Pharmacy Services

The Alliance’s Pharmacy philosophy is directed by community standards of best medical practice. Evidence-based assessment of drug efficacy and safety, coupled with cost-benefit analysis for drugs of similar function, determine both formulary designations of different drugs as well as criteria for authorization of non-formulary agents and Physician-Administered Drugs.

The Alliance’s pharmacy operations for the provision of pharmaceutical services to members are described on the following pages and in Policy 403-1101 – Pharmacy Operations Management. 

Medi-Cal Pharmacy

All pharmacy services billed as a pharmacy claim are a benefit under Medi-Cal Rx. Learn more on the Medi-Cal Pharmacy page.

Alliance Care IHSS Pharmacy

The Alliance has partnered with MedImpact, a Pharmacy Benefit Manager (PBM), to process pharmacy claims and prior authorization requests for Alliance Care IHSS members. Learn more on the Alliance Care IHSS Pharmacy page.

Physician-Administered Drugs (for Medi-Cal and IHSS)

Visit the Physician-Administered Drugs page for information on prior authorization criteria, drugs carved out to fee-for-service Medi-Cal, submitting authorization requests, continuity of care for new members, and billing and reimbursement.

Drug Recalls and Withdrawals

The Alliance is committed to providing quality care to our members, which is why we prioritize equipping providers with the most up to date drug information. Staying informed about company and FDA-issued drug recalls and withdrawals can help providers deliver quality care to our members.

Additional Pharmacy Information

For information on drug utilization review and medication and sharps disposal, visit our Additional Pharmacy Information page.