Welcome to the California Department of Health Care Services 

 

Medi-Cal Drug Rebate Branch

The Drug Rebate Branch administers the drug rebate program.  A national leader in drug rebate administration, promoting fiscal responsibility and encouraging working relationships with the pharmaceutical community through cost effective use of resources, supporting a financially secure California.

"The mission of the Drug Rebate Unit is to secure maximum value and benefit to all Californians through the careful Administration of the Drug Rebate Program.

  

What do you want to do?

 View Program information 

 View Latest News 

 What is the new address of Affiliated Computer Services (ACS)

 What's new with COHS 

 How can I view Medi-Cal provider claims electronically 

 Where do I start if I want to pay my invoice electronically 

 Where do I find information regarding submitting AMP to the State 

 Where do I start if I have a dispute with a Medi-Cal Rebate invoice 

 Where do I find Medi-Cal Drug Rebate newsletters

 

  

 

 

 

 

Latest News 

ATTENTION!

 

Beginning October 3, 2011, the State of California’s Department of Health Care Services (DHCS) will have successfully transferred its Fiscal Intermediary (FI) contractor for the Medi-Cal Program from HP Enterprise Services (HP) to the new (FI) contractor Affiliated Computer Services Inc. (ACS), a Xerox Company.  Therefore, please note the following information for contacting the FI regarding correspondence or communications related to Drug Rebate:

 

The NEW email address for the submission of ROSI’s, PQAS, EFT payment documentation and AMP pricing is:  DrugRebateMedi-Cal@acs-inc.com.

For EFT payment documentation and AMP pricing or general inquiries, please mail to: 

                ACS               

                Attn: Drug Rebate Supervisor

                820 Stillwater Road

                West Sacramento, CA 95605

  Please continue to submit your checks to the DHCS Accounting address noted on your Invoice Cover Letters.

 

 Additional Phone Contact Numbers:

(916) 636-1217         General Drug Rebate Questions

(916) 636-1086         FAX Number

(916) 373-2830         FI Drug Rebate Supervisor

COHS Expansion Reminder: On July 1, 2011, three new counties (Marin, Mendocino and Ventura) were added to the COHS program.  You will begin seeing claims units on the 3Q2011 invoices.

COHS Claims: COHS PBMs are still working the changes over to the new NCPDP post adjudication format of 2.2.  Therefore, COHS Invoices are going to be extremely low due to the lack of claims data.   Next quarter, 4Q2011, look for the invoicing in the prior period adjustments.

 

Links to Drug Rebate Resources and Forms 

The Electronic Interface System (EIS) allows registered users to download Medi-Cal drug utilization (up to date NDC paid claims) information for a specific quarter dating back to 1Q1991. Complete the following form to apply for this resource: EIS Application form.pdf       EIS Application form.doc 

NOTE:  

Opening Claims pulled from the EIS system

There has been an issue opening claims obtained from the EIS system using WinZip.  This is an issue with Internet Explorer 8 and WinZip combination.

When you double-click on the link and try to download the file, Internet Explorer automatically changes the file extension from ".gz" to ".zip" and WinZip does not recognize the “.zip” extension as a valid archive file.  This issue does not arise in other browsers and some other zipping utilities do recognize the “.zip” extension as a valid archive file.

The following file provides instructions:    Opening EIS Claims ____________________________________________________________________________________________________________________________________________________________________________________________

The Electronic Fund Transfer (EFT) payment option permits registered users to pay quarterly Medi-Cal drug utilization invoices electronically without having to submit traditional paper checks. The following form is required for this service:     EFT Application form.pdf        EFT Application form.doc             

EFT users must include the following Summary Log with their electronic payment: EFT Payment Accting Summary Log.xls  

____________________________________________________________________________________________________________________________________________________________________________________________

AMP pricing data for AMP supplemental contracts must be submitted quarterly using the following form:

California AMP Submission Instructions - Microsoft Excel (XLS) 

 California AMP Submission Instructions - Adobe Acrobat (PDF) 

The California State Plan can be accessed at the following website:  http://www.dhcs.ca.gov/formsandpubs/publications/Pages/StateMedicare.aspx

  

The California Department of Health Care Services, in an attempt to streamline the dispute resolution process has prepared the following documents.

California has many unique situations with regards to resolving drug rebate disputes with pharmaceutical manufacturers. Medi-Cal has prepared a FAQ sheet specific to situations that may occur in California. A Dispute Resolution Package is available to be used as an aid in the dispute resolution process as well. Contact your analyst for details.

  • FAQ's
    Frequently Asked Questions concerning Dispute Resolution in California, the Medi-Cal drug rebate program, pharmacy reimbursement rate and more.
  • AMP Submission Guidelines
    Contains details about Average Manufacturer Pricing submission instructions.                

 

 Drug rebate newsletters are available detailing some of the more frequently asked questions about programs or other topics. Manufacturers should find this information helpful.

August 2004, COHS
Download as: Adobe Acrobat (PDF)  |  Microsoft Word (DOC)

December 2004, FPACT
Download as: Adobe Acrobat (PDF)  |  Microsoft Word (DOC)

February 2008, Manufacturer Rebate Credit Policy
Download as: Adobe Acrobat (PDF)  |  Microsoft Word (DOC)

June 2008, First Quarter 2008 COHS Invoices, Changes to Drug Rebate Invoices
Download as: Adobe Acrobat (PDF)  |  Microsoft Word (DOC)

August 2008, Modifications Made to California Invoices and Electronic File
Download as: Adobe Acrobat (PDF)  |  Microsoft Word (DOC)

November 2008, Reduction in FPACT Rebate Due Beginning 4th Quarter 2008 Invoice
Download as: Adobe Acrobat (PDF)  |  Microsoft Word (DOC)

December 2008, Medicaid Claims Now Available Through The Electronic Interface System
Download as: Adobe Acrobat (PDF)  |  Microsoft Word (DOC)

January 2010, Update on Breast and Cervical Cancer Treatment Program Invoice
Download as: Adobe Acrobat (PDF)  |  Microsoft Word (DOC)

February 2012,  4th Quarter Invoice Insert; AWP Reporting; Electronic Interface System
Download as: Adobe Acrobat (PDF)Microsoft Word (DOC)

March 2012,  4th Quarter ACS Invoice Insert
Download as: Adobe Acrobat (PDF)  |  Microsoft Word  (DOC)

         

Additional Sources of Information 

 The following websites may be of beneficial use to manufacturers.