HEALTHmattersMD

Welcome to the HEALTHmattersMD blog—an online resource where providers can find the latest news and updates about HPSM. Top stories are highlighted with images, and you can find more stories listed under them. To read a story, just click the headline or the "Read more" link. In the side menu, you can also select articles by topic or see our newsletter archive and provider notices.

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Medi-Cal: HPSM Still Covers Physician Administered Drugs

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Medi-Cal: HPSM Still Covers Physician Administered Drugs

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Medi-Cal: HPSM Still Covers Physician Administered Drugs

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Medi-Cal: HPSM Still Covers Physician Administered Drugs

Since January 1, 2022, Medi-Cal members’ pharmacy services have been primarily managed by the California Department of Health Care Services (DHCS) through their Medi-Cal Rx program. However, there is one exception: HPSM still covers physician administered drugs (PADs), which are medicines that providers administer to patients in an office or clinic setting. You may need pre-approval (prior authorization) from HPSM for coverage of PADs based on medical necessity.