New website: MAIC rate files and program information can now be found at https://ca.mercerrxpassage.us/.

The California Department of Health Care Services (DHCS) has contracted with Magellan, who has contracted with Mercer Government Human Services Consulting (Mercer), part of Mercer Health and Benefits LLC, to establish and maintain a Maximum Allowable Ingredient Cost (MAIC) program for generic drugs. Mercer also administers the annual provider self-attestation survey to determine your pharmacy’s professional dispensing fee. More information on attestation can be found on the Attestation tab.

The objective of the MAIC program is to establish upper limit generic ingredient reimbursement rates that encourage efficient purchasing while being responsive to drug pricing fluctuations. Providers may request a review of a MAIC rate for a specific drug by submitting the following rate review request form. All inquiries regarding general provider reimbursement should be submitted to Magellan. Instructions can be found on the MAIC Rate Review Form. 

Medi-Cal Rx MAIC Price Research Request: DHCS form 6540   DHCS-6540-Medi-Cal-Rx-MAIC-Price-Research-Request-Form.pdf

Pharmacy providers can contact Mercer by at the contact information listed below. For any reimbursement questions not related to MAIC pricing, pharmacy prior authorization questions, or policy related questions, please contact Medi-Cal Rx directly. 

Contacting Mercer:
Email: CAMAICsurvey@mercer.com 
Help Desk: 844-294-9982
Fax: 612-642-8931

Helpful Links:
https://www.mercer-government.mercer.com/
https://www.medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing/index.html
https://www.cms.gov/
https://medi-calrx.dhcs.ca.gov/home/



 

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