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.

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

• Updates to the List of Contracted Personal Blood Pressure Monitoring Devices and Blood Pressure Cuffs, Effective July 1, 2023 and October 1, 2023 (June 1) 
• Updates to the List of Contracted Enteral Nutrition Products, Effective July 1, 2023 and October 1, 2023 (June 1) 
• Medical Supplies Update: Updates to Diabetic Blood Glucose Test Strips and Lancets Quantity Limits, Effective July 1, 2023 (June 1) 
• Updates to Diabetic Testing Supplies, Effective July 1, 2023 (June 1) 
• Updates to Medical Supplies: Basal Thermometers, Effective July 1, 2023 (June 1) 
• Maximum Allowable Ingredient Cost 30-day Pharmacy Provider Notice (June 1) 
• Medi-Cal Rx Monthly Bulletin for June (June 1) 
• Changes to the Contract Drugs List (June 1) 
• Changes to Contract Drugs List – Over-the-Counter Drugs (June 1) 
• Changes to Family PACT Pharmacy Formulary (June 1) 
• Updates to the Medi-Cal Rx Provider Manual (June 1) 
• Pharmacy Locator Tool – Enhanced Functionality (May 26) 
• Medi-Cal Rx Weekly Wrap-up for May 19-25 (May 26) 
• Reinstatement Spotlight (May 26) 
• Emergency Fill for Unbreakable Packages (May 24) 
• 30-day Countdown – Phase III, Lift 4: Retirement of the Transition Policy for Beneficiaries 22 Years of Age and Older (May 23) 

Also in California, Medi-Cal published this PHE Update for Who May Prescribe Home Health Services, DME and Medical Supplies (May 19). 

Also in California, the Department of Health Care Services announced this Medi-Cal Rx Update. 

On May 19, Medi-Cal Rx Reinstatement Phase III, Lift 3 was successfully launched. On May 23, a 30-day notification for Phase III, Lift 4: Retirement of the Transition Policy for Beneficiaries 22 Years of Age and Older was released, notifying stakeholders that on June 23, 2023, Phase III, Lift 4 (P3/L4) will be implemented, lifting the Transition Policy for 46 Standard Therapeutic Classes. This is the fourth in a series of lifts to retire the Transition Policy by reinstating NCPDP Reject Code 75 – Prior Authorization Required.  

Also in California, as part of the Board of Pharmacy’s April 2023 Board Meeting, the Board approved a policy statement related to digital signatures. 

Finally, the Board of Pharmacy posted the agenda for the Medication Error Reduction and Workforce Ad Hoc Committee Meeting scheduled for June 7. 

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

AB 317, legislation requiring a health care service plan or certain disability insurers that offer coverage for a service that is within a pharmacist’s scope of practice to pay or reimburse the cost of the service provided by the pharmacist at an in-network pharmacy or by a pharmacist at an out-of-network pharmacy if the health care service plan or insurer has an out-of-network pharmacy benefit, passed the Assembly on April 27 and was referred to the Senate Committee on Health on May 10. 

Also in California, AB 1341, legislation authorizing a pharmacist to furnish COVID-19 oral therapeutics following a positive CLIA-waived test, passed the Assembly on April 17 and was referred to the Senate Business, Professions and Economic Development Committee on May 10. Prior to passage in the Assembly, the bill was amended to include an urgency statute meaning it will be effective immediately upon enactment. 

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

• Medi-Cal Rx Weekly Wrap-up for May 12-18 (May 19) 
• Reinstatement Spotlight (May 19) 
• Billing Tips: Non-Covered Medical Supplies (May 12) 

 Finally in California, Medi-Cal posted the following:   

• Medi-Cal Update – Pharmacy – May 2023 – Bulletin 1039 (May 16) 
• Medi-Cal Update – Durable Medical Equipment and Medical Supplies – May 2023 – Bulletin 572 (May 16) 

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

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

• List of Medications Eligible for an Extended Duration Prior Authorization (May 12) 
• Reinstatement Spotlight (May 12) 
• Medi-Cal Weekly Wrap-up for April 28-May 4 (May 5) 
• Reinstatement Spotlight (May 5) 

Also in California, the Board of Pharmacy posted the agenda and meeting materials for the May 17 meeting of the Full Board. Discussion topics include proposed regulations related to automated drug delivery system self-assessment form and the draft legislative report regarding assessment of Standard of Care Enforcement Model in the Practice of Pharmacy. 

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