Apple Health (Medicaid): Enteral Nutrition Grace Period Announcement

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Apple Health (Medicaid): Provider Alert

Effective for dates of service on and after July 1, 2017, Health Care Authority (HCA) implemented new coverage requirements and new expedited prior authorization forms for enteral nutrition.

  • Clients with new prescriptions on and after July 1, 2017, for enteral nutrition products must meet the requirements outlined in the current billing guide published July 1.

  • Clients receiving enteral nutrition services before July 1, 2017, will have six months to meet the new requirements (i.e. if needed to schedule appointments with their medical provider and/or dietitian to discuss the new requirements for these products).

See the What has Changed table in the July 1, 2017, version of the Enteral Nutrition Billing Guide.

Effective for dates of service on and after January 1, 2018, all enteral nutrition prescriptions must meet the new requirements.