Pharmacy Benefits Will Change: January 1, 2021

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Date: October 15, 2020
To: Health Plan of San Joaquin (HPSJ) Provider Network
From: Health Plan of San Joaquin
Subject: Pharmacy Benefits Will Change: January 1, 2021
Business: Medi-Cal

Effective January 1, 2021 –

  • Health Plan of San Joaquin pharmacy benefits will be transitioned to and administered by the new agency, Medi-Cal Rx.
  • ALL outpatient pharmacy drugs will be covered by Medi-Cal Rx.
  • The Department of Health Care Services (DHCS) has partnered with Magellan Medicaid Administration, Inc. to provide this benefit and support Medi-Cal Rx.

(4) Things you can do NOW!

  1. Register for the secure Medi-Cal Rx Provider Web Portal.
    o https://medi-calrx.dhcs.ca.gov/home
  2. Create a plan for your HPSJ patients’ medication starting January 1, 2021. DHCS has created a transition plan to ensure that coverage for beneficiaries’ medication will continue from January 1, 2021.
  3. Review online, www.Medi-CalRx.dhcs.ca.gov:
    1. Medical Rx Pharmacy Transition Policy
    2. Contract Drug List (CDL)
    3. List of covered pharmacy providers
  4. Call, if you have questions:
    1. Before Jan 1: Medi-Cal Member Help Line, 1-800-541-5555 TTY/TDD 711, Monday through Friday, 8 am to 5 pm.
    2. As of Jan 1, 2021, Medi-Cal Rx Call Center Line, 1-800-977-2273 TTY/TDD 711, 24/7, or visit www.Medi-CalRx.dhcs.ca.gov

During this transition, HPSJ wants to make sure our members are served without disruption – and you, your staff and business operations are supported. Look for more from HPSJ in coming days.

Attached: 90-Day Notice from DHCS to Medi-Cal Members (3 pages)

Posted on October 16th, 2020

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