Starting April 1, 2021, 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.
- 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.
Medi-Cal Rx News
- 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
Starting in October 2020, members can expect to receive a series of communications from GCHP and DHCS about Medi-Cal Rx:
- October 2020: 90-day notice letter from DHCS based on the previous implementation date.
- November 2020: 60-day notice letter from DHCS based on the previous implementation date.
- December 7, 2020: Letter from DHCS about the new implementation date.
- February/March 2021: GCHP radio and print outreach campaign.
- March 2021: 30-day notice letter from GCHP.
- April 2021: New member ID cards from GCHP.
Providers can expect to receive a series of communications from GCHP and DHCS about Medi-Cal Rx as the April 1, 2021 implementation nears.
- August 2020: Pharmacies and prescribers receive training announcements and instructions.
- September 2020: Pharmacies and prescribers receive 120-day pharmacy transition information based on the previous implementation date.
- October 2020: Pharmacies receive a 90-day notice letter based on the previous implementation date.
- November 20, 2020: Medi-Cal Rx: New Implementation Date
- August 20, 2020: Coming Soon: Medi-Cal Rx
- October 23, 2020: Medi-Cal Rx - Prescriber Registration and Training
Training for pharmacies and prescribers will be ongoing. Visit the Education and Outreach page on the Medi-Cal Rx website to access training resources.
- August 2020: Pharmacies and prescribers receive registration instructions for the secured portal and associated applications.
- September 2020: General training begins for pharmacies and prescribers.
- October 2020: General training continues for pharmacies and prescribers.
- November 2020-April 2021: Information will be forthcoming.