AB 378 Summary

• Adds pharmacy goods to the list of medical services and products that physicians are prohibited from referring patients to if the physician or immediate family has a financial interest, with violations constituting a misdemeanor.

• Requires compounded drug products to be billed at the ingredient level using National Drug Codes, with reimbursement limited to 100% of Medi-Cal allowance plus dispensing fee, or for physician-dispensed compounds, 300% of documented costs but no more than $20 above cost.

• Sets maximum reimbursement caps for dangerous drugs and devices dispensed by physicians: FDA-approved drugs follow official fee schedule; dangerous devices capped at 120% of documented cost or cost plus $250; other pharmacy goods capped at 120% of cost or cost plus $250.

• Prohibits maximum pharmacy services and drug fees from including Medi-Cal payment system reductions under Welfare and Institutions Code Section 14105.192.

• Specifies that physician-dispensed pharmacy goods provisions cannot be superseded by official medical fee schedule provisions unless explicitly applicable to physician-dispensed goods.