Apple Health (Medicaid): Provider Alert

Proposal - Public Hearings (CR102) Supplemental

182-531-0050, -0550, Experimental and investigational services
(WSR 17-05-092) Purpose: The agency revised WAC 182-531-0050 to remove the definition of "ADSA," clarify the definitions of "experimental" and "investigational," and aligned the definition of "peer-reviewed medical literature" with other agency rules. The agency revised WAC 182-531-0550 to reflect that the definition of medical necessity and the evidence-based process in WAC 182-501-0165 for determining medical necessity provides the standard for authorizing services and that the evidence-based process in WAC 182-501-0165 prevails. These revisions do not change current policy. Housekeeping changes were also made in these WACs.

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