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MedicaidPrior AuthMedium impact

20-581 Stay Up to Date with Medication Trend Updates and Preferred Drug List Changes - 3rd Quarter 2020

Health Net·CA · Family Medicine, Internal Medicine, Endocrinology +5 more·Prior Authorization
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

CalViva Health Medi-Cal has updated their preferred drug list for Q3 2020, moving multiple medications to non-formulary status requiring prior authorization, and withdrawn weight-loss drugs Belviq and Belviq XR from the market due to cancer risk. This affects prescribing and prior authorization requirements for oral, topical, and injectable medications in Fresno, Kings, and Madera counties.

Action Required

Action needed
Immediately: Billing team must update prior authorization requirements for newly non-formulary medications including Ayvakit, Brukinsa, Oxbryta, Palforzia, Reyvow, Rinvoq, Tazverik, Aklief, and Skyrizi. Stop prescribing and billing for Belviq and Belviq XR (lorcaserin). Update encounter forms to reflect formulary alternatives. Contact CalViva Health Pharmacy Department at 1-800-867-6564 option 2 for prior authorization requests for non-formulary medications.