Professional dispensing fee allowance for pharmacies

Washington State Health Care Authority sent this bulletin at 02/05/2024 01:27 PM PST

February 5, 2024

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Professional dispensing fee allowance for pharmacies

In compliance with the Settlement Agreement in the case of National Association of Chain Drug Stores, et al., v. Health Care Authority (Washington State Court of Appeals No. 51489-3-II), the Health Care Authority (HCA) updated the professional dispensing fees for pharmacies.

HCA began issuing adjusted dispensing fee payments on the December 29^th remittance advice for pharmacy claims submitted between April 1, 2017, to June 30, 2023. For claims submitted on or after July 1, 2023, HCA will provide additional guidance soon. Do not resubmit or reprocess claims for updated dispensing fee payment.

For more information regarding the updated professional dispensing fees for pharmacies and adjusted dispensing fee payments, see the Professional dispensing fee allowance for pharmacies frequently asked questions.

Professional dispensing fee allowance for pharmacies FAQ

Questions?

For additional questions, please email us at:

applehealthpharmacypolicy@hca.wa.gov

About the Health Care Authority (HCA)

Functioning as both the state's largest health care purchaser and its behavioral health authority, the Washington State Health Care Authority (HCA) is a leader in ensuring Washington residents have the opportunity to be as healthy as possible.

There are three pillars of our work: Apple Health (Medicaid); the Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) programs; and behavioral health and recovery. Under these pillars, HCA purchases health care, including behavioral health treatment for more than 2.7 million Washington residents and provides behavioral health prevention, crisis, and recovery supports to all Washington residents.

Please do not reply directly to this message. For more information, visit the HCA website, where you'll also find contact information.

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The Washington State Health Care Authority (HCA) complies with all applicable federal and Washington state civil rights laws and is committed to providing equal access to our services. Visit HCA’s website to view complete nondiscrimination statements.