Repository
Medicaid Update Articles
- Pharmacy Benefit Transition
- NYRx Pharmacy Benefit Transition: Part Four Special Edition - (Web), (Interactive PDF) or (Print-Ready PDF).
- NYRx Pharmacy Benefit Transition: Part Three Special Edition - (Web), (Interactive PDF) or (Print-Ready PDF) - March 2023
- NYRx Pharmacy Benefit Transition: Part Two Special Edition - (Web), (Interactive PDF) or (Print-Ready PDF) - January 2023
- NYRx Pharmacy Benefit Transition: Part One Special Edition - (Web), (Interactive PDF), or (Print-Ready PDF) - October 2022
- Medicaid Pharmacy Prior Authorization Programs Update & Practitioner Dispensing - (PDF) - January 2021
- Attention: Pharmacies, Durable Medical Equipment, Prosthetics, Orthotics and Supply Providers, and Prescribers That Are Not Enrolled in Medicaid Fee-For-Service (Pg. 10) - (PDF) - October 2020
Resources & Materials
Member Materials
- Member Fact Sheet: What You Need to Know (Web)
- Dual Eligible Member Notice of Change - (Web) - (PDF)
- Member Notice of Change - (Web) - (PDF)
- Mailing Schedule for Member Notice of Change - (Web) - (PDF)
- Restricted Recipient Program (RRP) Member Notice - (Web) - (PDF)
- User Guide for Member Tools - (PDF)
Video Resources
Pharmacy Benefit Transition
- Pharmacy Checklist - (PDF) - Updated 03.15.2023
- Pharmacy Quick Reference Guide - (PDF) - Updated 03.23.2023
- Scope of Benefits - (Web) - (PDF) - Updated 12.1.2023
- Transition and Communication Activities Timeline - (Web) - (PDF) - Updated 3.30.2023
- 1557 Non-Discrimination and Language Services Template - (PDF)
- Frequently Asked Questions (FAQs) - (Web) - (PDF) - Updated - 10.1.2024
- Roles & Responsibilities - (Web) - (PDF) Updated - 10.1.2024
Practitioner Administered Drugs (PADs) Added to NYRx Formulary - (Web) - (PDF) - Updated 8.2.2023
NYS DOH analyzed PADs that are provided as a Pharmacy Benefit through MMC Plans. As a result of this analysis, NYS DOH has added certain PADs to the NYRx formulary. Please note: PADs dispensed as a Pharmacy Benefit must be delivered by the pharmacy directly to the site of administration. Additional information regarding pharmacy dispensing of PADs and delivery requirements can be found in the NYRx, The NY Medicaid Pharmacy Program - Pharmacy Manual Policy Guidelines, under the following sections: "Pharmacy Dispensing of Drugs That Require Administration by a Practitioner" and "Delivery". These requirements ensure proper storage and handling.
Stakeholder Engagement
Presentations from All Stakeholder Meetings:
Transition of the Pharmacy Benefit from Managed Care to NYRx:
Implementation Update
Follow Us