The Department of Health Care Services continues to post and publish information to prepare pharmacy providers for the implementation of Medi-Cal Rx effective January 1, 2022. See “Medi-Cal Rx begins January 1st, are you ready?”. Note: use this link Office Hour Luncheon Session ,which is only available Monday-Friday, 12 p.m. to 1 p.m. PST (excluding holidays). Please note the prior authorization process and other essential information. Lastly, the Medi-Cal Rx customer service number is 1-800-977-2273 and is available 24 hours a day, 365 days a year after January 1, 2022. The Customer Service Center published a list of Main Menu Prompt Options.
Also in California, the Medi-Cal Rx Web Portal has been updated with the following. Note: Medi-Cal Rx will be implemented effective January 1, 2022.
- Countdown to Go-Live – Have You Reviewed the Medi-Cal Rx Pharmacy Transition Policy?
- Medi-Cal Rx Electronic Claims Agreement
Also in California, the Department of Health Care Services (DHCS) published its Stakeholder Communication Update – December 2021. Highlights include the following. See update for details and additional information.
- Continuous glucose monitors, as a pharmacy-billed medical supply benefit through Medi-Cal Rx, will be covered effective January 1, 2022. See Medi-Cal Rx: Transitioning Medi-Cal Pharmacy Services from Managed Care to Fee-for-Service Frequently Asked Questions (Version 10.0 – December 3, 2021).
- Medi-Cal Rx: For questions or comments related to Medi-Cal Rx, email RxCarveOut@dhcs.ca.gov
- CMS has approved SPA 21-0028, adding MTM as a payable Medi-Cal Fee-for-Service pharmacy service provided in conjunction with certain complex chronic medical conditions. participate in the program, Medi-Cal-enrolled pharmacies will be required to enter a contract with DHCS.
Also in California, the Department of Consumer Affairs issued a news release reminding providers of mandatory e-prescribing requirements effective January 1, 2022, pursuant to AB 2789 (Chapter 438, 2018).
Finally in California, the Department of Justice (DOJ) recently announced that Bamboo Health will be the new vendor for prescription data collection services for the Controlled Substance Utilization Review and Evaluation System (CURES). Additional details and information will be provided in the coming weeks regarding the transition process in early 2022 from the current vendor, Atlantic Associates Inc. (AAI), to the new vendor, Bamboo Health.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.