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.
House Letter Urges Appropriators to Block Funding for 340B Rebate Model
What’s happening: U.S. Rep. Doris Matsui led a bipartisan letter requesting that the fiscal year 2027 appropriations bill include language barring the use of funds for implementation of any 340B Rebate Model, including the previously proposed pilot program.