Rebilling HCA for Naloxone may be needed

December 13, 2022

Recently, Health Care Authority (HCA) staff alerted WSHA  HCA corrected an error in the fee schedule amount for Naloxone for Medicaid enrollees and uninsured patients. The previous fee schedule incorrectly reflected payment for a single dose, rather than the two-pack normally distributed. The correction to the fee schedule was made in August so hospitals should submit requests for adjustment if they were paid the incorrect amount prior to when the correction was made. Billing information is in a prior Fiscal Watch article.

HCA staff also provided an update on creation of the bulk purchasing program for Naloxone distributed to commercial enrollees. HCA provided an preliminary report to the legislature January 2022 with a second update due January 2023. WSHA is concerned about how long the process to create the bulk purchasing program is taking and will be monitoring its progress.  (Andrew Busz, andrewb@wsha.org)

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