Skip to Main Content

California Health & Wellness uses cookies. By continuing to use our site, you agree to our Privacy Policy and Terms of Use.

California Health & Wellness is no longer a Medi-Cal plan starting January 1, 2024. Regardless of the county you live in, your Medi-Cal service and benefits will not be impacted by the health plan changes since you will be assigned to a new health plan. The county you live in determines your new health plan. Learn more
California Health & Wellness is no longer a Medi-Cal plan starting January 1, 2024. Regardless of the county you live in, your Medi-Cal service and benefits will not be impacted by the health plan changes since you will be assigned to a new health plan. The county you live in determines your new health plan. Learn more

20-443 New Prior Authorization Requirements

Date: 06/08/20

Request prior authorizations for medications listed in this update

Please review the medications in this update to find out when you need to request prior authorization (PA) for California Health & Wellness Plan (CHWP) members.

Medications requiring PA immediately

The below medications require PA immediately per new injectable medication HCPCS codes issued by the Centers for Medicare & Medicaid Services (CMS) on April 1, 2020:

  • Adakveo®
  • Givlaari®

New PA requirements starting August 11, 2020

All providers must request PA for the medications listed below:

Erbitux®

Ozurdex®

Triptodur®

Vyondys 53®

Faslodex®

Panhematin®

Vectibix®

Zaltrap®

Mozobil®

Synribo®

Vidaza®

 

View PA requirements online

Prior authorization requirements are available on www.CAHealthWellness.com.

Providers participating through the Community Care Independent Practice Association (CCIPA) must contact CCIPA, follow CCIPA’s prior authorization process and use CCIPA’s forms.

Additional information

If you have questions regarding the information contained in this update, contact CHWP at 1-877-658-0305.