DHCS to Host July 30 Town Hall on Enrollment Requirements for Pharmacy and Medical Billing Claims
What’s happening: The Department of Health Care Services (DHCS) will host a town hall on July 30 at 9:30 a.m. (PT) to explain Ordering, Referring, and Prescribing (ORP) enrollment requirements for claims across both pharmacy (Medi-Cal Rx) and medical (CA-MMIS) billing systems. While event registration is currently full, interested members should join the waitlist — CHA...
Immediate Action Needed for Prescribers: Ensure Enrollment as Medi-Cal FFS Provider
What’s happening: Claims and prior authorizations will not be processed by Medi-Cal Rx if the prescribing health care provider is not enrolled in Medi-Cal fee-for-service (FFS) with a Type 1 National Provider Identifier. Prescribers not yet enrolled should immediately submit their Medi-Cal provider enrollment application via the Provider Application and Validation for Enrollment page.
Reminder: Include ICD-10-CM Diagnosis Codes on Medi-Cal Rx Claims
What’s happening: As a reminder, ICD-10-CM diagnosis codes will be required for Medi-Cal Rx claims starting this fall.
CHA Pushes Back on Commentary Attacking 340B Program
What’s happening: CalMatters has published a CHA counter op-ed on 340B that reinforces the program’s importance for patients and safety-net providers.
Medi-Cal Rx Claims to Require ICD-10-CM Diagnosis Codes Beginning This Fall
What’s happening: Starting this fall, ICD-10-CM diagnosis code(s) will be required for Medi-Cal Rx claims. This change is being made to better implement appropriate utilization management controls, including prior authorization.