Beginning Summer 2025, NYRx, the Medicaid Pharmacy Program, will accept electronic PA requests via CoverMyMeds®. For more information, reach out to NYRxEO@primetherapeutics.com.
About Us
The NYRx Education and Outreach (E&O) team serves as a liaison between stakeholders (such as Prescribers, Pharmacies, and Managed Care Plans) and New York State Department of Health to support care coordination and provide informing materials, trainings, and timely communications regarding NYRx, the Medicaid Pharmacy Program.
NYRx E&O supports and helps solve complex pharmacy cases for:
- Managed Care Plans
- Case workers and New York State agencies
- Prescribers and pharmacies with questions regarding NYRx drug coverage, prior authorization requirements, and NYRx enrolled pharmacies
- Complex care coordination for populations including but not limited to youth who are in Foster Care and those living with HIV/AIDS, bleeding disorders such as Hemophilia, Serious Mental Illness, Substance Use Disorder, and Hepatitis C.
Contact Us
The NYRx Education & Outreach Call Center is available by phone at 1-833-967-7310 or by email at NYRxEO@primetherapeutics.com from 8:00 AM to 5:00 PM ET, Monday through Friday, excluding holidays. For privacy and security, Protected Health Information (PHI) sent through email must be encrypted.
Office Hours
The NYRx E&O team hosts virtual support drop-in sessions daily during the week for stakeholders to hop in and ask questions when support is needed.
Managed Care Organization (MCO) Office Hours:
Providers and Pharmacies Office Hours:
Trainings
The NYRx E&O team hosts weekly live training webinars providing an overview of NYRx, the Medicaid Pharmacy Program.
Registration is required to join.
Prescriber webinar occurs on Mondays. View the calendar with upcoming dates and registration links.
Pharmacy webinar occurs on Wednesdays. View the calendar with upcoming dates and registration links.
NYRx, the Medicaid Pharmacy Program overview webinar occurs on Fridays. View the calendar with upcoming dates and registration links.
Each webinar is from 12:00 PM - 1:00 PM ET, excluding holidays. To receive an invitation to join a webinar, please send an email request to NYRxEO@primetherapeutics.com.
In addition, recorded sessions of NYRx E&O educational webinars are available on the NYRx E&O YouTube channel. To view a specific webinar or for a copy of the slides select from the list below.
Resources
NYRx Newsletters
Publications
| Date |
Title |
| 05/01/25 |
NYRx Notice to Pharmacies: Sodium Glucose Co-Transporter-2 Inhibitors |
| 05/01/25 |
NYRx Notice to Pharmacies: Gabapentin |
| 05/01/25 |
NYRx Notice to Providers and Pharmacies: Becoming a Mifepristone Certified Pharmacy |
| 05/01/25 |
Reminder: NYRx Electronic Prior Authorization via CoverMyMeds Summer 2025 |
| 04/30/25 |
NYRx Helpful Hints for Pharmacies: Diabetic Testing Supplies |
| 04/21/25 |
Three Ways to Submit a Prior Authorization to NYRx, the Medicaid Pharmacy Program |
| 04/01/25 |
NYRx Electronic Prior Authorization via CoverMyMeds Summer 2025 |
| 03/14/25 |
NYRx Formulary Update: Hydroxym (hydrocortisone gel) |
| 03/14/25 |
NYRx Formulary Update: Tirosint® |
| 03/14/25 |
NYRx Drug Class Coverage Overview: Triglyceride Lowering Agents |
| 01/01/25 |
NYRx Formulary Update: Nucynta and Xtampza |
| 12/06/24 |
NYRx Drug Class Coverage Overview: Immunomodulators & Related Agents - Topical |
| 11/26/24 |
NYRx 90-Day Supply Update |
| 10/14/24 |
NYRx Highlight: Respiratory Syncytial Virus |
| 10/11/24 |
NYRx Notice to Prescribers: Prior Authorization Submission Requirements |
| 10/02/24 |
NYRx Reminder to Providers: Aripiprazole, Quetiapine, and Risperidone Diagnosis Requirements |
| 07/17/24 |
NYRx Pharmacy Rejections - How to Identify and Resolve |
| 07/02/24 |
NYRx Pharmacy Reminder: SMAC Price Research Requests and NYRx Reimbursement |
| 06/21/24 |
NYRx, the Medicaid Pharmacy Program Information for Medical Residents |
| 06/21/24 |
NYRx, the Medicaid Pharmacy Program Information for Pharmacies |
| 06/10/24 |
NYRx Billing Guidance: Non-Patient-Specific Orders |
| 06/06/24 |
NYRx Drug Class Coverage Overview: HIV Post-Exposure Prophylaxis Agents |
| 05/29/24 |
NYRx Third-Party Liability and Coordination of Benefits |
| 04/04/24 |
NYRx Drug Class Coverage Overview: Proton Pump Inhibitors |
| 04/04/24 |
NYRx Notice to Providers and Pharmacies: Claim Submission with ICD-10 |
| 04/03/24 |
NYRx Drug Class Coverage Overview: Antimigraine Agents |
| 03/13/24 |
NYRx Drug Class Coverage Overview: Skeletal Muscle Relaxants |
| 03/01/24 |
NYRx Drug Class Coverage Overview: Central Nervous System Stimulants and Other Agents for Attention Deficit Hyperactivity Disorder |
| 02/29/24 |
NYRx Drug Class Coverage Overview: Benzodiazepines |
| 02/08/24 |
NYRx Drug Class Coverage Overview: Pubertal Suppressants and Hormone Replacement Therapy for Treatment of Gender Dysphoria |
| 02/07/24 |
NYRx and NYS Medicaid DMEPOS Nebulizers |
| 02/07/24 |
NYRx Opioid Dependence Agents |
| 02/06/24 |
NYRx Notice to Prescribers: Coverage of Antiretroviral Agents for HIV Treatment and HIV Pre-Exposure Prophylaxis |
| 02/02/24 |
NYRx Drug Class Coverage Overview: Immunomodulators - Systemic and Benlysta |
| 01/22/24 |
NYRx Drug Class Coverage Overview: HIV Pre-Exposure Prophylaxis Agents |
| 01/11/24 |
NYRx Drug Coverage Overview: Albuterol HFA |
| 12/14/23 |
NYRx Preferred Diabetic Agents |
| 12/07/23 |
NYRx Drug Class Coverage Overview: Sodium Glucose Co-Transporter 2 Inhibitors |
| 11/30/23 |
NYRx Authorized Prescribers for Medicaid Members Reminder to Pharmacy Providers |
| 11/30/23 |
NYRx Drug Class Coverage Overview Antipsychotics Second Generation |
| 11/22/23 |
NYS Medicaid Enteral Prior Authorization - Prescribers, DME Providers and Pharmacies |
| 11/09/23 |
NYS Medicaid Practitioner-Administered Drugs Frequently Asked Questions |
| 11/08/23 |
NYRx Drug Class Coverage Overview: Long-Acting Opioids |
| 10/23/23 |
NYRx Durable Medical Equipment, Prosthetics, Orthotics and Supplies |
| 10/20/23 |
NYRx Prescription Requirements & Regulations |
| 10/20/23 |
NYRx Notice to Providers: Duplicate Prior Authorization Requests |
| 10/16/23 |
NYRx Out-of-State Traveling |
| 10/03/23 |
NYRx Vaccine Billing |
| 09/19/23 |
NYRx Drug Class Coverage Overview: Short Acting Opioids |
| 09/13/23 |
NYRx Drug Class Coverage Overview: Glucagon-Like Peptide-1 (GLP-1) Agonists |
| 08/21/23 |
NYRx Excluded Diagnoses |
| 07/18/23 |
NYRx, Drug Utilization Review (DUR) FAQ |
| 07/18/23 |
NYRx, Drug Utilization Review (DUR) Program |
| 07/18/23 |
NYRx, Preferred Drug Program (PDP)/Preferred Drug List (PDL), FAQ |
| 07/18/23 |
NYRx, Preferred Drug Program (PDP)/Preferred Drug List (PDL) Overview |
| 07/13/23 |
NYRx Program Review Notice |
| 07/07/23 |
NYRx Brand Less Than Generic (BLTG) Program |
| 07/07/23 |
NYRx Brand Less Than Generic (BLTG) FAQ |
| 06/23/23 |
NYRx Dose Optimization (DO) |
| 06/23/23 |
NYRx Frequency/Quantity/Duration (FQD) |
| 06/23/23 |
NYRx Step Therapy (ST) |
| 04/28/23 |
NYRx Education and Outreach for Managed Care Organizations (MCOs) |
| 04/28/23 |
NYRx Education and Outreach for Providers |
