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46 Effective Date: July 1, 2009

Approval Date: of participating facilities is not practical. This advice and authorization must be made by a licensed health care professional. • Mechanisms must be established to assure the accessibility of primary care services, urgent care services and member services. • Standards (which apply to HO, BHP, PEBB and CHIP) must be established that are no longer than the following: o Non-symptomatic (i.e., preventive care) office visit – within 30 calendar days; o Non-urgent, symptomatic (i.e., routine care) office visit – within 10 days; o Urgent, symptomatic (i.e., presentation of medical conditions requiring immediate attention, not life-threatening) office visit within 48 hours; and o Emergency medical care within 24 hours per day, 7 days per week.

• MCOs must collect and analyze data to measure their performance against the above standards. FFS quality standards and utilization controls are consistent with all quality and utilization review requirements under the state’s Medicaid plan. • Washington State Well-Child Exam Forms, developed collaboratively with the Washington Chapter of the American Academy of Pediatrics, the Department of Health, Head Start/ECEAP staff, health plan staff and many other stakeholder groups as part of a statewide focus on improving well-child care. Historical EPSDT chart review studies consistently demonstrated that providers using a structured charting or screening tool were significantly more likely to meet the minimum documentation requirements for a qualifying well-child visit. • These forms are free of charge to providers who deliver well-child care to Medicaid clients. The forms are unique to each age category and include the ages listed below: • Infancy – 2-4 weeks, 2 months, 4 months, 6 months, 9 months, 12 months, 18 months, and 2 years • Early childhood – 3 years, 4 years, 5 years, 6 years, 8 years, and 10 years • Late childhood – 12 years • Adolescence – 14 years, 16 years, 18 years