NACDS submitted a letter to the Assembly Appropriations Committee in support of SB 966, PBM reform legislation, including provisions prohibiting the use of spread pricing, requiring 100% pass-through of manufacturer rebates to plan sponsors, prohibiting the steering of patients to PBM-affiliated pharmacies and requiring PBMs to obtain a license to operate in the state. 

Also in California, the Department of Health Care Services (DHCS) announced it will host its quarterly Hearing Aid Coverage for Children Program (HACCP) webinar for medical providers and hearing professionals on August 15 from 12:00 noon to 1:00 pm PDT. For more information and to pre-register, please visit DHCS' HACCP webpage. 

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

• July 2024 Pharmacy Medi-Cal Update Bulletin  

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

Also in California, the Board of Pharmacy posted the agenda and meeting materials for the Full Board Meeting being held July 31-August 1. Please note the inclusion of compounding regulations. 

• Agenda 

• Board Meeting Materials 

Finally in California, the Department of Health Care Services posted the following alert on the Medi-Cal Rx Web Portal: Reminder: Quantity Limit Restrictions for Anti-Obesity Preparations. 

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

The Department of Health Care Servies posted the following weekly notice on the Medi-Cal Rx Web Portal: Medi-Cal Rx Weekly Wrap-up for July 5-11.

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

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

• State of Emergency Override Activation: Submission Clarification Code 13
• Medi-Cal Rx Weekly Wrap-up for June 28-July 4
• Medi-Cal Rx Monthly Bulletin for July
• Changes to the Medi-Cal Rx Contract Drugs List
• Changes to the Medi-Cal Rx Contract Drugs List – Authorized Drug Manufacturer Labeler Codes
• Updates to the Medi-Cal Rx Provider Manual

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

The Department of Health Care Servies posted the following weekly notice on the Medi-Cal Rx Web Portal: Medi-Cal Rx Weekly Wrap-up for June 14-20.

Also in California, as part of Gov. Gavin Newsom’s (D) Master Plan for Tracking the Fentanyl and Opioid Crises, California will make its own private label branded over the counter (OTC) naloxone hydrochloride (HCL) nasal spray (CalRx®). It will be available for free to eligible organizations through the California Department of Health Care Services (DHCS) Naloxone Distribution Project (NDP) or for sale for $24 per twin-pack. The state is also working on an option for individuals to buy CalRx OTC naloxone nasal spray directly.

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

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

• Mass Adjustment for Enteral Nutrition for Impacted Claims Submitted December 27, 2022, through March 13, 2023 
• Mass Adjustment for Blood Factors for Impacted Claims Submitted January 1, 2022, through October 25, 2022 
• Mass Adjustment for Diabetic Lancets for Impacted Claims with a Date of Service January 1, 2022, through December 31, 2022 
• Mass Adjustment for Disposable Insulin Delivery Devices for Impacted Claims Submitted April 1, 2022, through April 28, 2022 
• Code I Diagnosis Requirement for Chronic Weight Management 
• Medi-Cal Rx Weekly Wrap-up for June 7-13 

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

• June 2024 Pharmacy Medi-Cal Update Bulletin 
• June 2024 Durable Medical Equipment and Medical Services Medi-Cal Update Bulletin 
• Rate Update for Select Durable Medical Equipment (DME) Codes  

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.

• 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.