Medi-Cal Rx Update

MCRxSS Announcement

A new alert, Diabetic Supplies: Update to the Minimum Quantity for FreeStyle Libre 3, has been posted to the Medi-Cal Rx Web Portal on 10/14/2022. Medi-Cal Rx Week over Week Operating Metrics (attached) An alert (link below) relating to the impending termination of a diabetic supply contract with LifeScan was published on the Medi-Cal Rx web portal on September 20, 2022. The termination will be effective November 20 of this year.

A_Diabetic_Supplies_Updates_Diabetic_Test_Strips_Glucometers

As a result of this bulletin alert, the Department of Health Care Services (DHCS) has recently received several comments from concerned stakeholders. The DHCS response to these comments is below and being shared with you for awareness, as the products in question can be billed both as a pharmacy benefit through Medi-Cal Rx, or via a medical claim to MCPs (if covered as such by the respective MCPs).

Medi-Cal Rx currently has a variety of blood glucose test systems available on the contracted List available for coverage, to meet the diverse needs of our beneficiaries. For EPSDT, CCS, and GHPP beneficiaries, continued access to LifeScan test strips and lancets could be available with an approved prior authorization showing medical necessity and no other contracted product could meet the needs of the beneficiary. All currently contracted manufacturers and Medi-Cal providers have been contacted through the Alert notification and through advocacy to assist with access concerns for the transition from LifeScan products to another contracted manufacturers’ products. Manufacturers can be contacted at the toll free number on the contracted List for support, education, device training, and assistance with any contracted products on the List. Additionally, Medi-Cal managed care plan members can directly contact their plan for possible coverage of Medi-Cal Rx non-benefits as a medical benefit billed via HCPCS code on a CMS-1500 form. The individual plans establish their coverage criteria through this mechanism.

CalRecycle Update

CalRecycle received the attached revised home-generated sharps waste stewardship plan from The Drug Takeback Solutions Foundation on October 15, 2022, in response to the Request for Approval signed by CalRecycle’s director on August 16, 2022.

Please submit public comments to pharmasharps@calrecycle.ca.gov by October 31, 2022.

Please note that a public comment period for stewardship plan review is not required by statute or regulations. CalRecycle is voluntarily holding a comment period in an effort to allow for stakeholder input during the plan review process. 

Visit CalRecycle’s pharmaceutical waste stewardship plan and home-generated sharps waste stewardship plan webpages for the status of all stewardship plans submitted to CalRecycle.

The CalRecycle Pharmaceutical & Sharps Team

Website | https://www.calrecycle.ca.gov/epr/pharmasharps 

Listserv | https://www2.calrecycle.ca.gov/Listservs/Subscribe/73 

On October 18, 2022, CalRecycle’s director signed the following five Requests for Approval (also attached):

1. UltiMed’s Revised 2021 Annual Report for Home-Generated Sharps           Waste – Approved 

2. MED-Project’s Annual Program Budget for Covered Drugs – Approved 

3. MED-Project’s Annual Program Budget for Home-Generated Sharps Waste – Approved 

4. The Drug Takeback Solutions Foundation’s Annual Program Budget for Covered Drugs – Conditionally Approved; must be resubmitted to CalRecycle within 60 days

5. The Drug Takeback Solutions Foundation’s Annual Program Budget for Home-Generated Sharps Waste – Conditionally Approved; must be resubmitted to CalRecycle within 60 days

Board of Pharmacy Update – October 2022

Welcome to a monthly news roundup from the California State Board of Pharmacy. More information about news reported here is on the Board’s website, www.pharmacy.ca.gov.

Recent news:

·      Governor Gavin Newsom has appointed Trevor L. Chandler of San Francisco and Kartikeya “KK” Jha of Fresno to the Board. Mr. Chandler, a public member, is director of government affairs and public policy at Citizen. Mr. Jha, a licensee member, is district director of operations at Omnicare – a CVS Health Company.

·      The Board has approved an extension of the following waiver to 90 days following the end of the declared emergency: Prescriber Dispensing of Tecovirimat (TPOXX or ST-246) Oral Antiviral Medication to Emergency Room Patient (BPC sections 4068(a)(1), 4068(a)(5), 4068(a)(6), 4076.5 and 4427.2(a)). 

·      The Office of Administrative Law has approved rulemaking to add Division 17 of Title 16 of the California Code of Regulations, section 1708.1, related to Notification of Temporary Closure. The regulation took effect October 1, 2022. The Order of Adoption with the approved text for this regulation can be found under Approved Regulations.

·      The Medication Error Reduction and Workforce Committee met September 14. Links to the meeting agenda, materials, and a webcast recording can be found on the committee’s meeting page.

·      The Board met September 14 and September 21. Links to the meeting agendas, materials, and webcast recordings can be found on the Board’s meeting page.

·      The Enforcement and Compounding Committee met October 4. Links to the meeting agenda, materials, and webcast recording can be found on the committee’s meeting page.

Coming up:

·      The next CPJE will be administered October 15. Information about the exam is available under Pharmacist Examination and Licensure.

·      Upcoming meetings this month include the Licensing Committee on October 18, the Standard of Care Committee on October 25, and the Board on October 25-26.

A final word:

·      The California Department of Public Health (CDPH) has issued a statement on the emergency use authorization of updated COVID-19 boosters: the Moderna bivalent booster for individuals 18 and older and the Pfizer-BioNTech bivalent booster for individuals 12 and older. A link to this statement is posted along with Pharmacy Law waivers, guidance documents, and other COVID-19 resources and updates on the Board’s website.

·      The August 2022 issue of The Script is available online. The newsletter includes articles about new pharmacy regulations, notifying the Board when a pharmacy PIC stops acting as PIC, the top 10 citations issued in 2021-22, how to file complaints about pharmacy performance quotas, and other topics.

·      The FDA provides free, self-guided, online courses offering continuing education, webinar records, and presentation slides on compounding topics. The trainings are to support outsourcing facilities and other stakeholders in their efforts to enhance the quality of compounding drugs. Information about these resources will be included in the next issue of the newsletter.

The agendas for the Standard of Care Meeting scheduled for 10/25/22 at 9:00 a.m. and the Board Meeting scheduled for 10/25/22 at 1:30 p.m. and 10/26/22 at 9:00 a.m. have been posted. Go to Quick Hits, and then meetings at www.pharmacy.ca.gov.