Apple Health: Expedited Authorization for Smoking (Tobacco) Cessation Products
Washington State Health Care Authority sent this bulletin at 06/02/2017 02:17 PM PDT
Apple Health (Medicaid): Provider Alert
Effective
for dates of service on and after June 1, 2017, Washington Apple Health (Medicaid),
administered by the Health Care Authority, will implement two expedited
authorization codes to allow quicker access to smoking (tobacco) cessation
treatment.
EA
code 072 allows pharmacies to self-report that a client is receiving tobacco
cessation counseling through the Washington State Tobacco Quitline.The client must present a valid prescription
for a prescription smoking (tobacco) cessation product.
EA
code 073 allows pharmacies to self-report that a client is pregnant and receiving
counseling from the prescriber or other qualified practitioner.A client who is pregnant is not required to
be enrolled in the Quitline. However, the client must have face-to-face
counseling for smoking (tobacco) cessation with the provider and have a valid
prescription for the medication or over-the-counter product.The provider must write on the prescription
that the prescriber/qualified practitioner is providing counseling.A client who is pregnant can enroll in the
Quitline if the client is not receiving counseling from a prescriber.
Please do
not reply directly to this message. If you have feedback
or questions, please visit the HCA
website for contact information.
About
WashingtonStateHealth 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.