Medi-Cal Rx (Pharmacy) – Reminder – Provider Enrollment Requirement
| Date: | August 05, 2026 |
| From: | Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) |
| To: | Health Plan Practitioners, Facilities, and Hospitals |
| Type: | Informational/Educational |
| Subject: | Medi-Cal Rx (Pharmacy) – Reminder – Provider Enrollment Requirement |
| Business: | Medi-Cal Managed Care |
Reminder: The Department of Health Care Services (DHCS) requires all providers to enroll their National Provider Identifier (NPI) with Medi-Cal for pharmacy claim adjudications.
If the prescriber isn’t enrolled, a supplemental message will be generated at the point of sale (POS) stating that the provider isn’t enrolled with Medi-Cal. At this time, the pharmacy claims will still be processed and not be denied. Pharmacies must inform the prescriber to enroll. If the prescriber isn’t enrolled by the fully enforced deadline, the pharmacy claims will be denied.
To enroll, provider must register for an account on the Provider Application and Validation for Enrollment (PAVE) portal at: https://pave.dhcs.ca.gov/sso/login.do
For additional detailed information, please visit weblink: https://medi-calrx.dhcs.ca.gov/cms/medicalrx/static-assets/documents/provider/2026/07_A_Important_Provider_Enrollment_Requirement_Not_Yet_Active.pdf
If you have any further questions, please contact your Provider Services Representative, or call our Customer Service Department at 1-888-936-PLAN (7526). You may also visit https://www.hpsj.com/alerts/ for online access to the documents shared. The most recent information about Health Plan and our services is always available on our website www.hpsj-mvhp.org
