Starting January 1, 2022, pharmacy services will be provided under a new program called Medi-Cal Rx. Pharmacy services and support will be provided by Magellan Medicaid Administration, Inc. Starting January 1, 2022, prescribers can submit PAs using the cannels outlined below.
Please visit https://medi-calrx.dhcs.ca.gov/home/ for most updated information.
In response to the U.S. opioid epidemic, UnitedHealthcare has developed programs to help our members receive the care and treatment they need safely and effectively.
We’ve also established measures based on the Centers for Disease Control and Prevention’s (CDC) opioid treatment guidelines to help prevent overuse of short-acting and long-acting opioid medications.
Resources
See below for current pharmacy clinical guidelines and updates.
Visit the Policies and Clinical Guidelines page for more information.
Please visit https://medi-calrx.dhcs.ca.gov/home/ for most updated information.
Starting January 1, 2022, pharmacy services will be provided under a new program called Medi-Cal Rx. Pharmacy services and support will be provided by Magellan Medicaid Administration, Inc. Please visit https://medi-calrx.dhcs.ca.gov/home/cdl for most updated Contract Drug List (CDL).
Specialty pharmacy medications covered under the member’s medical benefit may be provided through various sources ‒ home infusion providers, outpatient facilities, physicians or specialty pharmacy.
Network Specialty Pharmacies
If you don’t want to buy and bill a specialty pharmacy medication covered under the member’s medical benefit, you may order it through the following network specialty pharmacies:
Coverage of a requested medication depends on the member’s benefit, and availability of a specific drug from a network specialty pharmacy may vary.
Upon request, a specialty pharmacy can deliver the medication to your office or another site such as a member’s home.
Medications obtained through a specialty pharmacy will be directly billed to the patient’s health plan.