The Department of Health Care Servies posted the following alerts, weekly report and monthly bulletin on the Medi-Cal Rx Web Portal.

• New Medi-Cal Rx Web Portal Resource Pages: FDA Drug Recall Notifications
• New Medi-Cal Rx Web Portal Resource Page: Mass Adjustment Notifications
• Medi-Cal Rx Weekly Wrap-up for May 31-June 6
• Billing Tips for Diabetic Test Strips and Lancets and Dual Eligible Beneficiaries

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

The Department of Health Care Servies posted the following alerts, weekly report and monthly bulletin on the Medi-Cal Rx Web Portal. Please note the “Maximum Allowable Ingredient Cost 30-Day Pharmacy Provider Notice”. Rates will be effective July 1, 2024, and were posted to the Mercer Medi-Cal Rx website no later than June 1. 

• Medi-Cal Rx Claims and Prior Authorization Submission Outage – System Issue Resolved 
• Enteral Nutrition Updates to the List of Contracted Enteral Nutrition Products, Effective September 1, 2024 
• Maximum Allowable Ingredient Cost 30-Day Pharmacy Provider Notice 
• Medi-Cal Rx Monthly Bulletin for June 
• Changes to the Medi-Cal Rx Contract Drugs List 
• Changes to the Medi-Cal Rx Contract Drugs List – Over-the-Counter Drugs and Cough/Cold Preparations 
• Changes to the Medi-Cal Rx Pharmacy Reimbursable Physician Administered Drugs 
• Updates to the Medi-Cal Rx Provider Manual 
• Medi-Cal Rx Weekly Wrap-up for May 24-30 
• Medi-Cal Rx Checkwrite Schedule – State Fiscal Year 2024-25 Available 

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

The Department of Health Care Services posted the following alerts and weekly report on the Medi-Cal Rx Web Portal. 

• Reminder: State Fiscal Year Two-Week Fee-for-Service Hold for Specific Provider Payments 
• Medi-Cal Rx Weekly Wrap-up for May 17-23 
• Updates to Continuous Glucose Monitoring and Disposable Insulin Delivery Devices Quantity Limits, Effective June 7, 2024 

 Also in California, on May 28, the article titled “Change Healthcare Cybersecurity Issue Update” was posted to the Medi-Cal News area on the Medi-Cal Provider website.

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

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.

The Department of Health Care Servies posted this alert “Medi-Cal Rx Provider Portal Troubleshooting and Support”. Visit the Medi-Cal Rx Web Portal to see a historical listing of alerts, weekly notices, and monthly bulletins.  

Also in California, the Board of Pharmacy posted the May 2024 issue of The Script. 

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

The Department of Health Care Services posted the following alerts, weekly notices, and monthly bulletin on the Medi-Cal Rx Web Portal. Please note the “Pharmacy Provider Dispensing Fee Self-Attestation.” This will be the final opportunity to attest for the upcoming fiscal year 2024-2025. All attestations must be received by May 31 to be accepted. Attestations will not be accepted after closing on May 31; no exceptions. 

• Medi-Cal Weekly Wrap-up for April 26-May 2 (May 3) 
• Medical Supplies: Updates to the Billing Policy for Contracted Blood Pressure Monitoring Devices and Cuffs (May 2) 
• Removal of Appendix H – List of Physician Administered Drugs with Reject Code 816 (May 1) 
• Availability of Extencilline on the Medi-Cal Rx Contract Drugs List (May 1) 
• Reminder Billing Tips: Non-Covered Medical Supplies (May 1) 
• Medi-Cal Rx Monthly Bulletin for May (May 1) 
• Changes to the Medi-Cal Rx Contract Drugs List (May 1) 
• Changes to the Medi-Cal Rx Pharmacy Reimbursable Physician Administered Drugs (May 1) 
• Changes to the Medi-Cal Rx Contract Drugs List – Over-the-Counter Drugs and Cough/Cold Preparations (May 1) 
• Changes to the Medi-Cal Rx Contract Drugs List – Authorized Drug Manufacturer Labeler Codes (May 1) 
• Updates to the Medi-Cal Rx Provider Manual (May 1) 
• Pharmacy Provider Dispensing Fee Self-Attestation (April 30) 
• Medi-Cal Rx Weekly Wrap-up for April 19-25 (April 26) 
• How to Address Reject Code 80 – Diagnosis Code Submitted Does Not Need to Meet Drug Coverage Criteria (April 23) 
• Closure of Latimer’s Pharmacy in Los Molinos and Old Time Drugs in Corning, Tehama County (April 19) 

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

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

Also in California, NACDS and the California Community Pharmacy Coalition, a project of the California Retailers Association, testified before the California Senate Business, Professions & Economic Development Committee in support of SB 1365, legislation expanding the pharmacist to pharmacy technician ratio to 1:6. The bill was amended changing the ratio from 1:6 to 1:4 and passed out of committee.  

Also in California, NACDS submitted a support letter for SB 966, PBM reform legislation to the Senate Appropriations Committee in advance of the hearing scheduled for May 13. 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 requires PBMs to obtain a license to operate in the state.  

Also in California, the Board of Pharmacy proposed modifications to the following: 

• Title 16 CCR § 1760, and the Disciplinary Guidelines, incorporated by reference. Any person who wishes to comment on the proposed modifications may do so by submitting written comments beginning April 29, 2024, and ending on May 14, 2024. 

• Notice of Proposed Action 
• Initial Statement of Reasons 
• Proposed Text 
• Disciplinary Guidelines 
• Notice of Modified Text 
• Modified Text 
• Modified Disciplinary Guidelines 

• Title 16 CCR § 1709.1, related to the Designation of Pharmacist-in-Charge. Any person who wishes to comment on the proposed modifications may do so by submitting written comments beginning April 29, 2024, and ending on May 14, 2024. 

• Notice of Proposed Action 
• Initial Statement of Reasons 
• Proposed Text 
• Notice of Modified Text 
• Modified Text 

Finally in California, the Board of Pharmacy has released a Notice of Proposed Action to amend Article 4.5, add Articles 4.6, 4.7, and 4.8, and repeal Article 7 of Title 16, Division 17, of the California Code of Regulations related to Compounded Drug Preparations. The Board will accept comments on the proposed text through June 3. 

• Notice of Proposed Action 
• Initial Statement of Reasons 
• Repealed Text 
• Proposed Text 
• Board Requested Format for Submitting Comments 

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

The Department of Health Care Services posted a weekly notice, “Medi-Cal Rx Weekly Wrap-up for March 29-April 4”.

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

The Board of Pharmacy posted the following to its website:  

• Licensing Committee Meeting – April 10 – Note: inclusion of technician, central fill and standard of care agenda items.  

• • Agenda 

• Enforcement and Compounding Committee Meeting – April 11 

• • Agenda 

• Legislation/Regulation Committee Meeting – April 11 

• • Agenda 

Also in California, the Board of Pharmacy is conducting an occupational analysis (OA) of the pharmacy technician profession in California. The survey is a part of the OA, which identifies competencies that will provide the basis for developing future licensure examinations in California. The survey weblink will be available 24/7 and must be completed by April 15. 

Finally in California, the Department of Health Care Services posted the following alerts, weekly notices, and monthly bulletin on the Medi-Cal Rx Web Portal.   

• Removal of Code I Restrictions for Medical Supplies (April 1) 
• Diabetic Test Strips and Lancets: Updates to the Code I Diagnosis and Quantity Limit Restrictions (April 1) 
• Medi-Cal Rx Monthly Bulletin for April (April 1) 
• Changes to the Medi-Cal Rx Contract Drugs List (April 1) 
• Changes to the Medi-Cal Rx Pharmacy Reimbursable Physician Administered Drugs (April 1) 
• Changes to the Medi-Cal Rx Contract Drugs List – Over-the-Counter Drugs and Cough/Cold Preparations (April 1) 
• Changes to the Medi-Cal Rx Family Planning, Access, Care and Treatment Pharmacy Formulary (April 1) 
• Updates to the Medi-Cal Rx Provider Manual (April 1) 
• Mass Adjustment for COVID-19 Vaccine Incentive Fee for Impacted Claims Submitted February 1, 2022, through March 31, 2022 (March 29) 
• Mass Adjustment for COVID-19 Antigen Tests for Impacted Claims Submitted on February 1, 2022 (March 29) 
• Mass Adjustment for Disposable Insulin Delivery Devised for Impacted Claims Submitted January 1, 2022, through March 31, 2022 (March 29) 
• Opill® Available for Over-the-Counter Under Medi-Cal Rx Prescription (March 29) 
• 30-Day Countdown: Implementation of Reject Code 80 (March 29) 
• Medi-Cal Rx Weekly Wrap-up March 22-28 (March 29) 
• Pharmacy Claims Mass Adjustments: New Resources (March 28) 
• Reminder: Medi-Cal Rx Secured Provider Portal Password Criteria Update Now in Effect (March 27) 
• Updates to Paper Checks and Remittance Advices (March 27) 
• Medi-Cal Rx Learning Management System Migration (March 25) 
• Medi-Cal Rx Secured Provider Portal Password Criteria Update (March 25) 
• Medi-Cal Rx Weekly Wrap-up for March 15-21 (March 22) 
• Medi-Cal Rx Email Domains, Mailboxes and Meeting Links Transitioning to Prime

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

The Department of Health Care Services posted the following alerts and weekly notices on the Medi-Cal Rx Web Portal.   

• Medi-Cal Rx Weekly Wrap-up for March 8-14 (March 15) 
• Medi-Cal Rx Claim and Prior Authorization Request Submission Outage (March 14) 
• Adalimumab biosimilar HADLIMA™ (adalimumab-bwwd) Added to Medi-Cal Rx Contract Drugs List on March 1, 2024 (March 8) 
• Medi-Cal Rx Weekly Wrap-up for March 1-7 (March 8) 

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

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

Finally in California, Gov. Gavin Newsom (D) appointed Tyler Sadwith as State Medicaid Director at the Department of Health Care Services (DHCS). This is a long-awaited appointment to fill the second half of former Medicaid Director Jacey Cooper’s position. As a reminder, Sarah Brooks was appointed in December as Chief Deputy Director of Health Care Programs at DHCS. Before that, Jacey Cooper held that position and the State Medicaid Director role. Her role was bifurcated and now Tyler Sadwith holds the Medicaid Director role and Sarah Brooks maintains the Chief Deputy Director of Health Care Programs position.  

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