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NYS Medicaid Pharmacy Prior Authorization Programs

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Latest News

January 2018
Changes to Medicaid FFS Pharmacy Reimbursement To Be Implemented February 22, 2018
https://www.health.ny.gov/health_care/medicaid/program/update/2018/2018-01.htm#reimburse

January 2018
Medicaid FFS Pharmacy Change in Early Fill Edit for Controlled Substances
https://www.health.ny.gov/health_care/medicaid/program/update/2018/2018-01.htm#earlyfill

November 2017
Authorized Agents for Prior Authorizations of Prescription Drugs
https://www.health.ny.gov/health_care/medicaid/program/update/2017/2017-11.htm#pa

Medicaid Preferred Drug Program

Welcome to the NYS Medicaid Pharmacy Prior Authorization Programs Web site.

The Preferred Drug List also includes links to the DUR program web site for drugs/drug classes within the Preferred Drug Program that are affected by step therapy and F/Q/D requirements.

List of Preferred and Non-Preferred Drugs
Prior Authorization forms
Single State Supplemental Rebate Agreements (SRAs) for Preferred Anti-Retrovirals (ARVs)
SMAC Information

Review information related to updated NYS Medicaid Drug Utilization Review Board recommendations.

Read about information regarding initiating prior authorization requests using a web-based application, PAXpress.

The Preferred Diabetic Supply Program (PDSP) covers blood glucose monitors and test strips through the use of a preferred supply list (PSL). Review recent changes to the program.

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