Provider Alert
Dear Provider,
Effective for claims with dates of service on and after March 15, 2015, Washington Apple Health (Medicaid), administered by the Health Care Authority, will update the Expedited Authorization (EA) list as follows:
Drug
|
Code
|
Criteria
|
Humira
|
085
|
Treatment of ulcerative colitis when prescribed by a gastroenterologist in those patients who have tried and failed conventional therapy. Maximum maintenance dose is 5mg/kg given every 8 weeks after the induction regimen of 5mg/kg given at week 2 and week 6 of therapy.
|
Ramipril
|
020
|
Removed
|
Remicade
|
046
|
Removed
|
Lamisil
|
|
Length of approval has shortened from 12 months to 12 weeks.
|
Terbinafine
|
|
Length of approval has shortened from 12 months to 12 weeks.
|
For more details, see the agency’s Expedited Authorization (EA) list.
Thank you.
Provider Publications Team Washington Apple Health Health Care Authority
|