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NYS Medicaid Pharmacy Prior Authorization Programs
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Current Pharmacy Programs and Updates
Preferred Drug List
Preferred Drug Program
Brand Less Than Generic Program
Dose Optimization Initiative
Drug Utilization Review Board (DURB) Recommendations
Preferred Diabetic Supply Program
Single State Supplemental Rebate Agreements (SRAs) for Preferred Anti-Retrovirals (ARVs)
SMAC Program
Recent Pharmacy News
August 2018
Pharmacy Update on the Dose Optimization Program
https://www.health.ny.gov/health_care/medicaid/program/update/2018/2018-08.htm#doseopt
July 2018
Changes to Medicaid FFS Pharmacy PA Programs Implemented August 2, 2018
https://www.health.ny.gov/health_care/medicaid/program/update/2018/2018-07.htm#priorauth
January 2018
Changes to Medicaid FFS Pharmacy Reimbursement 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
Access additional Medicaid Update articles.
Prior Authorization Resources
To obtain a prior authorization call (877) 309-9493 or fax the appropriate Prior Authorization form to (800) 268-2990.
PAXpress is a web-based application available for initiating prior authorization requests.
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