Important Updates on Medi-Cal Clawback (as of 5/31/19)

(한글 설명은 아래에 있습니다)

 

Your immediate Review and Action required!

1. Medi-Cal Clawback has started as of 5/29/19.

 

2. Steps to pull out RAD to calculate how much will be taken out from your pharmacy.

Medi-Cal website has the most recent RAD for 05/28/2019 and listed as RAD code 0812.

a. Log on to Medi-cal website with your NPI and Password.

b. click on RAD in the left-hand side of the page.

c. click on zipped file RAD for 05/28/19

d. It will download RAD on your computer and you need to enter your Medi-cal pin to open up the file.

 

3.  After pharmacies receive notice of clawback, immediately file for alternative repayment schedule by emailing GCU@dhcs.ca.gov or by calling (916) 650-0575. This will slow down the process as the state develops a payment plan for you. It buys you more time.

 

***Pharmacy Retractive Claim Adjustments FAQs

http://files.medi-cal.ca.gov/pubsdoco/ncpdp/Pharmacy_Retroactive_Claim_Adjustments_faq.asp

 

4. CPhA CPAG hired lawyers submitted Medi-Cal injunction on 5/30/19. Not only are pharmacists plaintiffs on the case, but also is a consumer advocacy group representing the HIV community. To add fuel to the fire, a breaking news report will be released during the week of 6/3/19.

 

CKAPhA President

Sean Kim, Pharm.D

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(Korean Translation below)

 

약국 회원님들께 알려드립니다. 

 

1. Medi-Cal Clawback 이 5월 29일에 시작 되었습니다.

 

2. 자기 약국에서 Clawback 규모가 얼마가 될지 알아보시려면 Medi-Cal website에 직접 들어가시면 가장 정확한 자료를 확인 할 수 있습니다 (RAD code 0812).

a. Log on to Medi-cal website with your NPI and Password.

b. click on RAD in the left-hand side of the page.

c. click on zipped file RAD for 05/28/19

d. It will download RAD on your computer and you need to enter your Medi-cal pin to open up the file.

 

3. Clawback notice를 받는 즉시 California Department of Health Care Service에 전화나 이메일로 alternative payment schedule 을 신청하셔야 합니다.

이메일 GCU@dhcs.ca.gov 또는 전화 (916) 650-0575.

 

***Pharmacy Retractive Claim Adjustments FAQs

http://files.medi-cal.ca.gov/pubsdoco/ncpdp/Pharmacy_Retroactive_Claim_Adjustments_faq.asp

 

4. CPhA CPAG 에서 고용한 변호사를 통해 Medi-Cal Injunction을 5월 30일에 제출했습니다. 다음주 (6월 3일 이후)에 breaking news report를 통해서 언론에도 알릴 예정입니다.

 

캘리포니아 한인 약사회 회장 김성현