Wash. Admin. Code § 182-530-7300

Current through Register Vol. 24-23, December 1, 2024

Section 182-530-7300 - Reimbursement-Requesting a change

Upon request from a provider, the medicaid agency may reimburse at the provider's actual acquisition cost AAC) for a drug that would otherwise be reimbursed at maximum allowable cost (MAC) when:

(1) The availability of lower cost equivalents in the marketplace is severely curtailed and the price disparity between AAC for the drug and the MAC reimbursement affects clients' access; and

(2) An invoice documenting AAC relevant to the date the drug was dispensed is provided to the agency.

Wash. Admin. Code § 182-530-7300

Amended by WSR 16-01-046, Filed 12/9/2015, effective 1/9/2016

Amended by WSR 17-07-001, Filed 3/1/2017, effective 4/1/2017

Amended by WSR 24-08-061, Filed 3/29/2024, effective 5/1/2024

11-14-075, recodified as §182-530-7300, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.04.050, 74.08.090, 74.09.530, and 74.09.700. 07-20-049, § 388-530-7300, filed 9/26/07, effective 11/1/07.