Apple Health (Medicaid): Provider Alert

Dear Provider,

Effective for claims with dates of service on and after January 9, 2017, the Health Care Authority’s Apple Health Fee-for-Service program will no longer require authorization for Vivitrol®.   

Effective for claims with dates of service on and after March 6, 2017, Health Care Authority’s contracted Managed Care Organizations (MCOs) will no longer require authorization for Vivitrol®.  Some MCOs may remove authorization requirements sooner.  Please consult your patient’s specific MCO for current authorization requirements if initiating treatment prior to March 6, 2017. 

Please see the Clinical Guidelines and Coverage Limitations for Medication Assisted Treatment (MAT) for more information.

Please do not reply directly to this message. If you have feedback or questions, please visit the HCA website for contact information.

About Washington State Health Care Authority
HCA oversees the state’s top two health care purchasers — Washington Apple Health (Medicaid) and the Public Employee Benefits Board Program. We work with partners to help ensure Washingtonians have access to better health and better care at a lower cost. For more information, visit www.hca.wa.gov.