September 13, 2022

As a reminder, prior to April 1, 2023, Mainstream Medicaid consumers accessed their pharmacy benefits through a health plan, rather than FFS. This includes anyone in Managed Care (MC) plans, Health and Recovery Plans (HARPs) and HIV-Special Needs Plans (HIV-SNPs). In this case, the state reimburses the health plan rather than the pharmacy.

According to NYS, ‘moving all Medicaid consumers under the FFS Pharmacy Program will allow for a single, uniform list of covered drugs and standardized, consistent rules and regulations. Thus, New York State will able to offer an improved, simplified process for Medicaid consumers to get the medicines and supplies they need. Medicaid consumers have comprehensive drug coverage and equitable access to an extensive network of over 5,000 pharmacy providers.’   

See below re: next DoH Webinar for all stakeholders, on this topic.
———- Forwarded message ———
From: doh.sm.mrtupdates <000000bdebb6a0e4-dmarc-request@listserv.health.state.ny.us>
Date: Tue, Sep 13, 2022 at 11:13 AM
Subject: NYS Medicaid Pharmacy Benefit Transition – All Stakeholders Meeting 9/20/22
To: <MRT-L@listserv.health.state.ny.us>

Dear MRT Listserv Subscriber:

The New York State Department of Health (DOH) is hosting an informational webinar about the transition of the pharmacy benefit from Medicaid Managed Care to NYRx, the Medicaid fee-for-service (FFS) pharmacy program. This is part of a series of recurring monthly webinars about this topic, which are open to all interested MRT stakeholders. There will be a designated question and answer period at the end of the webinar.

The All Stakeholders Meeting – Medicaid Pharmacy Benefit Transition webinar will be held on Tuesday, September 20, 2022 from 1:00 PM to 2:00 PM.  Following the webinar, the presentation will be posted to the DOH website. 

Please complete the registration form. Registration is required to attend this webinar. After registering, you will receive a confirmation email with information about joining the webinar. Please plan to join the webinar 5 minutes ahead of the start time. This will reduce wait times getting into the webinar and allow for a prompt start.