CA Managed Medicaid Share:

October 30, 2014   |   Jennifer Guinan

CA Managed Medicaid Share (test ajay 2):

Notes from a conversation with California Dept. of Health Care Services (Medi-Cal), Robert Shun, the Drug Rebate Branch Chief at California Medicaid;

• Robert’s understanding that approximately 90% of the pharmacy claims have been processed and manufacturers have been invoiced for claims all the way back to 2010 in the current invoice cycle.
• Robert stated that Physician administered claims (PADs) processing is only about 40% complete.
• PADs are typically injected drugs administered in a physician’s office and billed with j-codes.
• PAD claims were held up by a system implementation. This back-log won’t be cleared until 2015. However, the volume of PAD claims is low and fewer manufacturers are affected.”

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