The Medical Supplies & Enteral Nutrition Benefits Branch of the Department of Health Care Services (Department) recently completed a Product Category Review (PCR) for diabetic testing supplies (DTS). This resulted in three year negotiated contracts with manufacturers for maximum acquisition cost (MAC) for products listed in the attached document. Also, the Department proposes changes to utilization controls outlined in the second attached document.
The Department contract agreements with manufacturers is a guarantee that all Medi-Cal providers can purchase the DTS products listed at or below the contracted MAC from at least one source for dispensing to Medi-Cal beneficiaries. The proposed maximum allowable product cost (MAPC) is the same as the contracted MAC. The total reimbursement rates for DTS will continue to be the MAPC plus Medi-Cal’s pharmacy dispensing fee of $7.25 per claim.
This is a request for input from representatives of the Medi-Cal Provider community, California Association of Medical Product Suppliers and California Pharmacist Association regarding the DTS proposed product list, MAPC and utilization controls. The proposed policy and price updates would be effective for dates of service on and after January 1, 2013.
Your input will assist in our efforts to achieve the goal of providing Medi-Cal beneficiaries DTS in a fiscally prudent manner. A meeting will be held in Sacramento Thursday, September 27, 2012 at 2:30pm for you to provide your input in person or you may submit your input by email to medicalsupplies@dhcs.ca.gov no later than September 28, 2012.
If you would like to attend the meeting on Thursday, September 27, 2012 at 2:30pm reply to this email with your name, title and company. An email will follow to confirm your attendance and provide details on location.