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Dr. Cooper
Dr. Cooper, Pharm.D.
Category: Pharmacy
Satisfied Customers: 210
Experience:  Pharmacist
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What is the medi-cal reimbursement rate

Customer Question

What is the medi-cal reimbursement rate for methamphetamine sulfate generic at Walgreen in california
Submitted: 10 months ago.
Category: Pharmacy
Expert:  Dr. Cooper replied 10 months ago.
They don't disclose those. Medical in CA does not pay for generic. They ironically cover Brands.
Dr. Riaz, Pharm.D.
Expert:  Dr. Cooper replied 10 months ago.
As pharmacist, Walgreen's does not tell us what the reimbursement rate is.
Customer: replied 10 months ago.
Under SB 393 which requires pharmacies to sell drugs for cash to medicare recipients at the medical reimbursement price how do you know that is what you are charged
Customer: replied 10 months ago.
I should add the reimbursement price plus some other small fees. If they don't cover generics what is the brand reimbursement price
Customer: replied 10 months ago.
If they provide generics why are generics included in the medi-cal contract list
Customer: replied 10 months ago.
I should say if the don't provide generic why are generics included in the medi-cal contract list
Customer: replied 10 months ago.
This is copied from the contract list, does it mean brand? If so, why does it use the generic description?* DEXTROAMPHETAMINE SULFATE
* Restricted to use in Attention Deficit Disorder in individuals from 4 years through 16 years of age only.Tablets 5 mg ea
10 mg ea
Customer: replied 10 months ago.
I believe my client is being over-charged, how can I challenged the price under SB 393?
Expert:  Dr. Cooper replied 10 months ago.
I would contact Walgreen and make them do the leg work
Expert:  Dr. Cooper replied 10 months ago.
Medi-Cal Contract Drugs List have them listed under the Chemical name such as AMOXICILLIN/CLAVULANATEPOTASSIUM for Augmentin. But Medi-Cal covers brand, unless brand is not available. I suggest you file a complaint with Walgreen's Corporate for them to do a thorough research. I wonder if Walgreen's is charging extra to those patients and blaming Medi-Cal. Please let me know if need any more help
Expert:  Dr. Cooper replied 10 months ago.
They still can charge extra for the Medi-Cal drug utilization review process as under SB 393 the Medi-Cal drug utilization review process cost is not included.
Expert:  Dr. Cooper replied 10 months ago.
Here are some phone numbers to Dept of HealthCare***@******.***​***-***-****​Audits & Investigations
Expert:  Dr. Cooper replied 10 months ago.
http://www.dhcs.ca.gov/pages/contacts.aspx
Expert:  Dr. Cooper replied 10 months ago.
Checking back to be sure if you don't have any other questions. If no further questions, then please rate my answer. I only get credit for helping when it is rated. Take care.