Starting Jan. 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.
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 News
Communications timeline
Member communications
Starting in October, 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
- November 2020: 60-day notice letter from DHCS
- November/December 2020: Phone calls from GCHP
- December 2020: 30-day notice letter from GCHP
- January 2021: New member ID cards from GCHP
Provider communications
Providers can expect to receive a series of communications from GCHP and DHCS about Medi-Cal Rx starting in August:
- August 2020: Pharmacies and prescribers will receive training announcements and instructions.
- September 2020: Pharmacies and prescribers will receive 120-day pharmacy transition information.
- October 2020: Pharmacies will receive a 90-day notice letter.
- November 2020: Pharmacies will receive a 60-day notice letter.
- December 2020: Pharmacies will receive a 30-day notice letter.
GCHP Memos
Training timeline
- August 2020: Pharmacies and prescribers will 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: Pharmacies will receive web claims submission trainings.
- November 2020: General training continues for pharmacies and prescribers.