Medi-Cal Update

Pharmacy | August 2019 | Bulletin 950

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1. Medi-Cal List of Contract Drugs

The following provider manual sections have been updated: Drugs: Contract Drugs List Part 1 – Prescription Drugs and Drugs: Contract Drugs List Part 4 – Therapeutic Classifications.

A summary of drugs that have been added or changed is shown below. For additional information, click on the link to the manual section and scroll to the page indicated or use the find feature to search for the particular drug.

Added Drug(s)
Effective Date Drug Summary of Changes Page(s) Updated
April 1, 2019 LAROTRECTINIB Drug added, administrations added, restrictions added drugs cdl p1b (52)
June 11, 2019 POLATUZUMAB VEDOTIN-PIIQ Drug added, administration added, restrictions added drugs cdl p1c (34)
July 1, 2019 ALPELISIB Drug added, administration added, restrictions added drugs cdl p1a (8)
September 1, 2019 LIDOCAINE Drug added, administration added, restriction added, note added drugs cdl p1b (58)

Changed Drug(s)
Effective Date Drug Summary of Changes Page(s) Updated
August 1, 2019 ASENAPINE Strength added drugs cdl p1a (17)
August 1, 2019 BUDESONIDE/
FOMOTEROL FUMERATE DIHYDRATE
Restriction added drugs cdl p1a (27)

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2. Clinical Review Update: Concomitant Anticholinergic and Antipsychotic Use

A new DUR Educational Article titled “Clinical Review Update: Concomitant Anticholinergic and Antipsychotic Use” (PDF format) is available on the DUR: Educational Articles page of the Medi-Cal website.

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3. Authorized Drug Manufacturer Labeler Codes Update

The Drugs: Contract Drugs List Part 5 – Authorized Drug Manufacturer Labeler Codes section has been updated as follows.

Changes, effective July 1, 2019
NDC Labeler Code Contracting Company's Name
59310 TEVA RESPIRATORY, LLC

This information is reflected in the following provider manual(s):

Provider Manual(s) Page(s) Updated
Adult Day Health Care Centers
AIDS Waiver Program
Chronic Dialysis Clinics
Clinics and Hospitals
Expanded Access to Primary Care Program
General Medicine
Heroin Detoxification
Home Health Agencies/Home and Community-Based Services
Hospice Care Program
Multipurpose Senior Services Program
Obstetrics
Pharmacy
Rehabilitation Clinics
drugs cdl p5 (13)
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4. Updates to the List of Contracted Diabetic Test Strips and Lancets

Effective for dates of service on or after October 1, 2019, two newly contracted LifeScan, Inc. products, Delica Plus lancets, are added to the List of Contracted Diabetic Test Strips and Lancets.

Product Description Billing Code
OneTouch DELICA PLUS 30G LANCETS BOX 100 53885001110
OneTouch DELICA PLUS 33G LANCETS BOX 100 53885000810

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5. Provider Manual Revisions

Pages updated due to ongoing provider manual revisions:

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