On January 15th, the online attestation portal opened for fee-for-service Medi-Cal Pharmacy providers seeking the higher of two professional dispensing fees as part of the reimbursement for covered outpatient drugs. Medi-Cal Pharmacy providers should have received a mailer that includes the URL for the online attestation portal as well as a unique login ID and password. The two-tiered professional dispensing fee is based on a Pharmacy provider’s total (Medi-Cal and non-Medi-Cal) annual pharmacy claim volume ($13.20 if fewer than 90,000 claims per year; $10.05 if 90,000 or more). Reporting the claim volume is a self-attestation process, which must be submitted electronically and must be repeated annually. 

The attestation period for the calendar year 2019 is open from January 15, 2020, through February 29, 2020. The attestation for the 2019 calendar year reporting period will determine the professional dispensing fee component of the pharmacy claim reimbursement for claims with dates of service within the state’s following fiscal year (dates of service from July 1, 2020, through June 30, 2021). For additional information, providers may refer to the Pharmacy Provider Self-Attestation FAQs on the Medi-Cal website or the Pharmacy Reimbursement Project page of the DHCS website.  

Also in California... The Department of Health Care Services renamed its multi-year reform initiative aimed at improving the health outcomes and quality of life for California’s population in Medi-Cal. Effective immediately, the broad-based effort to transform the Medi-Cal delivery system, program and payment structure formerly called California Advancing and Innovating Medi-Cal (CalAIM), will be known as Medi-Cal Healthier California for All. 

Also in California... Gov. Gavin Newsom (D) appointed Jacey Cooper to serve as the state Medicaid Director and Chief Deputy Director of Health Care Programs at the Department of Health Care Services. Cooper has been Assistant Deputy Director of Health Care Delivery Systems at the Department of Health Care Services since 2016.   

Also in California... Earlier this month, Gov. Gavin Newsom (D) signed into law several bills adding or amending laws that govern the practice of pharmacy in California. Unless specified otherwise, the new laws took effect on January 1, 2020. Many of the key provisions are summarized below.  

  • AB 528 Controlled Substances: CURES Database Effective January 1, 2021, this law expands the CURES reporting requirements to include Schedule V drugs and reduces the reporting deadline to one working day from the date the prescription was released to the patient.  
  • AB 690 Pharmacies: Relocation: Remote Dispensing Site Pharmacy: Pharmacy Technician: Qualifications. Effective upon signing by the Governor, this law creates a limited exemption to the licensure transferability requirements for a pharmacy to relocate because of damage caused by a declared disaster. The law also establishes specific requirements for a pharmacy technician working in a remote dispensing site pharmacy.  
  • AB 973 Pharmacies: Compounding. This law requires that compounding of drug preparations by a pharmacy must be done consistent with the relevant compounding chapters of the United States Pharmacopeia-National Formulary (USP). The board recently released a policy statement regarding California legal requirements for compounding pharmacies pending information from USP regarding implementation of chapters 795, 797, and 800. The policy statement is available on the board’s website.  
  • AB 1723 Clinics: Purchasing Drugs at Wholesale. This law increases the maximum hours of operation for a primary care community clinic or free clinic from 20 hours to 40 hours per week.  
  • SB 159 HIV Preexposure and Postexposure Prophylaxis. This comprehensive law authorizes pharmacists to independently initiate and furnish HIV preexposure and postexposure prophylaxis under specific conditions. Key provisions also require the Board of Pharmacy, in consultation with the Medical Board of California (MBC), to approve training programs that pharmacists must complete before furnishing either preexposure or postexposure prophylaxis. In addition, the law specifies guidelines issued by the federal Centers for Disease Control and Prevention (CDC) that the Board of Pharmacy must use to establish the drug or drug combinations to be furnished:  

o   For HIV preexposure prophylaxis: “2017 Preexposure Prophylaxis for the Prevention of HIV Infection in the United States – 2017 Update: A Clinical Practice Guideline,” or any subsequent guidelines published by the CDC.  

o   For HIV postexposure prophylaxis: “Updated Guidelines for Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV–United States, 2016,” or any subsequent guidelines published by the CDC.  

The law also requires the Board of Pharmacy to consult with the medical Board in developing emergency regulations to be adopted by July 1, 2020, to implement the law. The board’s Licensing Committee held a meeting in early January with stakeholders regarding implementation of SB 159, and the committee will report its recommendations at the January 29-30 board meeting in Glendale.  

  • SB 569 Controlled Substances: Prescriptions: Declared Local, State, or Federal Emergency. This law authorizes a pharmacist to fill a prescription for a controlled substance that does not conform to the controlled substances security form requirements under specific conditions.

For more information, contact NACDS’ Mary Staples at 817-442-1155.