Please be advised that Medi-Cal Fee-For-Service (FFS) covers all HIV Pre-Exposure Prophylaxis (PrEP) and PEP (post-exposure prevention) drugs without requiring a Treatment Authorization Request (TAR). One example is Truvada for pre-exposure prophylaxis.

If a member of a Medi-Cal Managed Medicaid Plan has a prescription for any drugs used for PrEP and PEP please submit the claim to Medi-Cal FFS, not the managed care plan. If such medications are submitted to a Medi-Cal managed care plan processed by MedImpact, the claim will reject with a message directing you to submit to Medi-Cal FFS.

Delaying access to these life-altering medications may have damaging health effects for the patients.