Washington Administrative Code
Title 182 - Health Care Authority
WASHINGTON APPLE HEALTH
Chapter 182-554 - Enteral nutrition program
Section 182-554-525 - Covered orally administered enteral nutrition products, equipment and related supplies - Thickeners
Universal Citation: WA Admin Code 182-554-525
Current through Register Vol. 24-18, September 15, 2024
(1) The medicaid agency covers, with prior authorization (PA) thickeners for clients with dysphagia who are younger than age one. The request for PA must include:
(a) Proof the client has dysphagia
as documented by a speech therapist or an occupational therapist that
specializes in dysphagia;
(b) A
dysphagia diet plan and assessment for the client from a registered dietitian;
and
(c) Documented medical
necessity. The report recommending a thickener must be in the client's chart in
the prescriber's office.
(2) The agency covers, with expedited prior authorization (EPA), thickeners for clients with dysphagia who are older than age one. The provider must keep the following in the client's file:
(a) Proof the client has dysphagia as
documented by a speech therapist or an occupational therapist that specializes
in dysphagia;
(b) A dysphagia diet
plan and assessment for the client from a registered dietitian; and
(c) Documented medical necessity. The report
recommending a thickener must be in the client's chart in the prescriber's
office.
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