The Department of Health Care Services (DHCS) posted the following alerts and monthly bulleting on the Medi-Cal Rx Web Portal:

• Diabetic Supplies: Updates to the Quantity and Fill Limitations for Diabetic Testing Supplies (October 5)
• Updates to Enteral Nutrition Prescription Requirements (October 4)
• 90-Day Countdown: Medi-Cal Managed Care Plan Transition (October 3)
• Respiratory Syncytial Virus (RSV) Vaccines Arexvy^TM and Abrysvo^TM Now on the Contract Drugs List (October 3)
• How to Resolve Reject Code 76 – Plan Limitations Exceeded (October 2)
• COVID-19 Antigen Over-the-Counter Test Coverage Updates, Effective November 1, 2023 (October 1)
• Medical Supplies: Future Changes to Continuous Glucose Monitoring Systems Coverage Criteria and Prior Authorization Bundling (October 1)
• Diabetic Supplies: Updates to the Dexcom G7® Continuous Glucose Monitoring Sensor Package Size Description, Effective October 1, 2023 (October 1)
• Medi-Cal Rx Monthly Bulletin for October (October 1)
• Changes to the Medi-Cal Rx Contract Drugs List (October 1)
• Changes to Medi-Cal Rx Contract Drugs List – Authorized Drug Manufacturer Labeler Codes (October 1)
• Changes to Medi-Cal Rx Pharmacy Reimbursable Physician Administered Drugs (October 1)
• Updates to the Medi-Cal Rx Provider Manual (October 1)
• Medi-Cal Rx Weekly Wrap-up for September 22-28 (September 29)
• Reinstatement Spotlight (September 29)
• Update: Reimbursement for New Commercial COVID-19 Vaccines (September 22).

Also in California, NACDS submitted a letter of support to Gov. Gavin Newsom (D) urging him to sign AB 1341. The governor subsequently signed AB 1341 (Chapter 276, Statutes of 2023) on September 30. The newly bill enacted permits pharmacists to provide COVID-19 medication as well as offer broader options of substance use disorder treatments as specified in the bill.

Also in California, NACDS submitted a letter to Gov. Gavin Newsom (D) urging him to veto AB 1286, legislation that would impose arbitrary staffing limits and impede pharmacies’ ability to optimize the use of pharmacy technicians to assist with technical duties that do not require a pharmacist’s professional judgement.

Finally in California, NACDS submitted a letter of support to Gov. Gavin Newsom (D) urging him to sign AB 317, legislation helping to support patient access to essential healthcare services provided by pharmacists by requiring healthcare service plans that cover care that is otherwise within pharmacists’ scope of practice to reimbursement pharmacy providers for delivering those services.

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

The Department of Health Care Services (DHCS) posted the following bulletins, notices, and alerts on the Medi-Cal Rx Web Portal.  

• Now Available: Medi-Cal Rx Enteral Nutrition Prior Authorization Request Form (September 22) 
• Enteral Nutrition Shortages (September 22) 
• Medi-Cal Rx Weekly Wrap-Up for September 15 – September 21 (September 22)
• Reinstatement Spotlight (September 22)  
• Reimbursement for New Commercial COVID-19 Vaccines (September 21) 
• Medi-Cal Rx Weekly Wrap-up for September 8-14 (September 15) 
• Reinstatement Spotlight (September 15) 
• 30-Day Countdown: Phase IV, Lift III: Reinstatement of Reject Code 76: Plan Limitations Exceeded (September 13)
• Coming Soon: Commercialization of COVID-19 Vaccines (September 11) 
• State of Emergency Override Activation: Submission Clarification Code 13 (September 8) 
• How to Resolve Claim Rejection Code 78: Cost Exceeds Maximum (September 8) 
• Medi-Cal Rx Weekly Wrap-up for September 1-7 (September 8) 
• Reinstatement Spotlight (September 8) 

Also in California, Medi-Cal posted the following.  

• September 2023 Pharmacy Medi-Cal Update Bulletin 
• September 2023 Durable Medical Equipment and Medical Supplies Medi-Cal Update Bulletin 

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

The Department of Health Care Services (DHCS) posted the following bulletins, notices, and alerts on the Medi-Cal Rx Web Portal. Please note the Updated FAQs (Frequently Asked Questions) for the Pharmacy Retroactive Claim Adjustments.  

• Reinstatement of the Labeler Code Restriction for Brand Name Suboxone (September 5) 
• Reinstatement Spotlight (September 1)  
• Diabetic Supplies Update: Changes to Continuous Glucose Monitoring Systems Policy, Effective October 1, 2023 (September 1) 
• Medical Supplies Update: Updates to Contracted Diabetic Test Strips and Lancets List, Effective October 1, 2023 (September 1)  
• Maximum Allowable Ingredient Cost 30-Day Pharmacy Provider Notice (September 1)  
• Medi-Cal Rx Monthly Bulletin for September (September 1)  
• Changes to Medi-Cal Rx Contract Drugs List (September 1)  
• Updates to the Medi-Cal Rx Provider Manual (September 1) 
• Medi-Cal Rx Weekly Wrap-Up for August 18-24 (August 25)  
• Reinstatement Spotlight (August 25)  
• 30-Day Countdown: Reinstatement of Cost Ceiling and Prior Authorization for Enteral Nutrition and Specific Standard Therapeutic Classes (August 23)  
• Lift of Labeler Code Restriction for Truvada (August 22)  
• Recommencement of Pharmacy Retroactive Claim Adjustments: Publication of Updated Frequently Asked Questions (FAQs) (August 21) 
• Medi-Cal Rx Weekly Wrap-Up for August 11-17 (August 18)  
• Reinstatement Spotlight (August 18) 

Also in California, Gov. Gavin Newsom (D) declared a state of emergency in Del Norte and Siskiyou Counties due to fires. During a declared state of emergency, the Board of Pharmacy reminds licensees of information and state laws intended to help pharmacists provide prescription drugs – including controlled substances – for residents displaced because of emergency evacuation.  

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

The Department of Health Care Services (DHCS) posted the following bulletins, notices, and alerts on the Medi-Cal Rx Web Portal. Please note the Updated FAQs (Frequently Asked Questions) for the Pharmacy Retroactive Claim Adjustments. 

• Reinstatement Spotlight (September 1) 
• Diabetic Supplies Update: Changes to Continuous Glucose Monitoring Systems Policy, Effective October 1, 2023 (September 1) 
• Medical Supplies Update: Updates to Contracted Diabetic Test Strips and Lancets List, Effective October 1, 2023 (September 1) 
• Maximum Allowable Ingredient Cost 30-Day Pharmacy Provider Notice (September 1) 
• Medi-Cal Rx Monthly Bulletin for September (September 1) 
• Changes to Medi-Cal Rx Contract Drugs List (September 1) 
• Updates to the Medi-Cal Rx Provider Manual (September 1) 
• Medi-Cal Rx Weekly Wrap-Up for August 18-24 (August 25) 
• Reinstatement Spotlight (August 25) 
• 30-Day Countdown: Reinstatement of Cost Ceiling and Prior Authorization for Enteral Nutrition and Specific Standard Therapeutic Classes (August 23) 
• Lift of Labeler Code Restriction for Truvada (August 22) 
• Recommencement of Pharmacy Retroactive Claim Adjustments: Publication of Updated Frequently Asked Questions (FAQs) (August 21) 
• Medi-Cal Rx Weekly Wrap-Up for August 11-17 (August 18) 
• Reinstatement Spotlight (August 18) 

Also in California, Gov. Gavin Newsom (D) declared a state of emergency in Del Norte and Siskiyou Counties due to fires. During a declared state of emergency, the Board of Pharmacy reminds licensees of information and state laws intended to help pharmacists provide prescription drugs – including controlled substances – for residents displaced because of emergency evacuation. 

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

The Department of Health Care Services (DHCS) posted the following bulletins, notices, and alerts on the Medi-Cal Rx Web Portal. Please note the update on Pharmacy Retroactive Claim Adjustments in August 2023. 

• Temporary Lift of Labeler Code Restriction for Suboxone Film (August 17) 
• Enteral Nutrition for Members 22 Years of Age and Older: New Start Prior Authorization Reminders (August 16) 
• Remittance Advice (RA): Amount Billed/Total Claim Charge Amount Content Update (August 11) 
• Medi-Cal Rx Weekly Wrap-up for August 4-10 (August 11) 
• Reinstatement Spotlight (August 11) 
• 90-Day Countdown: Reinstatement for Prior Authorization Requirements for Enteral Nutrition Claims for Members 22 years of Age and Older (August 9) 
• Medi-Cal Rx Weekly Wrap-up for July 28-August 3 (August 4) 
• Reinstatement Spotlight (August 4) 
• Prior Authorization Submission Using the Electronic Health Record to Initiate an Electronic Prior Authorization Request via CoverMyMeds® (August 1) 
• Medi-Cal Rx Monthly Bulletin for August (August 1) 
• Changes to the Medi-Cal Rx Contract Drugs List (August 1) 
• Changes to the Medi-Cal Rx Contract Drugs List – Authorized Drug Manufacturer Labeler Codes (August 1) 
• Recommencement of Pharmacy Retroactive Claim Adjustments in August 2023 (July 31) 
• Medi-Cal Rx Weekly Wrap-up for July 21-27 (July 28) 
• Reinstatement Spotlight (July 28) 
• Reminder: Medi-Cal Rx Billing Policy for Physician Administered Drugs (July 26)
• Reinstatement Spotlight (July 21) 

Also in California, Medi-Cal posted the following. Please note the update on Pharmacy Retroactive Claim Adjustments in August 2023.  

• August 2023 Pharmacy Medi-Cal Update Bulletin 1045 (August 16) 
• August 2023 Durable Medical Equipment and Medical Supplies Medi-Cal Update Bulletin 575 (August 16) 
• Pfizer-BioNTech Bivalent COVID-19 Vaccine Booster Approved for Children 6 Months through 4 Years (August 1/Updated August 16) 
• Recommencement of Pharmacy Retroactive Claim Adjustments in August 2023 (July 31) 

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

Effective July 1, 2023, the Board of Pharmacy and all other Department of Consumer Affairs (DCA) licensing boards and bureaus were required to grant temporary licensure to the spouse or domestic partner of an active-duty military member stationed in the state if the applicate is currently licensed and holds an active and unrestricted license in another state with the same scope of practice as the profession in California for which they would like to practice. This applicant population also receives expedited processing and initial application and license fee waivers. Applications for this temporary licensure are available through the board or bureau with jurisdiction over the type of license being sought. DCA posted the requirements and additional information. 

Also in California, as required in Business and Professions Code Section 4301.3, the Board of Pharmacy submitted its report to the Legislature. The report provides summary information of the efforts undertaken to evaluate whether moving to a standard of care enforcement model would be feasible and appropriate. The report offers recommendations, including most notably that the Board concludes that a hybrid enforcement model remains appropriate for the regulation of the practice of pharmacy for consumer protection. The report also provides next steps, including continuing to work with stakeholders to advance patient access to care that achieves health equity for California consumers without compromise to public safety. 

Also in California, the Department of Health Care Services (DHCS) posted the following weekly notices and alerts on the Medi-Cal Rx Web Portal:   

• Medi-Cal Rx Weekly Wrap-up for July 7-13 (July 14) 
• Reinstatement Spotlight (July 14) 

• Prior Authorization Submission Processing – System Issue Resolved (July 13) 
• Medi-Cal Rx Weekly Wrap-up for June 30-July 6 (July 7) 
• Reinstatement Spotlight (July 7) 
• 30-day Countdown: Phase IV, Lift 1: Reinstatement of Claims Edits for Age, Gender, and Labeler Code Restrictions for Members 22 Years of Age and Older (July 3) 
• Medi-Cal Rx Monthly Bulletin for July (July 1) 

• Changes to the Medi-Cal Rx Contract Drugs List (July 1) 
• Changes to the Medi-Cal Rx Contract Drugs List – Blood Factors (July 1) 
• Changes to the Medi-Cal Rx Contract Drugs List – Over-the-Counter Drugs (July 1) 
• Changes to the Medi-Cal Rx Family Planning, Access, Care, and Treatment Pharmacy Formulary (July 1) 
• Updates to the Medi-Cal Rx Provider Manual (July 1) 

• Medi-Cal Rx Weekly Wrap-up for June 23-29 (June 30) 
• Reinstatement Spotlight (June 30) 
• 90-day Countdown: Reinstatement of Prior Authorization Requirements for Enteral Nutrition Products for Members 22 Years of Age and Older (June 23) 
• Medi-Cal Rx Weekly Wrap-up for June 16-22 (June 23) 

Finally in California, Medi-Cal posted the following: 

• July 2023 Pharmacy Medi-Cal Update Bulletin 
• July 2023 Durable Medical Equipment and Medical Supplies Medi-Cal Update Bulletin 
• COVID-19 Medi-Cal Response Page Update and Vaccine Guideline Removal 
• 2023 HCPCS Quarter 3 Update 

• Simplified Bivalent Vaccine Administration Codes Added for COVID-19 
• Pharmacy Medi-Cal Update Bulletin 
• June 2023 Update: Discontinuation of the COVID-19 Uninsured Group Program 
• National Correct Coding Initiative Quarterly Update for July 2023 

• June 2023 Pharmacy Medi-Cal Update Bulletin 
• June 2023 Durable Medical Equipment and Medical Supplies Medi-Cal Update Bulletin 

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

The Department of Health Care Services (DHCS) posted the following weekly notices on the Medi-Cal Rx Web Portal:  

• Reinstatement Spotlight (June 23) 
• Medi-Cal Rx Weekly Wrap-up for June 16-23 (June 23) 
• Drug Lookup Tool – Enhanced Functionality (June 20) 
• Reinstatement Spotlight (June 16) 

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

The Department of Health Care Services (DHCS) posted the following weekly notices on the Medi-Cal Rx Web Portal:   

• Medi-Cal Rx Weekly Wrap-up for June 2-8 (June 9) 
• Reinstatement Spotlight (June 9) 

 Also in California, on June 13, the Department of Health Care Services posted a Freeze on Processing Paper Electronic Health Care Claim Payment/Advice Receiver Agreement Form [DHCS 6246 form]. 

Finally in California, the Board of Pharmacy posted its agenda and meeting materials for the Full Board Meeting on June 21.  

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

The Department of Health Care Services (DHCS) posted these resources to provide further resources to assist with Medi-Cal Rx Reinstatement.

• Medi-Cal Rx Reinstatement: Phases II-III: Easy access to resources and support
• FAQ: Frequently asked questions regarding Medi-Cal Rx Reinstatement
• DHCS Medi-Cal Rx Reinstatement slide deck
• Medi-Cal Rx Reinstatement information page: Select Medi-Cal Rx Reinstatement tab, located on the left

For further questions, email Medi-Cal Rx Education & Outreach. DHCS values your input. Please complete this short survey to provide feedback.

Also in California, this week, the Board of Pharmacy issued a notice to be “Beware of Scam Calls” as a result of licensees reporting being victimized by scam callers claiming to represent the “California State Board of Pharmacy” (Board) or another government agency.

Finally in California, the Department of Health Care Services (DHCS) posted the following alerts and weekly wrap-ups on the Medi-Cal Rx Web Portal:

• Billing Tips Guide Updated (June 8)
• Reminder: Fiscal Year Two-Week Fee-for-Service Hold for Specific Provider Payments (June 2)
• Medi-Cal Rx Checkwrite Schedule – State Fiscal Year 2023-24 Available (June 2)
• Medi-Cal Rx Weekly Wrap-up for May 26-June 1 (June 2)
• Reinstatement Spotlight (June 2)

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