Apple Health (Medicaid) Provider Alert
Effective for claims with dates of service on and after April 15, 2018, the Health Care Authority
(HCA) requires the following services to undergo a medical necessity review by Qualis
Health:
-
Injections of OnabotulinumtoxinA to treat chronic migraines and tension headaches
- Hysterectomies, except hysterectomies that result from cancer or trauma and meet expedited prior authorization criteria
- Varicose vein treatment
These changes will appear in an April 15 publication
of the Physician-Related Services/Health Care Professional Services Billing
Guide.
HCA will send a reminder once the guide is published.
For more information, contact Jodi Kunkel at jodi.kunkel@hca.wa.gov.
|