MedicaidCoverageMedium impact
24-716 Pharmacists Can Provide More Services to Members Under AB 317
Health Net·CA·Prior Authorization
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Summary
Assembly Bill 317 expands pharmacist scope of practice for Medi-Cal members, requiring health plans and physician groups to reimburse pharmacists for covered services under the member's medical benefit. Pharmacists can now bill for services within their scope of practice that would normally be reimbursed when performed by other licensed healthcare providers.
Action Required
Immediately: Billing team must update systems to recognize and process pharmacist-delivered services for Medi-Cal patients in Fresno, Kings, and Madera counties. Ensure participating physician groups (PPGs) have processes to reimburse pharmacists at 85% of Medi-Cal fee schedule for services within pharmacist scope of practice. Update contracts and billing workflows to include both in-network and out-of-network pharmacy services under medical benefits.