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Family PACT Updates Pharmacy Formulary for Emergency Contraceptives

April 15, 2016

Effective for dates of service on or after June 1, 2016, the Family Planning, Access, Care and Treatment (Family PACT) Program pharmacy formulary for emergency contraceptives is updated to align with the Medi-Cal contract drugs list (CDL).

For specific coverage criteria for levonorgestrel emergency contraceptives, providers may refer to Drugs: Contract Drugs List Part 2 – Over-the-Counter Drugs in the Medi-Cal provider manual. Family PACT emergency contraceptive products not included in the CDL will require a Treatment Authorization Request (TAR).

As part of this alignment, new Pharmacy Formulary and Clinic Formulary sections replace the Pharmacy and Clinic Formulary section in the Family PACT Policies, Procedures and Billing Instructions manual.

Updates to the provider manual will take place in a future Family PACT Update.