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

• Coming Soon: Completion of Pediatric Integration of Members 21 Years of Age and Younger 

• 30-day Countdown: Medi-Cal Rx Contract Drugs List Loading Dose Quantity Policy Update 

• Pharmacy Provider Dispensing Fee Self-Attestation 

• Maximum Allowable Ingredient Cost 30-day Pharmacy Provider Notice 

• Updates to the List of Contracted Enteral Nutrition Products, Effective April 1, 2025 

• Medi-Cal Rx Monthly Bulletin for March 

• Changes to the Medi-Cal Rx Contract Drugs List 

• Updates to the Medi-Cal Rx Provider Manual 

• Mass Adjustment for Professional Dispensing Fee Amount Increase for Impacted Claims with Date of Service July 1, 2024, through July 25, 2024 

• Medi-Cal Rx Weekly Wrap-up for February 21-27 

• Medi-Cal Rx to Mail Amended 2024 1099-MISC Form 

• Medi-Cal Rx Weekly Wrap-up for February 14-20 

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

The Board of Pharmacy announced the modification and/or extension of the waivers of Pharmacy Law issued in response to the Los Angeles Fires.

The waiver that provides flexibility to increase the number of pharmacy technicians a pharmacist may supervise has been modified and the expiration date has been extended to June 30, 2025 (or the termination date of the state of emergency, whichever is sooner).

The expiration date of the waiver that provides flexibility for pharmacy personnel to perform some functions from outside of a licensed pharmacy has been extended to June 30, 2025 (or the termination date of the state of emergency, whichever is sooner).

The expiration date of the waiver to allow for the delivery of drugs to an alternate location has been extended to March 31, 2025 (or the termination date of the state of emergency, whichever is sooner).

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

• February 2025 Pharmacy Medi-Cal Update Bulletin
• February 2025 Durable Medical Equipment and Medical Services Medi-Cal Update Bulletin

Finally in California, the Department of Health Care Services posted the following alerts and a weekly notice on the Medi-Cal Rx Web Portal. Please note the 2025 prescription volume attestation survey will be available to providers March 1 through March 31. Also, to avoid mail delivery delays and save paper, Medi-Cal Rx encourages pharmacy providers to opt into receiving the Medi-Cal Rx remittance information via the Electronic Remittance Advice (ERA) format.

• Centers for Medicare and Medicaid Services Payment for Error Rate Measurement Review
• Upcoming Pharmacy Professional Dispensing Fee Provider Self-Attestation
• Medi-Cal Rx Weekly Wrap-up for January 31-February 6
• State of Emergency Override Extension: Los Angeles and Ventura Counties
• Reminder: Providers Encouraged to Sign Up for Medi-Cal Rx Electronic Remittance Advice

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

The Department of Health Care Services posted the following alerts, monthly bulletin, and weekly notice on the Medi-Cal Rx Web Portal:   

• Reminder: Populate Usual & Customary Charge Field When Submitting a Claim 

• Medi-Cal Rx Monthly Bulletin for February 

• Changes to the Medi-Cal Rx Contract Drugs List 

• Updates to the Medi-Cal Rx Provider Manual 

• Now Active – Pediatric Integration for New Start Therapies and CCS Panel Authority 

• Updated: Medi-Cal Rx Enteral Nutrition Prior Authorization Request Form 

• Medi-Ca Rx Weekly Wrap-up for January 17-23 

Also in California, the Board of Pharmacy shared the California Health Alert Network message related to "Emergency Assistance for Those Impacted by the Wildfires." 

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

As of January 27, the Palisades Fire, Eaton Fire, and Hughes Fire have burned nearly 50,000 acres in the Los Angeles County area. The Palisades Fire is at 94% containment, Eaton Fire is at 98% containment, Hughes Fire is at 95% containment. There have been minimal pharmacy closures in the impacted areas of California due to the wildfires. Healthcare Ready deactivated RxOpen on January 28 but will be monitoring the event in case any other impacts arise.

The Emergency Prescription Assistance Program (EPAP) was activated last week– and will remain active through March 15, 2025 – for those impacted by the California wildfires. Pharmacies and pharmacists play an essential role in educating patients about the availability of EPAP benefits. We encourage and support sharing the resources below with the public to enhance awareness:

• ASPR EPAP Notice: https://aspr.hhs.gov/EPAP/Pages/California-Wildfires-2025.aspx
  • EPAP Website: https://aspr.hhs.gov/epap/Pages/default.aspx
  • EPAP Hotline: 855-793-7470 (TTY 1-800-876-1089)
• Link to Fact Sheets:
  • English – https://aspr.hhs.gov/EPAP/Documents/epap-need2know-ENG.pdf
  • Spanish – https://aspr.hhs.gov/EPAP/Documents/epap-need2know-SPANISH.pdf

NACDS is working with Healthcare Ready to provide support with outreach. Any insight, feedback or concerns regarding patient utilization of EPAP is appreciated. Please share your feedback with NACDS’ Lincy Abraham no later than February 3. If you are interested and willing to help support efforts to enhance awareness, you may also contact Healthcare Ready at 866-247-2694.

Also in California, the Department of Health Care Services (DHCS) issued a Notice of Proposed Rulemaking pertaining to Pharmacist Services, DHCS-19-002. The written comment period closes on February 5, 2025. DHSC posted the following related to the Public Comment Period

• Initial Statement of Reasons
• Proposed Regulation Text (PDF)
• Proposed Regulation Text (PDF) (Text Only)

Also in California, the Department of Health Care Services posted the following weekly notice on the Medi-Cal Rx Web Portal: Medi-Cal Rx Weekly Wrap-up for January 17-23.

Also in California, the Board of Pharmacy has proposed additional modifications to Title 16 CCR § 1711, related to the Quality Assurance Programs. Any person who wishes to comment on the proposed modifications may do so by submitting written comments beginning January 27 and ending on February 11, to the following:

Contact Person: Lori Martinez

Agency Name: California State Board of Pharmacy

Address: 2720 Gateway Oaks Drive, Ste 100, Sacramento, CA 95834

Email: PharmacyRulemaking@dca.ca.gov

Fax: (916) 574-8618

Any responses to comments directly concerning the proposed modifications to the text of the regulations will be considered and responded to in the Final Statement of Reasons.

All documents related to this regulatory action are available on the Board’s website: https://www.pharmacy.ca.gov/laws_regs/pending_regs.shtml.

Also in California, the board of pharmacy issued a reminder that licenses that are eligible for renewal will be processed online effective January 1, 2025. Those who are eligible include:

• Pharmacist
• Advanced Practice Pharmacist
• Pharmacy Technician
• Designated Representative – Wholesaler
• Designated Representative – Veterinary Food-Animal Drug Retailer
• Designated Representative – 3PL
• Designated Representative – Reverse Distributor

In most cases, the license expires at the end of the month of the licensee’s registered birthday for pharmacists, advanced practice pharmacists and pharmacy technicians. For designated representatives, the license expires at the first of the month.

The Board of Pharmacy will no longer mail out a paper renewal application for the above licenses. In its place, a postcard reminder will be sent approximately six weeks prior to the license expiration date and the licensee will renew by going to www.pharmacy.ca.gov. The postcard is only a reminder, if the licensee does not receive a postcard, they are still required to submit his/her payment on-time to avoid a delinquency fee and possible cancellation of the license.

For Pharmacists and Advanced Practice Pharmacists, if your license expired more than two years ago, you are not eligible to renew your license online. Contact the Board at RenewalStatus@dca.ca.gov for assistance.

Renewal payment transactions must be completed prior to 5:00 pm Pacific on the date the license expires to avoid the delinquency fee.

Online payments made after 5:00 p.m. Pacific Time are not credited on the day of the transaction. Print the payment confirmation at the end of this transaction for your records. Once the online payment is submitted, please allow two business days for processing.

Licensees are required to notify the board of any change of address within 30 days. Change of address may take between 7-10 business days to update in the system. If the correct address is not in the system at the time of renewal, the process may be delayed. Address changes can be made on-line or in writing to the board.

When renewing online, the licensee must confirm that his/her address is correct before submitting the paymentFees changed beginning January 1, 2025. The updated fee schedule with the new fees has been posted on the board’s website.

Also in California, the Board of Pharmacy posted the February 5-6, 2025 Board meeting agenda on its website. Of interest, please note the discussion and possible action related to compounded drug preparations, hazardous drugs and radiopharmaceuticals and waiver of pharmacy law provisions in response to the state of emergency related to the Palisades Fire.

Finally in California, Covered California announced a special enrollment period for residents of Los Angeles and Ventura counties until March 8, 2025. Resources are available through Los Angeles County and the State of California.  Of the 1.3 million uninsured Californians who qualify for subsidies through Covered California or are eligible for Medi-Cal coverage, 356,000 reside in Southern California. Through the BenefitsCal portal, Californians can get and manage benefits online. This includes food assistance (CalFresh, formerly food stamps), cash aid (CalWORKs, General Assistance, Cash Assistance Program for Immigrants), and affordable health insurance (Medi-Cal).

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

On January 17, the Department of Health Care Services (DHCS) issued a news release detailing the Department's work to expand support for Medi-Cal members impacted by the Southern California wildfires. DHCS swiftly implemented key administrative flexibilities to protect Medi-Cal members in affected regions of the state. These efforts included simplified Medi-Cal enrollment and renewal processes, waived requirements to access prescription medications and medical devices and other flexibilities to ensure all Medi-Cal members have access to care during this emergency. Additionally, DHCS is actively seeking further federal flexibilities to expand support for impacted Medi-Cal members and providers.  

Also in California, beginning January 17, the federal Assistant Secretary for Preparedness and Response (ASPR) activated the Emergency Prescription Assistance Program (EPAP) for specific zip codes in California to help uninsured residents replace prescription medicines and/or certain medical equipment lost or damaged in the 2025 Los Angeles Fires. EPAP has been activated through March 15, 2025. To locate participating pharmacies, visit EPAP Enrolled Pharmacies.  

Also in California, on January 17, DHCS began hosting a weekly Medi-Cal Rx Pediatric Integration webinar. Webinars will be held every Friday from 12:00 noon to 1:00 pm PST to support partner readiness. Partners, including pharmacy providers and prescribers, should plan to attend a webinar prior to the implementation of Medi-Cal Rx Pediatric Integration on January 31. More information is available on the Medi-Cal Rx Education & Outreach webpage. 

Finally in California, the Department of Health Care Services posted the following alerts and weekly notice on the Medi-Cal Rx Web Portal:  

• Now Available: CCS Panel Authority Policy Exclusions on the Medi-Cal Rx Approved NDC List 

• Deactivation of Reject Code 16 – M/I Prescription/Service Reference Number 

• Medi-Cal Rx Weekly Wrap-up for January 10-16 

• Medi-Cal Eligibility Assistance for Medi-Cal Members Affected by California Wildfires 

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

Assemblywoman Mia Bonta (D) introduced AB 50, legislation permitting pharmacists to provide over-the-counter contraceptives without following the protocols required for prescription contraceptives.

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

• State of Emergency Override Activation: Submission Clarification Code 13
• Post-PREP COVID-19 Vaccine Policy Update
• Medi-Cal Rx Weekly Wrap-up for November 22-December 5

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

This week, Sen. Scott Weiner (D) introduced two bills in what he calls “the prescription drug affordability package, or PDA,” aimed at reducing the cost of prescription drugs for Californians.

• SB 40: Would cap monthly insulin co-pays at $35 a month for most private health plans.
• SB 41: Would
• Require PBMs to be licensed by the Department of Insurance by January 1, 2027.
• Impose duties and reporting requirements on PBMs, with violations subject to civil penalties.
• Prohibit a contract between a PBM and a health care service plan or insurer that is executed, amended or renewed on or after January 1, 2026, from authorizing spread pricing.
• Prohibit a health care service plan contract or health insurance policy issued, amended or renewed on or after January 1, 2026, from calculating an enrollee’s or insured’s cost sharing at an amount exceeding the actual rate paid for the drug and require the contract or policy to include cost-sharing provisions.

Also in California, the Department of Health Care Services posted the following alerts, weekly notice and monthly bulletin on the Medi-Cal Rx Web Portal.  Please note the maximum allowable ingredient cost notice with rates effective January 1, 2025. Also, on January 31, 2025, the Transition Policy will be retired and reinstatement of prior authorization (PA) requirements and other claim utilization management (UM) edits for members 21 years of age and younger will apply to both new start and continuation of therapy claims.

• Maximum Allowable Ingredient Cost 30-Day Pharmacy Provider Notice
• Medical Supplies: Updates of the List of Contracted Pen Needles, Effective January 1, 2025
• Updates to the List of Contracted Enteral Nutrition Products, Effective January 1, 2025
• Diabetic Supplies: Updates to the Contracted Disposable Insulin Delivery Devices, Effective January 1, 2025
• Diabetic Supplies: Updates to the List of Contracted Diabetic Testing Supplies, Effective January 1, 2025, and March 1, 2025
• Diabetic Supplies: Updates to the List of Contracted Continuous Glucose Monitoring (CGM) Systems, Effective January 1, 2025
• Updates to the List of Contracted COVID-19 Tests, Effective January 1, 2025
• Medi-Cal Rx Monthly Bulletin for December
• Changes to the Medi-Cal Rx Contract Drugs List
• Updates to the Medi-Cal Rx Provider Manual
• 60-Day Countdown: Pediatric Integration of Members 21 Years of Age and Younger
• Mass Adjustment for TPOXX Drug Reimbursement for Impacted Claims with a Date of Service August 20, 2022, through October 1, 2024
• Mass Adjustment for Mpox Vaccine Reimbursement for Impacted Claims with a Date of Service August 17, 2022, through October 11, 2024
• Medi-Cal Rx Weekly Wrap-up for November 15-21

Also in California, pursuant to Health and Safety Code section 11161.7(b), the Board of Pharmacy distributes a list of prescribers whose authority to prescribe controlled substances has been restricted by the Medical Board of California. This information is available to prevent the dispensing of prescriptions for controlled substances issued by restricted prescribers.

Questions or comments about the prescribers listed should be directed to the Medical Board of California.

Finally in California, the Board of Pharmacy issued a reminder. Starting January 1, 2025, licenses that are eligible for renewal will be processed online. Those who are eligible include:

• Pharmacist
• Advanced Practice Pharmacist
• Pharmacy Technician
• Designated Representative – Wholesaler
• Designated Representative – Veterinary Food-Animal Drug Retailer
• Designated Representative – 3PL (Third-Party Logistics)
• Designated Representative – Reverse Distributor

The Board of Pharmacy (Board) will no longer mail out a paper renewal application for the above licensees. In its place, a postcard reminder will be sent approximately six weeks prior to the license expiration date and the licensee will renew by going to www.pharmacy.ca.gov. The postcard is only a reminder, if the licensee does not receive a postcard, they are still required to submit their payment on-time to avoid a delinquency fee and possible cancellation of the license.

Renewal payment transactions must be completed prior to 5:00 pm Pacific Time on the date the license expires to avoid the delinquency fee. The Board recommends printing the payment confirmation at the end of this transaction for recordkeeping. Once the online payment is submitted, please allow two business days for processing.

The Board must be notified of any change in address within 30 days. Change of address may take between 7-10 business days to update in the system. If the correct address is not in the system at the time of renewal, the process may be delayed. Address changes can be made on-line or in writing to the board.

Fees are changing on January 1, 2025. The updated fee schedule with the new fees has been posted on the website.

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

The Department of Health Care Services posted the following:

• November 2024 Pharmacy Medi-Cal Update Bulletin
• November 2024 Durable Medical Equipment and Medical Services Medi-Cal Update Bulletin

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

• Mass Adjustment for COVID-19 Vaccine Incentive Fee for Impacted Claims with a Date of Service October 1, 2022, through December 31, 2023
• Medi-Cal Rx Weekly Wrap-up for November 8-14
• State of Emergency Override Activation: Submission Clarification Code 13

Finally in California, the Board of Pharmacy proposed the following rules:

• Discontinuation of Business
  • Notice of Proposed Action
  • Initial Statement of Reasons
  • Proposed Text
  • 45-Day Comment Period: November 15, 2024, to December 30, 2024
• Quality Assurance Programs
  • Notice of Proposed Action
  • Initial Statement of Reasons
  • Proposed Text
  • Notice of Modified Text
  • Modified Text
  • 15-Day Comment Period: November 15, 2024, to December 2, 2024
  • Please send your company’s comments on the modified text to Sandra Guckian by November 25, 2024.
• Compounded Drug Preparations
  • Notice of Proposed Action
  • Initial Statement of Reasons
  • Repealed Text
  • Proposed Text
  • Notice of Modified Text
  • Modified Initial Statement of Reasons
  • Modified Regulation Text

• • Board Requested Format for Submitting Comments
  • 30-day Comment Period: November 8, 2024, to December 9, 2024

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

The Department of Health Care Services posted the following alerts, weekly notice, and monthly bulletin on the Medi-Cal Rx Web Portal:

• Reminder: Dual Eligible Special Needs Plan Deeming Periods
• Medi-Cal Rx Weekly Wrap-up for November 1-7
• Medi-Cal Rx Finance Portal “Download All Files” Error – Issue Resolved
• How to Resolve Reject Code 16 – M/I Prescription/Service Reference Number
• Medi-Cal Rx Weekly Wrap-up for October 25-31
• Medi-Cal Rx Monthly Bulletin for November
• Changes to Medi-Cal Rx Contract Drugs List
• Updates to Medi-Cal Rx Provider Manual
• 90-Day Countdown: Pediatric Integration of Members 21 Years of Age and Younger

Also in California, Proposition 36, The Homelessness, Drug Addiction and Theft Reduction Act, passed resulting in various changes to criminal and drug laws, including increasing penalties for some offenses, and providing treatment programs for people with drug addictions. Proposition 36 increases punishment for some theft and drug crimes in three ways: 1) turns some misdemeanors into felonies; 2) lengthens some felony sentences; and 3) requires some felonies be served in prison.

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