MedicaidPrior AuthHigh impact
20-950 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
Summary
Medi-Cal pharmacy benefits are transitioning to a new program called Medi-Cal Rx managed by Magellan, effective April 1, 2021. All prescribing providers must register for the new Medi-Cal Rx Provider Portal to submit prior authorizations and access pharmacy services, as current systems will no longer work after the transition.
Action Required
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. Billing team must complete mandatory training through the Saba Learning Management System and familiarize themselves with the updated Contract Drug List. Current PA submission systems will no longer function after April 1st, causing claim denials.