On June 23, 2023 the Transition Policy for 46 drug classes will be retired. Prior authorizations will once again be required for the following 46 drug classes.
| Phase III, Lift 4 Drug Classes | ||
| Medical Supplies | Chloramphenicol | Enzymes |
| Emetics | Antineoplastics | Rauwolfias |
| Antidiarrheals | Trimethoprim | Vasodilators Peripheral |
| Antispasmodic and Anticholinergic Agents | Contraceptives, Non-Systemic | Xanthine Derivatives |
| Bile Therapy | Vaginal Cleansers | Hemostatics |
| Laxatives | Diagnostics | B-Complex with Vitamin C |
| Ataractics-Tranquilizers (remaining HIC3s) | Anesthetics Gen Inhalant (remaining HIC3s) | Hematinics and Blood Cell Stimulators |
| CNS Stimulants | Anesthetics Gen Inject | Allergens |
| Psychostimulants-Antidepressants | Sedative Barbiturate | Antipruritics |
| Amphetamine Preparations | Sedative Non-Barbiturate (remaining HIC3s) | Coal Tar |
| All Other Antiobesity Preps | Anticonvulsants (remaining HIC3s) | Hemorrhoidal Preparations |
| Antihistamines | Antinauseants | Oxytocics |
| Bronchial Dilators | Mineralocorticoids | Parasympathetic Agents |
| Cough Preparations/ Expectorants | Antidotes | Miscellaneous
|
| Cold and Cough Preparations | Antithyroid Preps | |
| Adrenergics | Digestants | |
Please note that the following are exempt from Phase III: Retirement of the Transition Policy:
- Beneficiaries 21 years of age and younger.
- Enteral nutrition products for beneficiaries of all ages.
What pharmacy providers and prescribers need to do
If a beneficiary is currently receiving a medication in a drug class listed in the table, pharmacy providers and prescribers can consider the following options:
- Consider covered therapies that may not require a PA, if clinically appropriate. Review the following:
- Medi-Cal Rx Contract Drugs Lists & Covered Products Lists
- Medi-Cal Rx Approved NDC List
- Prescribers: Refer to your ePrescribing application.
- If a change in therapy is not appropriate, submit a PA request via one of the approved Medi-Cal Rx submission methods:
- CoverMyMeds
- Medi-Cal Rx Secured Provider Portal
- Fax.
- U.S. Mail.
You can find additional resources in the DHCS notification.
Questions?
Call the Medi-Cal Rx Customer Service Center at 800-977-2273 (available 24/7) or email Medi-Cal Rx Education & Outreach at [email protected].
