New York state has launched a new pharmacy benefit program intended to improve prescription drug access and coverage for the eight million New Yorkers enrolled in Medicaid statewide.<\/p>\n
Officials said the NYRx, program will enable Medicaid recipients to access more prescription medications with fewer restrictions, reduce confusion over the brand-name and generic drugs covered by the program, and create the largest pharmacy network in New York state.<\/p>\n
\u201cThe transition to NYRx today is in the best interest of those New Yorkers relying on Medicaid for affordable prescription medication,\u201d Gov. Kathy Hochul said. \u201cIn addition to expanding coverage and access through this program, we are also committing hundreds of millions of additional Medicaid dollars to reinvest in critical providers, including Ryan White programs and Federally Qualified Health Centers, to ensure this change is seamless and has positive impacts across our state.\u201d<\/p>\n
Under the NYRx model, New York state\u2019s Medicaid program will pay pharmacy costs directly, eliminating the need for managed care organizations to administer this benefit through pharmacy benefit managers. The new process creates transparency in reimbursements to pharmacies, leverages the state\u2019s purchasing power to negotiate with drug manufacturers, and streamlines administration for practitioners.<\/p>\n
NYRx also improves coverage for Medicaid recipients by opening access to a statewide network of more than 5,000 pharmacies. In addition, the change establishes one comprehensive list of the brand-name and generic medications covered under the program, including all FDA-approved medications, which will broaden prescription drugs coverage for Medicaid recipients.<\/p>\n
<\/span><\/span>Additionally, NYRx will streamline the process for practitioners. Instead of working through varying rules and limitations for coverage under managed care organizations, pharmacists and physicians will be able to prescribe medication based on a uniform list that is less restrictive and governed by an independent public board of experts.<\/p>\n Acting Health Commissioner Dr. James McDonald said the shift back to a fee-for-service pharmacy benefit model \u201cis the right move for New York and ensures all communities across the state will have continued access to low-cost prescription medications.\u201d<\/p>\n State Medicaid Director Amir Bassiri said the eight million New Yorkers enrolled in Medicaid \u201cwill receive their same prescription medications, only from a larger network of pharmacies at no extra cost and with fewer restrictions and less confusion than before. With this transition, our Medicaid program will now pay all pharmacies directly rather than relying on corporate middlemen who do not always act in ways that align with the interests of Medicaid members. This will create both transparency and efficiency that will work to the benefit our members and ensure access to patient-centered, high-quality health care.\u201d<\/p>\n New York State Academy of Family Physicians Dr. Andrew Symons said NYRx, \u201cwill provide one formulary covering all FDA-approved medications, provide one set of rules for prescribers to follow to get needed coverage for patients and provide better access to lifesaving therapies for Medicaid patients. We commend their leadership in making this transformative step toward improving health care overall in New York state.\u201d<\/p>\n In anticipation of NYRx being implemented, Hochul committed $705 million in Medicaid dollars in her 2024 budget to ensure 340b health care providers that received critical funding through their pharmacy programs aren\u2019t negatively impacted by the transition.<\/p>\n Medicaid recipients or others with questions or in need of assistance with NYRx may visit the program\u2019s website, email NYRx@health.ny.gov or contact the Medicaid Helpline at 1-855-648-1909. The Helpline is available 8 a.m. to 8 p.m. Monday through Friday, and 9 a.m. to 1 p.m. on Saturday.<\/p>\n The state Department of Health also prepared a fact sheet available in multiple languages for consumers answering basic questions about the transition. Additional information is available at the on the eMedNY website.<\/p>\n","protected":false},"excerpt":{"rendered":" New York state has launched a new pharmacy benefit program intended to improve prescription drug access and coverage for the eight million New Yorkers enrolled in Medicaid statewide. Officials said the NYRx, program will enable Medicaid recipients to access more prescription medications with fewer restrictions, reduce confusion over the brand-name and generic drugs covered by […]<\/p>\n","protected":false},"author":89,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[33],"tags":[],"yoast_head":"\r\n