Section 5: Pharmacy

Table of Contents - Medi-Cal

Policy/Procedure Title	Policy Number
Pharmacy & Therapeutics Committee	MPRP4001
Conflict of Interest Agreement	MPPR4001-A
340B Compliance Program	MCRP4060
340B Compliance Program Agreement	MCRP4060-A
Reclassification of 340B drug claim service lines requiring the UD modifier	MCRP4060-B
PHC 340B Compliance Program White Paper	MCRP4060-C
Partnership HealthPlan 340B Policy for Primary Care Entities	MCRP4060-D
AB1114 Benefits Implementation and Oversight	MCRP4066
Continuation of Prescription Drugs	MCRP4064
Drug Wastage Payments	MPRP4062
Allowable Waste Drug List	MPRP4062-A
Medical Benefit Medication TAR Policy	MCRP4068
Medi-Cal Treatment Authorization Request Form	MCRP4068-A
PHC Treatment Authorization Request Form (Medical Drug Benefit - PAD Form)	MCRP4068-B
Pharmaceutical Patient Safety	MPRP4034
Prescriber Letter	MPRP4034-A
Sample Member Letter	MPRP4034-B

Please Direct Questions To:

Partnership HealthPlan of California
4665 Business Center Drive
Fairfield, CA 94534
Phone: (707) 863-4100