Medi-Cal Rx prescribers will again be required to submit prior authorizations (PAs) for new start medications in 11 drug classes for patients 22 and older effective September 16, 2022.

The 11 drug classes include:

• Diuretics
• Lipotropics, including statins and omega‐3 fatty acids
• Hypoglycemics, including glucagon
• Coronary vasodilators (nitrates and pulmonary arterial hypertension agents)
• Cardiovascular agents, including antiarrhythmics and inotropes
• Anticoagulants and antiplatelets
• Niacin, Vitamin B and Vitamin C products

According to the Department of Health Care Services (DHCS), new start prescriptions for pediatric patients 21 years of age and under are excluded to prevent additional administrative obligations for providers of specialty pediatric services who have been significantly impacted by the transition to Medi-Cal Rx.

For More Information

For more information about the phased implementation plan for Medi-Cal Rx, see the DHCS Prior Authorization Reinstatement Reference Guide.

The California Medical Association (CMA) also recently partnered with the California Primary Care Association and Magellan on a webinar to help physicians understand the implementation plan for Medi-Cal Rx. The one-hour webinar was recorded and is now available for on-demand playback. Also available is an FAQ document with the answers to questions fielded during the webinar. 

Stay up to date with the latest Medi-Cal Rx news by signing up for the Medi-Cal Rx Subscription Service. For questions, please contact the Medi-Cal Rx Customer Service Center at (800) 977-2273, available 24 hours a day, 365 days a year, or email MediCalRxEducationOutreach@magellanhealth.com.