This SPA increases the professional dispensing fee to $17.01 for pharmacies with an annual prescription volume between 0 and 39,999 prescriptions; $14.73 for pharmacies with an annual prescription volume between 40,000 and 69,999; or $12.46 for pharmacies with an annual prescription volume greater than or equal to 70,000.

This plan amendment updates rates for Physician, Certified Mid-wife, and Nurse Practitioner services.

This plan amendment updates rates for Prosthetic services.

This plan amendment updates rates for Dental services.

This plan amendment updates the outdated payment methodology for Diagnosis Related Group (DRG) hospital payments, remove the reference to a specific version of the All Patient Refined Diagnosis Related Group (APR-DRG) classification software, replace references to “chemical” use with “substance” use, and add a definition for medically necessary gender affirming care.

This plan updates the link to the fee schedule for eyeglasses and contacts, removes an unnecessary reference to Washington administrative code, and adds conversion factor clarification.

This plan amendment updates rates for Dialysis Services.

This plan amendment updates the reimbursement rates for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS).

This plan amendment updates the reimbursement methodology for out-of-state nursing facilities to ensure continued access to nursing facilities for District Medicaid.

The purpose of this SPA is to amend the provisions governing third party liability.