X

DHCS announces delay in Medi-Cal Rx transition

November 17, 2020
Area(s) of Interest: Public Payors 


In an effort to ensure a smooth transition amid the ongoing COVID-19 pandemic, the California Department of Health Care Services (DHCS) announced its decision to delay the transition to Medi-Cal Rx by three months, until April 1, 2021. In the interim, all current prescription drug service processes and protocols, both effectuated by DHCS and Medi-Cal managed care plans, will remain unchanged and in place until Medi-Cal Rx launches.

According to DHCS, the additional months will allow more time to develop safeguards to ensure a smoother and more complete transition of prescription drug services for Medi-Cal’s nearly 13 million beneficiaries during the public health emergency. The notice states the additional time will provide more opportunities for Medi-Cal providers, beneficiaries and others to become familiarize themselves with the new Medi-Cal Rx policies and processes, and will allow additional targeted stakeholder engagement and outreach efforts.

Medi-Cal Rx will include all pharmacy services billed as a pharmacy claim, including physician-administered drugs (PADs). However, PADs billed on medical or institutional claims are excluded from the requirement to transition to Medi-Cal Rx and should not be affected.

Under the Medi-Cal Rx program, physicians will use a secure provider web portal for key prescribing functions, such as:

  • Prior authorization information and submittal instructions
  • Beneficiary eligibility lookup
  • Web claims submission, activities and inquiries

With the additional time, physicians are encouraged to start the registration process as soon as possible to ensure their ability to prescribe for Medi-Cal patients is not interrupted. The first step in the registration process is to request a personal identification number (PIN), which will be sent via mail to the address on record with Medi-Cal. The letter with the PIN can take up to 10 days to arrive.

More information on the Medi-Cal Rx transition and the provider portal can be found at medi-calrx.dhcs.ca.gov/home.

 

Was this article helpful?    
Download the New CMADocs app!

Download the new CMADocs app!

CMA's new mobile app lets you connect with your colleagues and engage with CMA content!  Download the "CMADocs" app today from the Apple or Google Play app stores for daily news updates, events calendar, resource library and more.

Latest News

Load More