The Department of Health Care Services posted the following alerts to the Medi-Cal Rx Web Portal: 

• Clarification of Temporary Prior Authorization (PA) Policy Change (February 21) 
• Medi-Cal Rx Drug Lookup Tool and Contract Drugs List Tips (February 24) 
• Medi-Cal Rx Provider Portal Troubleshooting and Support (February 24) 
• Remdesivir (Veklury) for Outpatient Treatment of COVID-19 (February 24) 
• Required Documentation for Claim and Prior Authorization Support (February 24) 

 Also in California, COVID-19 related news highlighted below: 

• Governor Newsom Unveils SMARTER Plan Charting California’s Path Forward on Nation-Leading Pandemic Response 
• California SMARTER – The Next Phase of California’s COVID-19 Response 
• County of Los Angeles Department of Public Health Order of the Health Officer (Revised February 23, 2022) 

 Finally in California, the Department of Health Care Services is proposing a budget trailer bill language to require Medi-Cal pharmacy providers to maintain records for ten years, consistent with federal law.  The current requirement in the state is three years. DHCS prepared this fact sheet about the proposal.     

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

The following alerts have been recently posted to the Medi-Cal Rx Web Portal:  

• Updates to the List of Covered Diabetic Test Strips and Lancets (February 8)  
• Medi-Cal Rx Provider Payments (February 8)  

• Reject Code 606 – Temporary Suspension (February 9)  
• Medi-Cal Rx Policy Updates (February 11)  
• Medi-Cal Rx Weekly Wrap-Up for February 6-11 (February 14) 

Also in California, the Department of Health Care Services posted this article to the Medi-Cal Rx Web Portal: Professional Organizations Push for Recall of Buprenorphine Dental Warning.  

Also, in California, COVID-19 related news highlighted below: 

• Governor Newsom Signs $1.9 Billion COVID Package to Bolster State’s Ongoing Emergency Response 
• Governor Newsom Signs Paid Sick Leave Extension, Expanded Relief for Small Businesses, and Historic Package to Promote Innovation and Entrepreneurship in California 
• California Department of Public Health Issued Guidance for the Use of Face Masks effective February 16, 2022 

Finally in California, the Board of Pharmacy released Notices of Modified Text for the following and will accept written comments on the proposed modifications until March 2, 2022. 

• Self-Assessment of a Wholesaler/Third-Party Logistics Provider by the Designated Representative-In-Charge or Responsible Manager 

• Notice of Modified Text 
• Modified Text 

• Modified Self-Assessment Form (17M-26) 

• Self-Assessment of a Pharmacy by the Pharmacist-in-Charge 

• Notice of Modified Text 
• Modified Text 
• Modified Self-Assessment Form (17M-13) – Community Pharmacy/Hospital Outpatient Pharmacy 

• Modified Self-Assessment Form (17M-14) – Hospital Pharmacy 

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

The following alerts have been posted to the Medi-Cal Rx Web Portal:  

• Medi-Cal Rx Pharmacy Claim Processing for Other Health Care Benefits 
• DUR (Drug Utilization Review) Global Board Meeting – February 2022 
• Revised Emergency Fill Quantity Limit and Frequency Policy 
• Revised Prior Authorization Policy for Pharmacy Providers 
• Pharmacy Professional Dispensing Fee Provider Self-Attestation 

Also in California, Gov. Gavin Newsom (D) recently appointed two new public members to the Board of Pharmacy filling the remaining public member vacancies. Kula Koenig, of Sacramento, has been Senior Director of Impact at the United Way California Capital Region since 2018. Indira J. Cameron-Banks, of Los Angeles, has been a Sole Practitioner at Cameron Banks Law since 2021.  

Also in California, the Board of Pharmacy announced the first meeting of the Standard of Care Ad Hoc Committee being convened consistent with the requirements of AB (Assembly Bill) 1533 (Chapter 629). 

Also in California, the Board of Pharmacy distributed its February 2022 Update.  

Also in California, the Board of Pharmacy announced a schedule for the listening sessions to hear from California pharmacy technicians. Note: space is limited, and registration is required. The Board is also taking comments via a brief survey.  

Finally in California, the Department of Justice issued a notice to all CURES data submitters as a reminder of the transition from Atlantic Associates Inc. to Bamboo Health, the new contractor for prescription data collection services for CURES. Note: dispensers will continue to send data to Atlantic Associate through February 22. Effective February 23, dispensers will be required to report data to CURES via Bamboo Health’s PMP Clearinghouse.  

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

The following alerts have been posted to the Medi-Cal Rx Web Portal:  

• Daily Office Hour Sessions 
• Medi-Cal Rx Monthly Bulletin 
• Enteral Nutrition Updates 
• New Medications for Automatic Prior Authorization (Auto-PA) 

Also in California, the Department of Health Care Services (DHCS) provided the following information related to over the counter COVID-19 testing: 

• DHCS Communications – Stakeholder News 
• Medi-Cal Rx Coverage of Over-the-Counter COVID-19 Antigen Test Kits 
• List of Covered Emergency Use of Authorization (EUA) COVID-19 Antigen Tests (Note: the information at the top of the spreadsheet regarding reimbursement and dispensing of test kits.) 
• Department of Health Care Services’ Medical Director’s Prescribing Order COVID-19 Testing Accessibility for Over-the-Counter, FDA-authorized, Self-Administered COVID-19 Antigen Tests for All Eligible Medi-Cal Beneficiaries 

Also in California, the Department of Health Care Services adjusted the release date of the Med-Cal Managed Care Plan (MCP) Request for Proposal (RFP) from February 2 to February 9. Note: this adjustment will not affect the implementation date of January 2, 2024.  

Also in California, the Board of Pharmacy took the following actions during its recent public meeting held January 27-28. A complete list of actions is available here. 

• Voted to modify language and initiate a 15-day comment period on the modified text for Title 16, California Code of Regulations (CCR), sections 1793.5, 1793.6, and 1793.65, related to Pharmacy Technician Application. 

• 15-Day Comment Period: January 28 to February 12 
• Notice of Modified Text 
• Modified Text
• Voted to modify language and initiate a 15-day comment period on the modified text for CCR section 1708.1, related to Notification of Temporary Closure. 
• 15-Day Comment Period: January 28 to February 12 
• Notice of Modified Text 
• Modified Text 
• Voted to modify language and initiate a 15-day comment period on the modified text for CCR section 1715.65, related to Inventory Reconciliation. 
• 15-Day Comment Period: January 28 to February 12 
• Notice of Second Modified Text 
• Second Modified Text 

Also in California, the Board of Pharmacy issued an AMENDED WAIVER: Prescriber Dispensing of COVID-19 Antiviral Medication to an Emergency Room Patient. 

Also in California, AB (Assembly Bill) 1400, legislation that would have implemented single payer in the state, will not advance this year. It did not have enough votes to pass out of the Assembly so the author (Assemblymember Ash Kalra (D)) decided not to bring it up for a vote. 

Finally in California, last Friday, Attorney General Rob Bonta announced investigations into business operating loyalty programs and send notices regarding noncompliance with the California Consumer Privacy Act (CCPA).

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

The Board of Pharmacy distributed the following: 

• COVID-19 Vaccine Updates for Pharmacists 
• Joint Statement on Western States Recommendation of Expanded Pfizer – BioNTech Booster Eligibility for 12- to 15-Year Olds 
• Statement Regarding Dispensing Prescriptions Not Transmitted Electronically 
• Information and Additional Resources Regarding e-Prescribing Requirements

Also in California, the following alerts have been posted to the Medi-Cal Rx Web Portal: 

• Medi-Cal Rx Coverage of OTC COVID-19 Antigen Test Kits (January 26) 
• Prior Authorization Required: Reject Code 75 (January 26) 

Finally in California, the Office of Administrative Law has approved amendments to the following regulations:  

• Pharmacists Initiating and Administering Vaccines. (Effective immediately) 
• Address Change Notification. (Effective April 1) 
• Ownership, Management, and Control of Pharmacies and Other Regulated Business Entities. (Effective April 1) 

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

On January 10, Gov. Gavin Newsom (D) released his proposed 2022-23 State Budget. Both the Governor’s Budget Summary (See page 109+ for Health and Human Services) and Proposed Budget Detail have been posted. Of interest in the Health and Human Services section include: 

• Savings related to Medi-Cal Rx Implementation ($327 Million)
• Savings related to Pharmacy Recoupment (See bottom of page 10.) ($100 Million)  

Legislative hearings and negotiations will begin and February and continue through May. The Governor will release a revised budget in May. 

 Also in California, the Department of Health Care Services published the following alerts: 

• Alert Summary for the Week of January 9-14
• Medi-Cal Rx Customer Service Center Main Menu Prompt Options
• DHCS COVID-19 Vaccine Administration Provider FAQs – January 7, 2022 
• Reject Code 73: Max Refill 
• Medi-Cal Rx Finance Portal Job Aid Available 

Also in California, the Board of Pharmacy sent a notice about reissued pharmacy law waivers in response to Gov. Gavin Newsom’s (D) declaration of emergency and the nation declaration of emergency. 

• Duty to Consult (Title 16, California Code of Regulations, section 1707.2(a)) 
• Prelicensure Inspection at Proposed Location of an Automated Drug Delivery System (ADDS) – Business and Professions Code sections 4119.11(a)(9) and BPC 4427.2(e) 
• Signature Requirement for Receipt of Delivery of Drugs (BPC section 4059.5) 
• Requirement for Consulting Pharmacist to Make Quarterly Visits to Clinic (BPC sections 4182(a) & (b)/BPC 4192(a) & (b)) 

Also in California, the Board of Pharmacy issued a Notice of Meeting and Agenda for the Teleconference Medication Error Reduction and Workforce Committee Meeting on January 27. Meeting materials will be posted on the website in advance.  

Finally in California, the Board of Pharmacy published a Notice of Meeting and Agenda for the Teleconference Public Board Meeting scheduled to be held January 27-28. Meeting materials will be posted on the website in advance.

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

Medi-Cal Rx posted the following alerts. To view all alerts, visit Bulletins & News on the Medi-Cal Rx website. 

• Claim Submission Reminders (January 11) 
• Prior Authorization Required: Reject Code 75 (January 9) 
• Pharmacy Claims Reject Code 65 – Resolved (January 9) 
• Alert Summary for the Week of January 3-7 (January 7) 

Also in California, note the recently issued Billing Guidance for Pharmacy Providers on COVID-19 Oral Antivirals (January 6). 

Also in California, the Board of Pharmacy issued a pharmacy law waiver for Prescriber Dispensing of COVID-19 Oral Therapeutic Medication to Emergency Room Patients.  

Finally in California, the Board of Pharmacy has rescheduled its next quarterly two-day meeting.  The new meeting dates are January 27-28.   Committee meeting materials have also been posted. 

• January 18, 2022 

• • Enforcement and Compounding Committee, 9 a.m. 
  • Legislation and Regulation Committee2:30 p.m. 

• January 19, 2022 

• • Licensing Committee, 9 a.m. 
  • Communication and Public Education2:30 p.m. 

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

Medi-Cal Rx was implemented on January 1, 2021. The Monthly Bulletin for January has been posted to the Medi-Cal Rx Web Portal.  

Also in California, Medi-Cal Rx issued a Share of Cost bulletin to clarify that the process will be unchanged by the implementation of Medi-Cal Rx.  

Also in California, Medi-Cal Rx issued an alert announcing that reject code 16 M/I Prescription/Service Reference Number is temporarily suspended. Pharmacy providers may resubmit claims if they receive this rejection.  

Also in California, the Board of Pharmacy published its January 2022 monthly update. Note the last item about pharmacy laws effective in 2022. 

Finally, the Board of Pharmacy also published a reminder of the new e-prescribing laws effective January 1, 2022. 

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

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.