Starting Jan. 1, 2022, the state Department of Health Care Services (DHCS) will carve out all prescription benefits from Managed Care Plans (MCP) under a new program called Medi-Cal Rx. Upon implementation, all pharmacy claims will be submitted directly to the state via its pharmacy benefit manager (PBM), Magellan Medicaid Administration, Inc. Providers will receive information about the program as it becomes available.
Important links
- Medi-Cal Rx Website: Please bookmark this website and sign up for the Medi-Cal Rx Subscription Service (MCRxSS) to receive important information directly from DHCS.
- Medi-Cal Rx Prior Authorization Requests and Appeals: GCHP put together this information sheet about how to submit prior authorization requests and appeals.
Provider communications
Providers can expect to receive a series of communications from DHCS and GCHP about Medi-Cal Rx as the Jan. 1, 2022 implementation nears.
Medi-Cal Rx news from DHCS
- August 16, 2021: Medi-Cal Rx: New Implementation Date
- April 14, 2021: Medi-Cal Rx Transition and Resources Training
- April 7, 2021: Provider Registration and FAQs
- February 17, 2021: Important Update on Medi-Cal Rx
- November 16, 2020: Medi-Cal Rx Lengthens Transition Time to Full Implementation
- August 28, 2020: Update to Medi-Cal Rx Support Services and Key Payer Sheet Details
- October 22, 2020: MCP Prescriber Registration and Training Outreach Message
- October 22, 2020: NCPDP Standard Payer Sheet
- October 26, 2020: Prescriber Communication
Medi-Cal Rx news from GCHP
- November 17, 2021: Medi-Cal Rx Communications
- April 7, 2021: Medi-Cal Rx Training
- March 18, 2021: Medi-Cal Rx Readiness Survey for Pharmacy Providers and Prescribers
- February 25, 2021: Medi-Cal Rx On Hold
- January 26, 2021: Medi-Cal Rx Informational Webinars
- November 20, 2020: Medi-Cal Rx: New Implementation Date
- October 23, 2020: Medi-Cal Rx - Prescriber Registration and Training
- August 20, 2020: Coming Soon: Medi-Cal Rx