(8) A person is
eligible to receive intradialytic parenteral nutrition (IDPN) solutions when:
(a) The parenteral nutrition is not solely
supplemental to deficiencies caused by dialysis; and
(b) The person meets the criteria in
subsection (4) and (5) of this section and other applicable WAC.
11-14-075, recodified as §182-553-300, filed 6/30/11,
effective 7/1/11. Statutory Authority:
RCW
74.08.090. 10-19-057, § 388-553-300,
filed 9/14/10, effective 10/15/10. Statutory Authority:
RCW
74.08.090,
74.09.530. 04-11-007, §
388-553-300, filed 5/5/04, effective
6/5/04.
