Machine Readable Data
Centers for Medicare and Medicaid Services (“CMS”) regulations and guidance requires certain health plans to publish information regarding their provider directories and formulary drug lists on their website in a machine-readable format. L.A. Care complies with applicable rules, regulations, and guidance, including those of CMS.
The following files are available in the formats required by CMS and/or applicable State regulations and guidance for the purposes allowable under applicable rules, regulations, and guidance, including to increase and enhance consumer transparency by allowing software developers to access certain formulary and provider data to create innovative and informative tools to help consumers better understand their care options. L.A. Care uses reasonable efforts to provide accurate and current data as of the date provided on the respective files. These files are not intended for direct use by L.A. Care Members or others. To learn about L.A. Care’s benefits, medications, and providers (doctors and hospitals) please use L.A. Care’s online provider and formulary directory, and refer to the coverage materials for the respective product offered by L.A. Care.
In accordance with the above requirements, the following files are made available:
- Plan Data
- Provider Data
- Drug/Formulary Data - Medi-Cal: Starting January 1, 2022 Medi-Cal Pharmacy Benefits will be administered through the fee-for-service delivery system Medi-Cal Rx. Please visit the DHCS Medi-Cal Rx website for more information.
- Drug/Formulary Data - L.A. Care Covered