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MedicaidPrior AuthHigh impact

20-951 What You Need to Know: Medi-Cal Pharmacy Benefit Transition to Medi-Cal Rx

Health Net·CA·Prior Authorization
Effective date
Apr 1, 2021
We identified it
Jun 20, 2026
Days to comply

Summary

Medi-Cal pharmacy benefits are transitioning to a new program called Medi-Cal Rx managed by Magellan, effective April 1, 2021. All providers must register for the new Medi-Cal Rx Provider Portal to submit prior authorizations and access pharmacy services, as current PA systems will no longer work after the transition.

Action Required

Action needed
Before April 1, 2021: All prescribing providers must register for the Medi-Cal Rx Provider Portal at https://medi-calrx.dhcs.ca.gov/provider to submit prior authorizations and pharmacy claims. Complete mandatory training through the Saba Learning Management System. Update workflows to use the new portal instead of current PA systems. Familiarize staff with the updated Contract Drug List. Failure to register will prevent submission of pharmacy prior authorizations.