Gold Coast Health Plan will transition management of the pharmacy benefit to the state on April 1, 2021

The new program by the state Department of Health Care Services (DHCS), known as Medi-Cal Rx, will carve-out all prescription benefits from managed care plans like GCHP. Upon implementation, all pharmacy claims will be submitted directly to the state via its pharmacy benefit manager, Magellan Medicaid Administration, Inc. DHCS announced the new implantation date last month, citing “the ongoing uncertainties caused by the COVID-19 public health emergency” for its decision to extend the timeline.

GCHP will continue to offer pharmacy benefits through its pharmacy benefit manager, OptumRx, until the transition occurs.

“We remain committed to working with our providers to ensure that our members experience a smooth transition to Medi-Cal Rx,” said Anne Freese, GCHP’s pharmacy director. “We encourage providers and their staff to continue preparing for the transition by becoming acquainted with the Medi-Cal Rx provider portal and completing any necessary training to learn how to help members access their pharmacy benefits.”

Members will be receiving information about the transition in the mail. GCHP will reach out to providers as DHCS releases updated timelines for the implementation.