MedicaidPrior AuthMedium impact
20-141 Medication Trend Updates and Preferred Drug List Changes - 1st Quarter 2020
Health Net·CA · Oncology, Urology, Gastroenterology +4 more·Prior Authorization
We identified it
Jun 20, 2026
Summary
CalViva Health Medi-Cal updated their Preferred Drug List for Q1 2020, moving several new medications to non-formulary status requiring prior authorization. The policy also provides information about upcoming patent expirations for brand-name drugs that will have generic alternatives available throughout 2020.
Action Required
Immediately: Billing team must update prior authorization requirements for the listed non-formulary medications including Aemcolo, Nubeqa, Piqray, Sunosi, Turalio, Xpovio, Zelnorm, Annovera, Ultomiris, and Vyleesi. Update billing system to flag these medications as requiring member-specific medical reasons why formulary alternatives cannot be used. Contact Pharmacy Department at 1-800-867-6564 for prior authorization requests.