California

The Department of Health Care Service posted the following on the Medi-Cal Rx Web Portal:   

• Mass Adjustment for Lagevrio Claims Not Paying Ingredient Cost with a Date of Service November 1, 2023, through June 20, 2024 

• Mass Adjustment for Vaccines Reimbursement for Members 19 Years of Age and Older for Impacted Claims with a Date of Service January 1, 2024, through March 31, 2024 – Second Group 

• Mass Adjustment for Retroactive Enrollment in a PACE Plan for Impacted Claims with a Date of Service July 1, 2025, through September 30, 2025 

• Reminder: Changes to Medi-Cal Rx, Effective January 1, 2026 

• Action Required: Enroll as a Medi-Cal Provider 

• Reminder: Include ICD-10-CM Diagnosis Codes on Pharmacy Claims 

• Reminder: Prior Authorization Policy Updates 

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.