rx alert

 August 3, 2015   

Connect with CPhA

Like us on Facebook Follow us on Twitter View our profile on LinkedIn 

Member Benefits &
Important Links 

  

Update Your  Profile or Renew Your Membership 

 

Sign Up for Monthly Membership Dues   

 

Full List of Member Benefits 

 

CPhA/Mercer Insurance Program  

 

California Pharmacist Journal - Digital Issue

 

CPhA Career Center  

 

CPh-PAC 

 

Pharmacy Defense Fund of California  

 

California State Board of Pharmacy 

 

Board of Pharmacy Law Book 

 

CPhA Current Legislation  

 

FDA Recalls 

 

About CPhA

Since its establishment in 1869, the California Pharmacists Association continues as the largest state association in the nation representing pharmacists. CPhA's membership covers the entire spectrum of pharmacy practice settings and includes student pharmacists and pharmacy technicians. The Association's vision is echoed by all CPhA members: A unified pharmacy profession, recognized as preeminent in patient care.

 

Contact Information:

www.cpha.com

ceo@cpha.com

(916) 779-1400 phone

(916) 779-1401 fax

Medi-Cal Retroactive Recoupments Rescheduled


 

 

The Department of Health Care Services (DHCS), which administers the Medi-Cal program, has announced that recoupment for retroactive payments associated with the 10% (AB 97) Medi-Cal providercuts will now begin no sooner than August 28, 2015.  DHCS and the state's Fiscal Intermediary, Xerox, had previously announced a start date of August 1, 2015.

 

DHCS states that pharmacies will begin receiving payable notices after August 28, however due to the volume of claims associated with the recoupment, initial notices will be rolled out to providers over approximately 16 weeks. Providers will receive supporting claim detail (in the form of a Remittance Advice Detail (RAD)) informing them of the total amount due and line-by-line adjustments.  Receipt of the RAD will then be followed by the five percent reductions to the provider's weekly check-writes. 

 

The state implemented the 10% Medi-Cal provider cuts in June 2011, however, for pharmacy providers these cuts did not begin until February 2014.  The retroactive recoupment discussed here covers claims submitted in that period between June 2011 and February 2014.  The "exempt drug list," which includes drugs that are not subject to the 10% cuts, will apply retroactively as well. 

 

DHCS has posted this update to the Pharmacy Benefits Division webpage under "Hot Topics."  Additional information related to the AB 97 reductions can be found on the DHCS AB 97 webpage.

 

Questions specific to the AB 97 EPC process should be directed to the  Telephone Service Center  at  1-800-541-5555 , option 1 (for English), option 1 (for Provider), option 5 (for HAP, Family PACT, CHDP, CCS, GHPP, Crossover, LTC and other general billing inquiries), followed by option 6 (for general billing).

 

CPhA continues to be engaged in this issue and will provide additional information when it becomes available.