MedicaidAdministrativeMedium impact
FAQ for CMS attestation form for qualifying clinical trials
Washington Apple Health·WA·Provider Alert
Effective date
Oct 1, 2022
We identified it
Jun 20, 2026
Summary
Washington State Apple Health (Medicaid) now requires attestation forms for qualifying clinical trials to determine coverage of routine patient costs. Forms must be signed by the principal investigator and treating provider, and submitted before services are provided for clients enrolled in trials after October 1, 2022.
Action Required
Before October 1, 2022: For Apple Health clients enrolled in clinical trials after this date, obtain CMS attestation forms from HCA's Forms & Publications webpage (search 'clinical trials attestation'). Have principal investigator and treating provider sign forms. Submit via ProviderOne portal or fax to 1-866-668-1214 for FFS clients before providing services. For MCO clients, follow MCO-specific submission process. Failure to submit forms may result in coverage denials.