# WAC 182-530-1000: WAC 182-530-1000. Outpatient drug program—General

> Washington · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_530_1000

## Section

- **Citation:** WAC 182-530-1000
- **Heading:** WAC 182-530-1000. Outpatient drug program—General
- **Jurisdiction:** Washington
- **Kind:** Regulations
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Washington Administrative Code / Title 182 / Chapter 182-530 / Section 182-530-1000

## Text

(1) The purpose of the outpatient drug program is to reimburse providers for outpatient drugs, vitamins, minerals, devices, and drug-related supplies according to medicaid agency rules and subject to the limitations and requirements in this chapter.
(2) The agency reimburses for outpatient drugs, vitamins, minerals, devices, and pharmaceutical supplies that are:
(a) Covered. Refer to WAC 182-530-2000 for covered drugs, vitamins, minerals, devices, and drug-related supplies and to WAC 182-530-2100 for noncovered drugs and drug-related supplies;
(b) Prescribed by a provider with prescriptive authority (see exceptions for family planning and emergency contraception for women 18 years of age and older in WAC 182-530-2000 (1)(b), and over-the-counter (OTC) drugs to promote smoking cessation in WAC 182-530-2000 (1)(g));
(c) Prescribed by:
(i) A provider with an approved core provider agreement;
(ii) A provider who is enrolled as a servicing provider on an approved core provider agreement; or
(iii) A provider who is enrolled as a nonbilling provider.
(d) Within the scope of an eligible client's medical assistance program;
(e) Medically necessary as defined in WAC 182-500-0070 and determined according to the process found in WAC 182-501-0165 ;
(f) Authorized, as required within this chapter;
(g) Billed according to WAC 182-502-0150 and 182-502-0160 ; and
(h) Billed according to the requirements of this chapter.
(3) Coverage determinations for the agency are made by the agency's pharmacists or medical consultants in accordance with applicable federal law. The agency's determination may include consultation with the drug use review (DUR) board.

## Nearby sections

- [WAC 182-530-1000 WAC 182-530-1000. Outpatient drug program—General](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_530_1000.md)
- [WAC 182-530-1050 WAC 182-530-1050. Definitions](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_530_1050.md)
- [WAC 182-530-1075 WAC 182-530-1075. Requirements—Use of tamper-resistant prescription pads](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_530_1075.md)
- [WAC 182-530-1080 WAC 182-530-1080. Requirements for prescribing and dispensing controlled substances — Prescription monitoring program (PMP)](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_530_1080.md)
- [WAC 182-530-2000 WAC 182-530-2000. Covered — Outpatient drugs, devices, and drug-related supplies](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_530_2000.md)
- [WAC 182-530-2100 WAC 182-530-2100. Noncovered — Outpatient drugs and pharmaceutical supplies](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_530_2100.md)
- [WAC 182-530-3000 WAC 182-530-3000. When the medicaid agency requires authorization](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_530_3000.md)
- [WAC 182-530-3100 WAC 182-530-3100. How the medicaid agency determines when a drug requires authorization](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_530_3100.md)
- [WAC 182-530-3200 WAC 182-530-3200. The medicaid agency's authorization process](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_530_3200.md)
- [WAC 182-530-4000 WAC 182-530-4000. Drug use review (DUR) board](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_530_4000.md)
- [WAC 182-530-4050 WAC 182-530-4050. Drug use and claims review](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_530_4050.md)
- [WAC 182-530-4100 WAC 182-530-4100. Medicaid preferred drug list (medicaid PDL)](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_530_4100.md)
- [WAC 182-530-4125 WAC 182-530-4125. Generics first for a client's first course of treatment](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_530_4125.md)
- [WAC 182-530-4150 WAC 182-530-4150. Therapeutic interchange program (TIP)](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_530_4150.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_530_1000. Check the current official text before relying on it. Not legal advice.