Prescribers that are not enrolled in the Fee-For-Service program must enroll, in order to continue serving Medicaid Managed Care members. Instructions for checking enrollment status and enrollment tips can be found on the eMedNY Provider Enrollment website.

Prescribers should review the Preferred Drug List (PDL), which contains a full listing of drugs/classes subject to the NYS State Medicaid FFS Pharmacy Programs and additional information on clinical criteria prior to April 1, 2023. Prescribers may either switch members to a preferred product or may obtain a PA for a non-preferred product. See below for instructions on requesting a PA or refer to the Preferred Drug Program (PDP) web page.

• To initiate the PA process, the prescriber can choose from three ways to submit a PA to NYRx, the Medicaid Pharmacy Program:
  1. Submit an electronic prior authorization (ePA) request via CoverMyMeds®. Providers can create an account or log into the CoverMyMeds portal from the CoverMyMeds homepage. For more information, see the NYRx Electronic Prior Authorization via CoverMyMeds Summer 2025 announcement and the Quick Guide to CoverMyMeds Prior Authorization Requests.
  2. Call the PA call center at (877) 309-9493 and select option "1" for prescriber. The call center is operational 24 hours a day, seven days per week.
  3. Fax requests are permitted for most drugs. Completed PA forms should be sent to (800) 268-2990. Fax requests may take up to 24 hours to process. PA forms and references are available on the webpage.
• For more information on the PA process for NYRx, the Medicaid Pharmacy Program, refer to the NYRx Prior Authorization Submission Guide on the NYRx Education & Outreach website.
• Billing questions should be directed to the eMedNY Call Center at (800) 343-9000.
• Clinical concerns or PDP questions should be directed to (877) 309-9493 or visit Prime Therapeutics's website for the NYS Medicaid Pharmacy Program.
• Medicaid pharmacy policy and operations questions should be directed to (518) 486-3209