Clarifying the definition of Medi-Cal carved-out drugs

DHCS has clarified to managed care plan how it defines carved-out versus capitated drugs once any particular drug is FDA-approved.  In general, any new combination of drugs that includes a carved-out drug may be considered a carved-out drug.  This includes new strengths, formulations, and delivery systems.  DHCS maintains a list of carved-out and capitated drugs in the Medi-Cal Providers Manual.  APL 16-004 (2/19/16).