Get ready for Medi-Cal Rx, live on January 1!
Starting January 1, 2022, the Medi-Cal pharmacy benefit will transition from the current Medi-Cal managed care delivery system to Fee-For-Service (FFS) under Medi-Cal Rx.
We’ve included a few reminders and resources to help our pharmacy providers and prescribers prepare for the transition.
- After Jan. 1, all benefits that are billed on a pharmacy claim will be transitioned to Medi-Cal Rx and all pharmacy Prior Authorizations will be reviewed by Medi-Cal Rx, NOT the Alliance.
- Medi-Cal Rx pharmacies enroll in FFS through the PAVE Portal.
- All Medi-Cal Rx pharmacy providers, prescribers and their staff will need to complete secure registration to access the secured areas of the Medi-Cal Rx Provider Portal.
- All Medi-Cal Rx pharmacy providers, prescribers and their staff are encouraged to sign up for training and information sessions on the transition. More information can be found on the Medi-Cal Rx Education & Outreach page.
Medi-Cal Rx Education & Outreach page – includes an overview of Medi-Cal Rx, pharmacy transition policy, trainings and more.
Medi-Cal Rx YouTube Channel – offers training videos, including an overview of the transition and the resources that directly impact Medi-Cal pharmacy providers and prescribers.
Medi-Cal Rx Provider Portal Forms & Information page, which includes:
- Prior Authorization (PA) Job Aid.
- Billing Tips.
- Payer Sheets.
- Searchable Contract Drugs List (CDL).
- Provider Manual.
Questions? Please contact Medi-Cal Rx Customer Service Center at 800-977-2273, available 24/7/365, or email [email protected].
COVID-19 vaccine incentives
With COVID cases once again rising in our counties, it’s more important than ever for members to protect themselves against the devastating effects of COVID-19, which includes receiving their COVID vaccines. As a reminder, we have a member incentive and several provider incentives available to help increase vaccination rates.