Apple Health Fee-for-Service – change in requirements for patient status form for Medication Assisted Treatment.

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Apple Health (Medicaid) Provider Alert

Effective for dates of service on and after January 17, 2018, the Health Care Authority’s (HCA) Apple Health Fee-for-Service program requires the Medication Assisted Treatment Patient Status form (HCA 13-333) to be completed every 12 months, instead of every six months. If treatment continues for longer than 12 months, prescribers must complete a new HCA 13-333 form and maintain it in the client’s records for later audit and review by the Health Care Authority. 

HCA’s Clinical Guidelines and Coverage Limitations for Medication Assisted Treatment (MAT) and links to related forms can be found on HCA’s website under Apple Health (Medicaid) Drug Coverage Criteria.

The agency updated the Prescription Drug Billing Guide, dated January 19, 2018, to reflect this change.