Q: How should I manage a patient with frequent migraines?
A: Please click here and refer to the Institute for Clinical Systems Improvement’s Migraine Prophylactic Treatment Algorithm (page 10).

Q: For Medi-Cal members, what is the prior authorization process for obtaining antipsychotics and anti-retroviral medications for the treatment of AIDS/HIV?
A:  Antipsychotics and anti-retroviral medications for the treatment of AIDS/HIV are excluded from the contract between California’s Medi-Cal Managed Care Division and San Francisco Health Plan.  This means that when dispensed, the pharmacy provider bills Fee-for-Service Medi-Cal instead of San Francisco Health Plan.  This also means that requests for non-formulary anti-psychotics and anti-retroviral medications for the treatment of AIDS/HIV should be submitted to Fee-for-Service Medi-Cal via a Treatment Authorization Request (TAR).  Non-formulary requests for all other drug classes should be submitted to San Francisco Health Plan Medi-Cal, or the patient’s primary insurance plan. 

Fee-for-Service Medi-Cal Northern California TAR fax numbers:
(800) 829-4325
(800) 641-1021*
* Over six prescription limit TARs only.

San Francisco Health Plan prior authorization fax numbers:
(630) 536-1241 or (866) 511-2202

For more information about the Fee-for-Service Medi-Cal TAR process click here.

For more information about the San Francisco Health Plan formulary and prior authorization process click here.