Bulletin No. 19-03
December 30, 2003

DWC to make Medi-Cal pharmacy fees for workers' compensation prescriptions available via web site

Senate Bill 228 requires that effective January 1, 2004, fees for pharmaceuticals in the workers' compensation system will be based on Medi-Cal prices. DWC is in the final stages of establishing a web site at which the Medi-Cal price for either simple or compound prescriptions can be obtained.

The web site is available now for public testing purposes with December, 2003 data. DWC encourages users to test it and provide us with their comments. However, for the next week this is a test site. Please do not use it for bill paying purposes. The web address to obtain the price of a simple prescription is: http://www.dir.ca.gov/dwc/pharmfeesched/pfs.asp. For compound prescriptions, the address is: http://www.dir.ca.gov/dwc/pharmfeesched/pfscompound.asp.

Users will need to enter the 11 digit NDC number, the number of units prescribed, the price billed, and the date of service. For users who have a 10 digit NDC number, two alternate sites have been set up which will allow them to enter the number in segments. For simple prescriptions, go to: http://www.dir.ca.gov/dwc/pharmfeesched/pfsseg.asp. For compound prescriptions, the web address is: http://www.dir.ca.gov/dwc/pharmfeesched/pfscompoundseg.asp.

Once the system becomes fully operational, some of these pages may be consolidated. Users will also be able to download all of the data in one file in zip format so that they can enter it into their own systems if they wish. That function is not available during the testing period.

The data is supplied by the state Department of Health Services and will be updated once per month, generally by the Monday following the first weekend of the month. When January data is received and posted, the public testing will be complete and the system should be fully operational.

DWC encourages potential users to try the system out over the next week and provide their comments and suggestions. They will be helpful and appreciated. Comments should be sent to dwcrules@dir.ca.gov. Please put "pharmacy test" in the subject line.