September 2022 Virtual Immunization Training
Central California Alliance for Health is partnering with the California Department of Public Health (CDPH) to host an immunization training for Merced, Monterey and Santa Cruz counties!
|2022 Virtual Immunization Training for Merced, Monterey and Santa Cruz counties|
Thursday, September 8, 2022
12 – 1:30 p.m.
Discussion topics will include:
- Updates from the Alliance and Merced County. Alliance staff will share immunization rates, resources and immunization-related Care-Based Incentives.
- Flu and COVID-19 vaccine training with Steven Vantine, Education Consultant with CDPH.
We hope you join us! This will be a virtual training, so please extend this invite to others you feel would benefit from it.
- Merced County: Please contact Veronica Lozano, QI Program Advisor II with the Alliance, at [email protected].
- Monterey and Santa Cruz counties: Please contact Jo Pirie, QI Program Advisor II with the Alliance, at [email protected].
The Medi-Cal Rx Phased Reinstatement Plan begins in July 2022
Effective July 22, 2022, claim edits for diagnosis and drug utilization review (DUR) requirements will be reinstated. These updates represent Phase 1, Wave 1 of the Medi-Cal Rx Reinstatement Plan (the Plan).
The Plan is a three-phase approach to restoring select claim edits and prior authorizations (PAs) by drug class while phasing out the Medi-Cal Rx 180-day transition policy. See the chart below for more details on the phases.
PA claim edits will come in on a phased approach by drug class one step at a time.
As part of this phase of the Plan, which is effective on July 22, claims will now reject for:
- National Council for Prescription Drug Programs (NCPDP) Reject Code 80 – Diagnosis Code Submitted Does Not Meet Drug Coverage Criteria. Code 1 diagnosis restrictions are found in the Code 1 columns of the Medi-Cal Rx Contract Drugs List and the Medi-Cal Rx Contract Drugs List: Over-the-Counter Drugs. Review the NCPDP Reject Code 80 Reference Guide for more details.
- DUR NCPDP Reject Code 88 – Drug Utilization Review Reject Error for DUR alerts such as drug-drug interactions, high dose and early refill. Review the NCPDP Reject Code 88 DUR Reference Guide for more details.
For assistance with claims or prior authorization:
- Stop by online for a Medi-Cal Rx Office Hour to get your questions answered about the reinstatement of Reject Codes 80 and 88. Office hours are Monday through Friday from 12 to 1 p.m. Dial in at 888-788-0099 (US Toll Free) or use the Zoom link to join.
- Call the Medi-Cal Rx Customer Service Center (CSC) at 800-977-2273 (available 24 hours a day, 7 days a week, 365 days per year).
- Email [email protected].
To keep up with Medi-Cal Rx news: