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NYS Medicaid Pharmacy Prior Authorization Programs

Notifications

Notifications

Provider Notifications
Date Title
Date Title
05/16/19 Tighten Editing on Pharmacy Claims When Prescribed by Non-Enrolled Prescribers
05/14/19 New System Editing on Fee-for-Service (FFS) Pharmacy Claims for the Vaccines for Children (VFC) Program
05/10/19 Medicaid Pharmacy Prior Authorization Programs Update
05/01/19 Retroactive Repricing Update
04/08/19 Regulatory Change to Prescription Contraceptive Coverage
03/01/19 Retroactive Repricing Update
02/08/19 NYS Medicaid Fee-for-Service (FFS) Retroactive Repricing per Prior Changes Made to Pharmacy Reimbursement
02/07/19 Reminder: Medicaid Billing for Vaccines for Children
01/16/19 NYS Medicaid Fee-For-Service (FFS) Retroactive Repricing per prior changes made to Pharmacy Reimbursement
01/09/19 New Resource: Medicaid Pharmacy Program Opioid Management webpage and Non-opioid alternative chart
12/20/18 Important Change: Fidelis to Provide Family Planning and Reproductive Health Benefit
12/13/18 Reminder: Ordering, Prescribing, Referring, Attending (OPRA) Prescription Requirements for Unlicensed Providers ONLY
11/27/18 Prior Authorization of Topical Compounded Drug Products
11/16/18 Medicaid Pharmacy Prior Authorization Programs Update
11/06/18 Preferred Diabetic Supply Program Update
11/02/18 Delay in Professional Dispensing Fee Change
10/29/18 Medicaid Fee-for-Service (FFS) Coverage of Topical Compounded Drug Products
10/26/18 Update to Medicaid FFS Pharmacy Professional Dispensing Fee
10/25/18 Pharmacists as Immunizers Fact Sheet (October 2018)
10/01/18 Pharmacy Pricing Policy – Submission of Usual and Customary (U&C) Price
09/27/18 Pharmacy Provider - Rebate Signer Update
09/12/18 New Duplicate Editing for Pharmacy and Medical Crossover Claims
09/12/18 New Edit to Validate Submitted Procedure Codes and Associated NDCs
08/31/18 NYS Medicaid FFS Program - Pharmacists as Immunizers Fact Sheet (Update August 2018)
07/12/18 Medicaid Pharmacy Prior Authorization Programs Update
07/09/18 Foster Care Carve Out Drug List
07/09/18 Hep C Prescriber Experience Criteria Lifted
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