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Board recommends support for AB 25 65 to clarify Medi‑Cal coverage of pharmacist services
Summary
The committee recommended support for AB 25 65, which directs DHCS to issue guidance clarifying that pharmacist services are covered under Medi‑Cal managed care plans, and to take corrective action for noncompliance; CPHA told the board the bill would improve transparency and implementation.
AB 25 65, as amended, would require the Department of Health Care Services to issue guidance clarifying Medi‑Cal managed care plans’ obligations to cover pharmacist services, update model evidence of coverage to explicitly state pharmacist services are covered, and direct DHCS to take corrective action when plans fail to comply. The board’s committee recommended a support position.
Sean Kim of the California Pharmacists Association, which is sponsoring the measure, told the committee that the bill aims to capture transparency and practical implementation details—how pharmacies enroll in managed care networks and how delegated entities coordinate coverage—so that statutory provider status translates into day‑to‑day reimbursement and access.
The committee voted to recommend support and will monitor implementation details and DHCS guidance.
