Pharmacy Resources and Physician Administered Drugs

Starting January 1, 2022, pharmacy services will be provided under a new program called Medi-Cal Rx. Pharmacy services and support will be provided by Magellan Medicaid Administration, Inc. Starting January 1, 2022, prescribers can submit PAs using the cannels outlined below.

  • Medi-Cal Rx Secure Provider Portal
  • CoverMyMeds (CMM)
  • Fax: 1-800-869-4325
  • Mail: Customer Service Center, PO Box 730, Rancho Cordova, CA 95741

Please visit https://medi-calrx.dhcs.ca.gov/home/ for most updated information.

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In response to the U.S. opioid epidemic, UnitedHealthcare has developed programs to help our members receive the care and treatment they need safely and effectively.

We’ve also established measures based on the Centers for Disease Control and Prevention’s (CDC) opioid treatment guidelines to help prevent overuse of short-acting and long-acting opioid medications.

Resources from UnitedHealthcare and Optum

Other Resources

See below for current pharmacy clinical guidelines and updates.

Visit the Policies and Clinical Guidelines page for more information. 

Please visit https://medi-calrx.dhcs.ca.gov/home/ for most updated information.

Preferred Drug List

Starting January 1, 2022, pharmacy services will be provided under a new program called Medi-Cal Rx. Pharmacy services and support will be provided by Magellan Medicaid Administration, Inc. Please visit https://medi-calrx.dhcs.ca.gov/home/cdl for most updated Contract Drug List (CDL).

Specialty pharmacy medications covered under the member’s medical benefit may be provided through various sources ‒ home infusion providers, outpatient facilities, physicians or specialty pharmacy.

Network Specialty Pharmacies 

If you don’t want to buy and bill a specialty pharmacy medication covered under the member’s medical benefit, you may order it through the following network specialty pharmacies:

  • Optum Specialty Pharmacy: 855-427-4682 
  • Accredo: 800-803-2523
  • Biologics: 800-850-4306
  • Caremark Specialty Pharmacy: 800-237-2767
  • Eversana: 800-305-7881
  • Option Care Health: 866-827-8203
  • Orsini Pharmaceutical Services: 800-410-8575
  • PantheRx: 855-726-8479
  • US Bioservices: 888-518-7246

Coverage of a requested medication depends on the member’s benefit, and availability of a specific drug from a network specialty pharmacy may vary.

Upon request, a specialty pharmacy can deliver the medication to your office or another site such as a member’s home.

Medications obtained through a specialty pharmacy will be directly billed to the patient’s health plan.