Medi-Cal Rx Stakeholder Invitation

The Department of Health Care Services (DHCS) is soliciting applications for participation in the Medi-Cal Rx Advisory Workgroup. This Advisory Workgroup is intended to help facilitate and further inform the Department’s ongoing efforts to implement the Governor’s Executive Order, which directed DHCS, in part, to transition all Medi-Cal pharmacy services from managed care to fee-for-service by January 1, 2021 (collectively referred to as “Medi-Cal Rx”).

DHCS has engaged its external partners around Medi-Cal Rx implementation efforts through two initial public presentations. However, as the Department continues toward implementation, we have looked for better ways to engage with our stakeholder partners to enhance stakeholder participation and encourage dialogue and feedback. Accordingly, DHCS is revamping its external stakeholder engagement approach through the creation of this new workgroup, which will support more informative and effective engagement around Medi-Cal Rx.

Beginning in January 2020 and continuing through April 2021, DHCS will conduct seven in-person, targeted meetings around Medi-Cal Rx. Each Medi-Cal Rx Advisory Workgroup meeting will be held in Sacramento for approximately four hours. Workgroup membership will be limited, aiming for 25-30 members, to ensure a productive discussion environment. The Department’s aim is for the workgroup to be comprised of organizations and entities such as hospitals, clinics, health plans, counties, pharmacies, tribal health programs, consumer advocates and others. During the meetings, DHCS will provide updates on the pharmacy transition and request the workgroup provide dialogue and input key topics, such as:

• Roles and responsibilities of DHCS, the Medi-Cal Rx Contractor, and Medi-Cal Managed Care Plans
• DHCS’ implementation strategies, tools, and timelines, including but not limited to, provider education and outreach and beneficiary notifications
• Medi-Cal pharmacy policy development, which will include the scope of the carve out, prior authorization, and utilization management protocols
• Changes to existing Medi-Cal pharmacy committees

Post-transition, the Medi-Cal Rx Advisory Workgroup meetings will focus on gathering information, experiences and/or feedback from workgroup members to help refine Medi-Cal Rx processes and policies on an ongoing basis. The meetings will be open to the public, and in-person public comment will be accepted near the end of each of the meetings, consistent with our other stakeholder advisory groups.

Throughout calendar years 2020 and 2021, DHCS will quarterly host larger Medi-Cal Rx Public Forums via webinar and in-person meetings. This will ensure that the broader stakeholder community is kept up-to-date about Medi-Cal Rx implementation activities and timelines. DHCS will post the dates and times for these forums as that information becomes available, and will release reminder notices through various DHCS stakeholder email distribution lists.

Medi-Cal Rx Advisory Workgroup Participation

If you wish to be considered by DHCS for membership, please fill-out and submit the linked “Participation Request Form” PDF to RxCarveOut@dhcs.ca.gov no later than 11:59 p.m. on Monday, November 18, 2019. Here is a link to the form: Medi-Cal_Rx_Stakeholder_Form

DHCS will notify individuals who are selected for the Medi-Cal Rx Advisory Workgroup no later than Friday, December 13, 2019.