The Health Services (Health Services) established a countywide retail and 340B pharmacy network for MHLA participants. Our Pharmacy Services Administrator (PSA) is Ventegra, a local Glendale-based company which provide participants with broad access to medications through their extensive countywide network of pharmacies.
The following documents are now available for all CPs. For any questions, please contact your MHLA Program Advocate.
- MHLA Pharmacy Phase 2 Orientation (with audio) Revised 07/18/2018
- Pharmacy Fact Sheet (English/Spanish)
- New Member Letter to get Medications (English/Spanish)
- Onsite Pharmacy and Electronic Dispensary Best Practices – quick tips on the claim adjudication process to ensure appropriate payment for your prescription dispensations – developed by Ventegra New 05/16/2019
- Provider Bulletin #17 – Sunsetting of MHLA Pharmacy Services
For more information on Ventegra: Ventegra Introductory Overview Presentation
MHLA Prior Authorization Form for Vivitrol (injectable naltrexone)
MHLA Prior Authorization Form for Empagliflozin (Jardiance), Canagliflozin (Invokana) Updated 03/21/2023
MHLA Prior Authorization Form for Exenatide (Byetta)
MHLA Prior Authorization Form for Liraglutide (Victoza)
MHLA Prior Authorization Form Updated 05/31/2019
MHLA PAP Drug Notification Form Updated 10/25/2016
MHLA PAP Notification Excel Form Updated 10/25/2016
Note: MHLA is a no-cost health care program for low-income individuals who live in Los Angeles County – MHLA is not health insurance and prior authorization is not required for PAP eligibility. Please see this letter confirming that MHLA is not insurance. If you have any questions about PAP for MHLA participants, please contact DHS Pharmacy Affairs | Office: 213-288-8476.
- Ventegra Network Pharmacy Location by Name Updated Quarterly
- Ventegra Network Pharmacy Location by Zip Code Updated Quarterly
- Ventegra Network Pharmacy Location by City Updated Quarterly
- MHLA Pharmacy Network Listing Updated Quarterly
- MHLA Pharmacy Network Updates Updated 06/19/2018
- Formulary – Updated May 2023
- Formulary – Updated March 2023
- Formulary – Updated February 2023
- Formulary – Updated February 2023
- Formulary – Updated January 2023
- Formulary – Updated September 2022
- Formulary Request Form Updated 05/31/2019
- Formulary Conflict of Interest Form
- MHLA PA/PAP Non-Formulary Request Flow Chart Updated 03/29/2023
- Formulary Alternatives for Commonly Rejected Medications
- Updates from May 2023
- Updates from March 2023
- Updates from 2nd February 2023
- Updates from February 2023
- Updates from January 2023
- Updates from September 2022
- Updates from September3rd 2022
- Updates from August 2022
- Updates from January 2022
- Updates from September 2021
- Updates from August 2021
- Updates from November 2020
- Updates from December 2019
- Updates from August 2019 updated 10/22/2019
- Updates from March 2019 updated 03/19/2019
- Updates from October 2018
- Updates from April 2018 updated 04/25/2018
- Updates from December 2017
- Updates from August 2017
- Updates from January 2017
- Updates from September 2015
- Updates from August 2016
For daily submission of data by dispensaries
- Best Practices updated 02/24/2022
- Formulary Guide
- Use and Instructions
- Refill Instructions
- Patient Enrollment Form (English/Spanish)
- Glucometer and Test Strips
- Central Fill Pharmacy Flyer (English/Spanish) updated 01/31/2018