HEALTHmattersMD Newsletter

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 drugs 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.