Monday, January 11, 2021
DHCS”) will be transitioning all Medi-Cal pharmacy benefits from managed care to fee-for-service (“
FFS”). This new system to administer FFS pharmacy benefits is being called “Medi-Cal Rx” and was developed by DHCS in response California Governor Gavin Newsom’s January 7, 2019 executive order (the “
Order”), which instructed DHCS to transition all Medi-Cal pharmacy benefits to FFS by January 1, 2021. The rationale behind the Order is to combat rising prices for prescription drugs by increasing the State’s bargaining power in negotiating prescription drug prices with pharmaceutical companies. The date of transition was subsequently pushed back to April 1, 2021 so currently no pharmacy managed care benefits have been impacted.