Washington State Office of the Insurance Commissioner
Connect with us
Laws & rules
Your experience on this website will be less than optimal using this browser.
What is your name?
What email will be used?
What email will be used to track the pharmacy appeals and receive decisions?
Please confirm your email address.
Does this appeal meet the regulatory requirements?
Is the appeal from a small pharmacy in WA State?
Is the appeal specific to only the reimbursement cost of the drug?
Is the PBM reimbursement rate being appealed for a multi-source generic drug?
Do you have the authority to submit an appeal on behalf of the pharmacy?
Online Services Production 18 Version 22.214.171.124 Dated: March 14, 2018
Copyright © 2015 - Washington State Office of the Insurance Commissioner