The Health Care Authority (HCA) is requiring a new prescription monitoring program (PMP) check requirement for outpatient prescribing and dispensing of controlled substances to Apple Health patients beginning Oct. 1, 2021. This new requirement is being promulgated as a result of the federal Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act) passed in 2018. Under new WAC 182-530-1080, prescribers must conduct a PMP check for controlled substances prescribed to Apple Health patients in an outpatient context.
In addition, dispensing pharmacists must conduct a PMP check for controlled substances prescribed to Apple Health patients before dispensing from an outpatient pharmacy. According to its recent announcement, HCA is “finalizing guidelines for determining appropriate reviews of the Washington PMP consistent with SUPPORT Act requirements. These will be reflected in the Oct. 1 prescription drug program billing guide.” To prepare for the new rule, hospitals should review WSHA’s recent bulletin and watch for HCA’s Oct. 1 Prescription Drug Program Billing Guide. Specific questions about the rule may be sent via email to AppleHealthPharmacyPolicy@hca.wa.gov. Click here to read WSHA’s bulletin.