Human immunodeficiency virus postexposure prophylaxis drugs—Coverage—Reimbursement. (Effective January 1, 2025.)
(1) The authority and all medicaid contracted managed care organizations shall provide coverage without prior authorization for the drugs that comprise at least one regimen recommended by the centers for disease control and prevention for human immunodeficiency virus postexposure prophylaxis.
(2) Notwithstanding the coverage requirements of this section, the authority or a medicaid contracted managed care organization shall reimburse a hospital that bills for a 28-day supply of any human immunodeficiency virus postexposure prophylaxis drugs or therapies dispensed or delivered to a patient in the emergency department for take-home use, pursuant to RCW
70.41.495, as a separate reimbursable expense. This reimbursable expense is separate from any bundled payment for emergency department services.
NOTES:
Effective date—2024 c 251: See note following RCW
70.41.495.