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Family PACT Offers Interim Alternative to Requesting a TAR

July 19, 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 oral contraceptives was updated to align with the Medi-Cal contract drugs list (CDL).

For specific coverage criteria for oral contraceptives, providers may refer to the Drugs: Contract Drugs List Part 1 – Prescription Drugs sections in Part 2 of the Medi-Cal provider manual. Family PACT oral contraceptive products not included in the CDL require a Treatment Authorization Request (TAR).

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

With the implementation of this policy, some providers have reported that they are not able to request a TAR through the system. The Department of Health Care Services is working on this issue. In the interim, providers may consider alternative options covered under Family PACT, such as:

  • Oral contraceptives covered under Family PACT for pharmacy dispensing follow those listed in the CDL, as noted above. Alternatively, oral contraceptives may also be dispensed onsite by community clinics.
  • Emergency contraceptives covered under Family PACT for pharmacy dispensing include levonorgestrel, as noted above, and ulipristal acetate (no TAR is required). For more information on ulipristal acetate, providers may refer to Drugs: Contract Drugs List Part 1 – Prescription Drugs sections in the Medi-Cal provider manual. Additionally, both types of emergency contraceptives may also be dispensed onsite by community clinics.

The recent policy updates were for pharmacy dispensing of oral contraceptives and emergency contraceptives only. The policy for clinic dispensing remains the same.