Wash. Admin. Code § 182-553-400

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

Section 182-553-400 - Home infusion therapy and parenteral nutrition program - Provider requirements

(1) Eligible providers of home infusion supplies and equipment and parenteral nutrition solutions must:

(a)Have a signed core provider agreement with the medicaid agency; and

(b)Be one of the following provider types:

(i) Pharmacy provider;

(ii) Durable medical equipment (DME) provider; or

(iii) Infusion therapy provider.

(2) The agency pays eligible providers for home infusion supplies and equipment and parenteral nutrition solutions only when the providers:

(a) Are able to provide home infusion therapy within their scope of practice;

(b)Have evaluated each client in collaboration with the client's physician, pharmacist, or nurse to determine whether home infusion therapy and parenteral nutrition is an appropriate course of action;

(c)Have determined that the therapies prescribed and the client's needs for care can be safely met;

(d)Have assessed the client and obtained a written physician order for all solutions and medications administered to the client in the client's residence or in a dialysis center through intravenous, epidural, subcutaneous, or intrathecal routes;

(e) Meet the requirements in WAC 182-502-0020, including keeping legible, accurate, and complete client charts, and providing the following documentation in the client's medical file:

(i) For a client receiving infusion therapy, the file must contain:

(A)A copy of the written prescription for the therapy;

(B)The client's age, height, and weight; and

(C)The medical necessity for the specific home infusion service.

(ii) For a client receiving parenteral nutrition, the file must contain:

(A)All the information listed in (e)(i) of this subsection;

(B)Oral or enteral feeding trials and outcomes, if applicable;

(C)Duration of gastrointestinal impairment; and

(D)The monitoring and reviewing of the client's lab values:

(I)At the initiation of therapy;

(II)At least once per month; and

(III)When the client, the client's lab results, or both, are unstable.

Wash. Admin. Code § 182-553-400

Amended by WSR 15-08-103, Filed 4/1/2015, effective 5/2/2015

Amended by WSR 15-15-152, Filed 7/21/2015, effective 8/21/2015

11-14-075, recodified as §182-553-400, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090. 10-19-057, § 388-553-400, filed 9/14/10, effective 10/15/10. Statutory Authority: RCW 74.08.090, 74.09.530. 04-11-007, § 388-553-400, filed 5/5/04, effective 6/5/04.