Governor Gavin Newson issued an Executive order (N-01-19) in 2019 to transition the pharmacy services from Managed Care Plans (MCPs) and Fee for Service to Medi-Cal Rx. It is to be administered by Magellan Medicaid Administration under Department of Health Care Services (DHCS) guidance. MCPs like Central California Alliance for Health (CCAH) provided our historical claims and prior authorization data to facilitate continuation of care for Medi-Cal members. After several delays in Medi-Cal Rx implementation, the pharmacy benefit was finally transitioned from CCAH and other managed care plans to Medi-Cal Rx on January 1, 2022. There were several issues surfaced at go-live. For our plan, we encountered: • 86 Separate operational issues impacting several thousand members. • 7 drug class specific policy issues impacting several thousand members. • 6 operational policy issues regarding appeals/grievances/complaints process, missing peer-topeer review option, others. • Comparing DHCS policies with CCAH’s practices, it was clearly visible that the members don’t have the same rights and have access to similar medications as they would under a MCP. DHCS didn’t hold themselves to the same standards as they would a MCP to. For example, despite having 180 transitional policy in place by DHCS, the claims were still rejecting at point of sale because of DHCS having manufacturer specific rebate contracts in place. Member has been on the medication, but can’t get it because it is not from a manufacturer that have rebate associate. This practice is quite bothersome to me. It would never be tolerated for a commercial plan or a MCP. Medi-Cal members should have the same rights regardless who is responsible for managing their pharmacy benefit. That is the right thing to do!