California

This week, SB 966 (Wiener) passed the Senate floor with a vote 39-0-1. SB 966 includes provisions that would prohibit the use of “spread pricing”. The bill would also provide other vital reforms, including requiring 100% pass-through of manufacturer rebates to plan sponsors to keep patient premiums low, prohibiting the steering of patients to PBM-affiliated pharmacies and requiring PBMs to obtain a license to operate in the state.

Also in California, SB 1365, legislation increasing the pharmacist to pharmacy technician to 1:4, was placed on the suspense file by the Senate Appropriations Committee and, subsequently, held in committee.

Also in California, the Department of Health Care Services posted the following alert and weekly report on the Medi-Cal Rx Web Portal.

• Member Eligibility Lookup Tool – Enhanced Functionality
• Medi-Cal Rx Weekly Wrap-up for May 10-16

Also in California, as a reminder, this will be the final opportunity to attest for the upcoming fiscal year 2024-2025. For details, review “Pharmacy Provider Dispensing Fee Self-Attestation”. All attestations must be received by May 31 to be accepted. Attestations will not be accepted after closing on May 31; there are no exceptions.

Also in California, the Medi-Cal Rx Diagnosis Crosswalk Navigation, video and the Medi-Cal Rx Reinstatement – Implementation of Reject Code 80 video have been published.

Finally in California, the Department of Health Care Services posted the following:

• May 2024 Pharmacy Medi-Cal Update Bulletin
• May 2024 Durable Medical Equipment and Medical Supplies Medi-Cal Update Bulletin

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