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NYS Medicaid Pharmacy Prior Authorization Programs

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PDP Notifications

Prescriber Notifications
Date Title
Date Title
11/27/17 Medicaid Pharmacy Prior Authorization Programs Update
08/11/17 Medicaid Fee-For-Service (FFS) to Systematically Enforce Legislation Limiting Initial Opioid Prescribing to a Seven Day Supply
06/30/17 Medicaid Pharmacy Reminder: Coverage of Outpatient Clotting Factor for Managed Care Enrollees
06/22/17 Pharmacy Update on Dose Optimization Program
06/01/17 Medicaid Pharmacy Prior Authorization Programs Update
05/12/17 Reminder: OPRA Prescription Requirements for Unlicensed Residents, Interns and Foreign Physicians in Training
03/28/17 Medicaid Pharmacy Prior Authorization Programs Update
12/21/16 New Legislation to be Enacted Regarding Emergency 5 Day Supply of Drugs used to Treat Substance Use Disorders in Medicaid Fee-for-Service (FFS) & Medicaid Managed Care
12/07/16 Attention Pharmacists and Prescribers: Emergency Services Only Coverage
10/24/16 Medicaid Pharmacy Prior Authorization Programs Update
08/31/16 MEDICAID FEE FOR SERVICE (FFS) MOSQUITO REPELLENT COVERAGE
08/12/16 Legislation Enacted Regarding Drugs used for Detoxification or Maintenance Treatment of Opioid Addiction in Medicaid Fee-for-Service (FFS) & Medicaid Managed Care
07/15/16 New Legislation Enacted to Limit Initial Opioid Prescribing to a 7 Day Supply for Acute Pain
07/15/16 Medicaid Fee-For-Service (FFS) Reimbursement of Medicare Part B Pharmacy Claims
07/14/16 Matching Origin Codes to Correct Prescription Serial Number in Medicaid Fee-for-Service (FFS)
07/11/16 Reminder: Medicaid Fee-for-Service (FFS) Emergency Services Only Coverage
05/19/16 Medicaid Pharmacy Prior Authorization Programs Update
05/12/16 Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program *REVISED*
04/08/16 Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program
03/11/16 NYS Medicaid FFS Program Naloxone Coverage through a Non-Patient Specific (Standing Order) Prescription
02/03/16 Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program
02/01/16 REMINDER: Electronic Prescribing Mandate
12/18/15 Medicaid Pharmacy Prior Authorization Programs Update
10/30/15 Medicaid Pharmacy Changes for Behavioral Health Medications
10/29/15 New York State Medicaid Managed Care Pharmacy Benefit Information Center Behavioral Health Update
10/27/15 Medicaid FFS Pharmacy Prior Authorization Programs Update
10/21/15 NYS Medicaid FFS Program Pharmacists as Immunizers Fact Sheet (Updated October 2015)
10/09/15 Medicaid FFS Pharmacy Changes for Behavioral Health Medications
10/06/15 Medicaid FFS Pharmacy Prior Authorization Programs Update
08/27/15 Retroactive Prior Authorization (PA) for Point-of-Service (POS) Medicaid Fee-for-Service Pharmacy claims
07/31/15 New Edit on Orally Prescribed Controlled Substances to be Implemented in Medicaid Fee-for-Service
07/23/15 ATTENTION: 340B COVERED ENTITIES AND THEIR CONTRACT PHARMACIES - NYS MEDICAID FEE FOR SERVICE - NCPDP D.0 BILLING CHANGES FOR 340B DRUG CLAIMS
05/28/15 Medicaid FFS Pharmacy Prior Authorization Programs Update
03/23/15 Medicaid Pharmacy Prior Authorization Programs Update
01/12/15 Medicaid Pharmacy Prior Authorization Programs Update
11/06/14 Pharmacy Update on Dose Optimization Program
11/03/14 Medicaid Pharmacy Prior Authorization Programs Update
06/25/14 Update on Pharmacy Billing for Compounded Prescriptions
06/16/14 New York State Medicaid Drug Utilization Review (DUR) Board recommended changes to the Medicaid pharmacy prior authorization programs
06/02/14 Update on Drug Coverage for the Dual Eligible Population
05/28/14 Important Notice to Pharmacy Providers Regarding Prescriptions Written by Ordering/Prescribing/Referring/Attending (OPRA) Providers
05/15/14 Medicaid Pharmacy Prior Authorization Programs Update
03/18/14 Medicaid Pharmacy Prior Authorization Programs Update
02/18/14 Medicaid Pharmacy Prior Authorization Programs Update
11/19/13 Medicaid Pharmacy Prior Authorization Programs Update
11/06/13 Pharmacy Update Dose Optimization Initiative
09/09/13 Medicaid Pharmacy Prior Authorization Programs Update
06/06/13 Medicaid Pharmacy Prior Authorization Programs Update
03/21/13 Medicaid Pharmacy Prior Authorization Programs Update
01/18/13 New York State Medicaid Pharmacy & Therapeutics Committee recommended changes to the Medicaid pharmacy prior authorization programs
11/29/12 Medicaid Pharmacy Drug Utilization Review (DUR) Program Update
08/13/12 New York State Medicaid Pharmacy & Therapeutics Committee recommended changes to the Medicaid pharmacy prior authorization programs
06/21/12 New York State Medicaid Pharmacy & Therapeutics Committee recommended changes to the Medicaid pharmacy prior authorization programs
04/12/12 Medicaid Pharmacy Drug Utilization Review (DUR) Program Update
07/28/11 New York State Medicaid Pharmacy & Therapeutics Committee recommended changes to the Medicaid pharmacy prior authorization programs
06/11 Commissioner of Health has accepted the recommendations and approved changes made by the P&T Committee on April 15, 2011
12/09 New York State Medicaid Pharmacy and Therapeutics (P&T) Committee recommended changes to the Medicaid Pharmacy Prior Authorization Programs
09/22/09 New York State Medicaid Pharmacy and Therapeutics (P&T) Committee reviewed 16 drug classes currently subject to the Preferred Drug Program (PDP)
07/17/09 New York State Medicaid Pharmacy and Therapeutics (P&T) Committee reviewed 21 drug classes currently subject to the Preferred Drug Program (PDP)
05/15/09 New York State Medicaid Preferred Drug Program (PDP) is expanding to include additional drug classes
01/16/09 New York State Medicaid Pharmacy and Therapeutics (P&T) Committee reviewed 11 drug classes currently subject to the Preferred Drug Program (PDP)
08/29/08 New York State Medicaid Pharmacy and Therapeutics (P&T) Committee reviewed 11 drug classes currently subject to the Preferred Drug Program (PDP)
07/31/08 Medicaid Pharmacy and Therapeutics (P&T) Committee reviewed 20 drug classes currently subject to the Preferred Drug Program (PDP)
03/14/08 New York State Medicaid Preferred Drug Program (PDP) is expanding to include additional drug classes
01/22/08 Medicaid Pharmacy and Therapeutics (P&T) Committee re-reviewed 16 drug classes subject to the Preferred Drug Program (PDP)
09/01/07 Medicaid Preferred Drug Program (PDP) is expanding to include additional drug classes
07/28/07 Medicaid Pharmacy and Therapeutics (P&T) Committee re-reviewed 21 drug classes subject to the Preferred Drug Program (PDP)
04/01/07 Medicaid Preferred Drug Program (PDP) is expanding to include additional drug classes
03/07/07 New York State Medicaid program has reviewed current utilization of third generation cephalosporins in the community
01/01/07 Medicaid Preferred Drug Program (PDP) is expanding to include additional drug classes
09/07/06 Expansion of the Medicaid Preferred Drug Program (Phase II) and changes to the current prior authorization process under the Clinical Drug Review Program
05/23/06 Introduce prescribers to the New York State Medicaid Preferred Drug Program (PDP)
Pharmacy Provider Notifications
Date Title
Date Title
02/01/18 CHANGE IN MEDICAID FEE FOR SERVICE BILLING FOR FLU VACCINE ADMINISTRATION
01/30/18 Medicaid FFS Pharmacy - Change in Early Fill Edit for Controlled Substances
01/24/18 System enhancements to improve the submission of Medicaid FFS pharmacy claims for Long Term Care (LTC) pharmacy providers when reporting Short Cycle Billing
01/24/18 NYS MEDICAID FEE FOR SERVICE (FFS) - NCPDP D.0 SYSTEM EDITING ON 340B DRUG CLAIMS
01/24/18 Changes to Medicaid FFS Pharmacy Reimbursement - Changes to Fee-For-Service (FFS) pharmacy reimbursement for ingredient cost and professional dispensing fee per the enacted budget are scheduled to be implemented February 22, 2018
12/19/17 DELAYED: System Enhancements to the NCPDP Submission Clarification Field for Long Term Care Pharmacy Providers to Report Short Cycle Billing
11/08/17 Attention 340B Fee-For-Service Medicaid Pharmacy Providers
11/01/17 Changes to Medicaid FFS Pharmacy Reimbursement per CMS Final Rule on Covered Outpatient Drugs and the Enacted 17/18 Budget are Delayed
10/13/17 NYS MEDICAID FEE FOR SERVICE - NCPDP D.0 BILLING CLARIFICATION FOR 340B DRUG CLAIMS
10/12/17 Changes to Medicaid FFS Pharmacy Reimbursement per CMS Final Rule on Covered Outpatient Drugs and the Enacted 17/18 Budget
10/12/17 Attention Pharmacy Providers: Coordination of Benefits (COB) Processing Change for Other Payer ID and Other Payer ID Qualifier
09/18/17 NYS Medicaid FFS Program Pharmacists as Immunizers Fact Sheet (Updated August 2017)
08/11/17 Reminder: Medicaid Billing for Prescription Drugs when Prescribed by Unlicensed Residents, Interns and Foreign Physicians in Training
06/30/17 Update on Medicaid Fee-for-Service (FFS) Pharmacy Billing Instructions for Coordination of Benefits (COB) Submission
12/09 New York State Medicaid Pharmacy and Therapeutics (P&T) Committee recommended changes to the Medicaid Pharmacy Prior Authorization Programs
09/22/09 New York State Medicaid Pharmacy and Therapeutics (P&T) Committee reviewed 16 drug classes currently subject to the Preferred Drug Program (PDP)
07/17/09 New York State Medicaid Pharmacy and Therapeutics (P&T) Committee reviewed 21 drug classes currently subject to the Preferred Drug Program (PDP)
05/15/09 New York State Medicaid Preferred Drug Program (PDP) is expanding to include additional drug classes
01/16/09 New York State Medicaid Pharmacy and Therapeutics (P&T) Committee reviewed 11 drug classes currently subject to the Preferred Drug Program (PDP)
08/29/08 New York State Medicaid Pharmacy and Therapeutics (P&T) Committee reviewed 11 drug classes currently subject to the Preferred Drug Program (PDP)
07/31/08 Medicaid Pharmacy and Therapeutics (P&T) Committee reviewed 20 drug classes currently subject to the Preferred Drug Program (PDP)
03/14/08 New York State Medicaid Preferred Drug Program (PDP) is expanding to include additional drug classes
01/22/08 Medicaid Pharmacy and Therapeutics (P&T) Committee re-reviewed 16 drug classes subject to the Preferred Drug Program (PDP)
09/01/07 Medicaid Preferred Drug Program (PDP) is expanding to include additional drug classes
07/28/07 Medicaid Pharmacy and Therapeutics (P&T) Committee re-reviewed 21 drug classes subject to the Preferred Drug Program (PDP)
04/01/07 Medicaid Preferred Drug Program (PDP) is expanding to include additional drug classes
01/01/07 Medicaid Preferred Drug Program (PDP) is expanding to include additional drug classes
09/07/06 Important changes to the Medicaid pharmacy benefit will be implemented on October 18, 2006
05/23/06 Introduction to New York State Medicaid's Preferred Drug Program (PDP)
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