California Pharmacists

California Pharmacists Feel the Pressure

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Medi-Cal’s planned clawback recoupment is putting an even greater squeeze on community pharmacy and jeopardizing patient healthcare. The California Pharmacist Association (CPhA) is asking for your help. Through legislation and advocacy, CPhA leads the battle against the Department of Healthcare Services (DHCS), who oversees Medi-Cal.

The critical decision made by DHCS to not carve out expensive brand and specialty items from the NADAC outpatient drug reimbursement process directly impacts you. Already, you know the pain of substantial underwater claims and the cost of providing patient care.

Now DHCS is seeking re-adjudicated recoupment for the 2 years it took to develop a reimbursement process from April 2017 to February 2019. This aggressive clawback will start on May 31, 2019 and could result in DHCS withholding up to 100% of a Medi-Cal check from your pharmacy until the total recoupment is complete.

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