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Pharmacy Provider Communications

New York State Medicaid Billing Guidelines for Administering Mental Health or Substance Abuse Treatment Injections at the Pharmacy - April 9, 2024 (PDF 141KB)

New York State Medicaid (NYRx) Coverage Policy and Billing Guidance for Pharmacist Dispensing of Self-Administered Hormonal Contraception - April 3, 2024 (PDF 205KB)

New York State Medicaid (NYRx) Coverage Policy and Billing Guidance for Pharmacist Ordering and Dispensing of Self-Administered Hormonal Contraception - March 22, 2024 (PDF 212KB)

Reorganization of the 2024 Durable Medical Equipment, Prosthetics, Orthotics and Medical Supplies (DMEPOS) Procedure Code Manual and Fee Schedules - March 14, 2024 (PDF 144KB)

NYRx BLTG Program Update - March 8, 2024 (PDF 176KB)

NYRx BLTG Program Update: Advair - February 16, 2024 (PDF 177KB)

NYRx Drug Coverage Overview: Albuterol HFA - the NYRx Preferred Drug List - January 26, 2024 (PDF 157KB)

NYRx BLTG Program Update: Flovent and Advair - January 8, 2024 (PDF 200KB)

New York State Medicaid (NYRx) Policy of Commercially Acquired COVID-19 Oral Antivirals - December 22, 2023 (PDF 206KB)

UPDATE: Medicaid Coverage for the 2023-2024 COVID-19 Vaccines for Pharmacy Providers Not Enrolled in the Vaccines for Children (VFC) Program - December 21, 2023 (PDF 188KB)

Reminder: Pharmacy Providers Regarding Member Out-of-Pocket Costs - December 14, 2023 (PDF 169KB)

Addition of Parenteral Nutrition HCPCS B4187 - December 7, 2023 (PDF 149KB)

NYRx BLTG Program Update - December 5, 2023 (PDF 168KB)

New York State (NYS) Medicaid Pharmacy Policy and Billing Guidance for At Home COVID-19 Testing Coverage - December 1, 2023 (PDF 205KB)

Enteral Nutrition Pricing Increase - November 30, 2023 (PDF 165KB)

NYRx Medicaid Pharmacy Prior Authorization Programs Update #2 - November 20, 2023 (PDF 149KB)

NYRx Medicaid Pharmacy Prior Authorization Programs Update - November 20, 2023 (PDF 148KB)

UPDATE: Long-Term Care Pharmacies New Patient and Leave of Absence - November 1, 2023 (PDF 211KB)

Reminder: Pharmacy Provider Options Available for the COVID-19 and Influenza 2023-2024 Vaccine Season - October 30, 2023 (PDF 201KB)

Pharmacy Billing Guidance for Brand Name Drugs with New Generic Launches - October 24, 2023 (PDF 145KB)

Importance of Medical Coding on Practitioner Drug Claims - October 10, 2023 (PDF 234KB)

NYRx BLTG Program Update - October 2, 2023 (PDF 167KB)

UPDATED: New York State Medicaid Coverage Policy and Billing Guidance for Pharmacy Providers for the 2023-2024 COVID-19 Vaccines - September 22, 2023 (PDF 144KB)

Pharmacy Coverage Expanded to Include OTC Naloxone - September 15, 2023 (PDF 163KB)

NYS Medicaid Billing Guidance on Adult RSV Vaccines - August 30, 2023 (PDF 172KB)

Important Communication: Exception to Medicaid Provider Enrollment for Unlicensed Interns, Residents & Foreign Physicians in Training Programs - August 25, 2023 (PDF 229KB)

Pharmacists as Immunizers Fact Sheet - August 23, 2023 (PDF 229KB)

NYRx Medicaid Pharmacy Prior Authorization Programs Update - July 14, 2023 (PDF 171KB)

Prior Authorizations for Medical Supplies - July 7, 2023 (PDF 129KB)

NYRx Medicaid Providers Dispense Brand Name Drug when Less Expensive than Generic Program - July 6, 2023 (PDF 200KB)

Medicaid Drug Rebate Program Updates for July 1st, 2023 - July 3, 2023 (PDF 247KB)

Prior Approval/Authorization Requirements for Medical Supplies reinstated on July 6, 2023 - June 27, 2023 (PDF 155KB)

Important Information: Coordination of Benefit (COB) Reversals with Other Coverage Code (OCC) value "4" - June 26, 2023 (PDF 123KB)

Update to New York State Medicaid Fee-for-Service Pharmacy Billing Instructions for Coordination of Benefits Submission - June 21, 2023 (PDF 261KB)

Enteral Product Classification List 2023 - June 12, 2023 (PDF 184KB)

30-Day Countdown - NYRx Transition Fill Period Ending - June 6, 2023 (PDF 140KB)

Important Information Regarding Electronic Claims Capture and Adjudication (ECCA) for Pharmacy Providers - June 6, 2023 (PDF 190KB)

Important Information Regarding Electronic Claims Capture and Adjudication (ECCA) for Pharmacy Providers - May 10, 2023 (PDF 191KB)

Coordination of Benefits & Workers Compensation Coverage - May 8, 2023 (PDF 169KB)

*Program Update* - NYRx Providers Dispense Brand Name Drug when Less Expensive than Generic Program - April 26, 2023 (PDF 154KB)

Information for DMEPOS Providers and Pharmacies dispensing Medical Supplies for Members affected by the Managed Care NYRx/ Fee for Service Benefit Transition beginning April 1, 2023 - April 17, 2023 (PDF 175KB)

Matching Origin Codes to Correct Prescription Serial Number in Medicaid - April 10, 2023 (PDF 167KB)

NYRx - Claims Submitted 4/1 - 4/4/2023 - April 10, 2023 (PDF 174KB)

Pharmacy Billing Guidance Exceptions for Non-Enrolled Prescribers in Medicaid - March 27, 2023 (PDF 201KB)

NYRx BLTG Program Update - March 23, 2023 (PDF 223KB)

Option to Bill Additional Medical Supply Products - March 22, 2023 (PDF 171KB)

Clarification for Long-Term Care Pharmacies New Patient and Leave of Absence - March 14, 2023 (PDF 139KB)

Additional Option Available to Now Bill Select Syringe and Diabetic Supply Products - February 23, 2023 (PDF 186KB)

Correction - 2023 Coding Changes for Continuous Glucose Monitoring - January 13, 2023 (PDF 160KB)

Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - January 12, 2023 (PDF 191KB)

Pharmacy Billing Guidance Exceptions for Non-Enrolled Prescribers in Medicaid - December 23, 2022 (213 KB)

Delay in Update to Coordination of Benefits (COB) Submissions for Medicaid Fee-for-Service (FFS) Pharmacy Billing - November 22, 2022 (144 KB)

New York State Medicaid Policy and Billing Guidance for Pharmacy Reimbursement of COVID-19 Oral Antivirals - November 17, 2022 (205 KB)

Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - November 7, 2022 (166 KB)

NYS Medicaid Fee-For-Service (FFS) Retroactive Lump Sum Payment for the ATB 1% Increase in Pharmacy Dispensing Fee Payment - November 2, 2022 (133 KB)

Medicaid Pharmacy Prior Authorization Programs Update - October 20, 2022 (198 KB)

Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - September 28, 2022 (167 KB)

New York State Medicaid Policy and Billing Guidance for Pharmacy Reimbursement of COVID-19 Oral Antivirals - September 28, 2022 (218 KB)

Pharmacy Professional Dispensing Fee Update - September 28, 2022 (132 KB)

New York State Medicaid Pharmacy Coverage of Polio Vaccine - September 19, 2022 (203 KB)

New York State Medicaid Fee-for-Service Program Pharmacists as Immunizers Fact Sheet (Update September 2022 - Updates are highlighted) - September 12, 2022 (230 KB)

Practitioner Administered Drug Update: New York State Medicaid Fee-for-Service Policy Guidance for esketamine (SPRAVATO®) nasal spray - August 31, 2022 (160 KB)

The Issue That Caused Some Claims for Services Ordered by Nurse Practitioners to Incorrectly Deny has been Resolved - July 5, 2022 (116 KB)

Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - May 22, 2022 (PDF 175 KB)

Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - March 22, 2022 (PDF 174 KB)

Updated Guidance: Statewide Formulary for Opioid Dependence Agents and Opioid Antagonists - February 15, 2022 (PDF 147 KB)

Medicaid Pharmacy Prior Authorization Programs Update - February 7, 2022 (PDF 138 KB)

Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - January 24, 2022 (PDF 154 KB)

Attention Pharmacy Providers - Important Information Regarding Inhaled Corticosteroids in Children - January 14, 2022 (PDF 125 KB)

Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - January 13, 2022 (PDF 183 KB)

Attention Pharmacy Providers - Important Information Regarding Inhaled Corticosteroids in Children - January 13, 2022 (PDF 126 KB)

Clozapine Risk Evaluation and Mitigation Strategy (PDF REMS) Certain Program Requirements Temporarily Suspended - November 22, 2021 (PDF 154 KB)

Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - October 28, 2021 (PDF 178 KB)

Attention Medicaid Fee-for Service (PDF FFS) Providers: Brand Less than Generic Update-Suboxone Film - October 15, 2021 (PDF 145 KB)

Statewide Formulary for Opioid Dependence Agents and Opioid Antagonists - October 4, 2021 (PDF 207 KB)

Medicaid Pharmacy Prior Authorization Programs Update - September 29, 2021 (PDF 129 KB)

Clozapine Risk Evaluation and Mitigation Strategy Requires Providers and Pharmacies to Re-certify and Re-enroll Patients by November 15, 2021 - September 22, 2021 (PDF 150 KB)

Updated Billing and Reimbursement Guidelines for HCPCS Code A4232 - September 17, 2021 (PDF 131KB)

Statewide Formulary for Opioid Dependence Agents and Opioid Antagonists - September 3, 2021 (PDF 214 KB)

Mosquito Repellent Coverage - August 20,2021 (PDF 156 KB)

New York State (PDF NYS) Medicaid Fee-for-Service (PDF FFS) Policy and Billing Guidance for COVID-19, Testing and Specimen Collection at Pharmacies - August 11, 2021 (PDF 247 KB)

Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - July 22, 2021 (PDF 184 KB)

Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - July 22, 2021 (PDF 186 KB)

Update to the NYS Medicaid Fee-for-Service (PDF FFS) Preferred Diabetic Supply Program - July 22, 2021 (PDF 179 KB)

Medicaid Pharmacy Prior Authorization Programs Update - July, 22, 2021 (PDF 142 KB)

The Issue That Caused Some Claims for Services Ordered by Nurse Practitioners to Incorrectly Deny has been Resolved - July 9, 2021 (PDF 178 KB)

Medicaid Pharmacy Guidance Regarding the End of the Declared Disaster Emergency in the State of New York - COVID-19 - July 9, 2021 (PDF 192 KB)

Medicaid Pharmacy Prior Authorization Programs Update - June 24, 2021 (PDF 174 KB)

Reminder: Drug Coverage for New York State Medicaid Dual Eligible Members - June 21, 2021 (PDF 135 KB)

Attention Pharmacy Providers- Important Information Regarding Drug Shortages as of June 2021 - June 10, 2021 (PDF 176 KB)

The Pharmacy Carve-Out Has Been Delayed by Two Years, until April 1, 2023 - April 15, 2021 (PDF 177 KB)

Pharmacy Carve-Out Medicaid Update Articles - March 31, 2021 (PDF 127KB)

Webinars for the Interactive Voice Response System (IVR) for Medicaid Fee for Service (FFS) Enteral Product Authorizations - March 24, 2021 (PDF 140KB)

Attention: COVID-19 Vaccine Administration Billing Guidance for Managed Long-Term Care Members without Medicare Coverage - March 16, 2021 (PDF 168 KB)

Webinars for the Interactive Voice Response System (IVR) for Medicaid Fee for Service (FFS) Enteral Product Authorizations - March 15, 2021 (PDF 140KB)

New York State (PDF NYS) Medicaid Fee-for- Service (PDF FFS) Policy and Billing Guidance for COVID-19, influenza, and respiratory syncytial virus (PDF RSV) testing and Specimen Collection at Pharmacies - February 18, 2021 (PDF 250 KB)

New York State (PDF NYS) Medicaid Fee-for- Service (PDF FFS) Policy and Billing Guidance for COVID-19 (PDF influenza, and respiratory syncytial virus (PDF RSV) testing and Specimen Collection at Pharmacies - February 18, 2021 (PDF 185 KB)

Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - February 4, 2021 (PDF 185 KB)

New York State (PDF NYS) Medicaid Fee-for- Service (PDF FFS) Policy and Billing Guidance for COVID-19 Testing and Specimen Collection at Pharmacies As of 1/7/2021 Updates are highlighted - January 7, 2021 (PDF 146 KB)

Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - December 31, 2020 (PDF 185 KB)

Statewide Formulary for Opioid Dependence Agents and Opioid Antagonists - December 1, 2020 (PDF 228 KB)

Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - November 5, 2020 (PDF 189 KB)

Medicaid Pharmacy Prior Authorization Programs Update - November 5, 2020 (PDF 125 KB)

Medicaid Pharmacy Prior Authorization Programs Update - November 5, 2020 (PDF 163 KB)

NYS Medicaid Fee-for-Service (PDF FFS) Program Pharmacists as Immunizers Fact Sheet - November 2, 2020 (PDF 212 KB)

Statewide Formulary for Opioid Dependence Agents and Opioid Antagonists - October 9, 2020 (PDF 738 KB)

PROVIDER NOTIFICATION – COORDINATION OF BENEFITS UPDATE - September 25, 2020 (PDF 144 KB)

New York State (PDF NYS) Medicaid Fee-for- Service (PDF FFS) Policy and Billing Guidance for COVID-19 Testing and Specimen Collection at Pharmacies - September 18, 2020 (PDF 221 KB)

UPDATE: Statewide Formulary for Opioid Dependence Agents and Opioid Antagonists - September 9, 2020 (PDF 127 KB)

NYS Medicaid Fee-for-Service (PDF FFS) Program Pharmacists as Immunizers Fact Sheet - Septemeber 3, 2020 (PDF 272 KB)

Retroactive Dispensing Fee Update - August 28, 2020 (PDF 140 KB)

New York State (PDF NYS) Medicaid Fee-for- Service (PDF FFS) Policy and Billing Guidance for COVID-19 Testing and Specimen Collection at Pharmacies - August 6, 2020 (PDF 218 KB)

Medicaid Pharmacy Prior Authorization Programs Update - July 23, 2020 (PDF 125 KB)

Updated Pharmacy Guidance for Long Term Care (PDF LTC) Providers and Prior Authorization Requirements - June 24, 2020 (PDF 362 KB)

Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - June 18, 2020 (PDF 347 KB)

Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - June 18, 2020 (PDF 176 KB)

New York State (PDF NYS) Medicaid Fee-for- Service (PDF FFS) Policy and Billing Guidance for COVID-19 Testing and Specimen Collection at Pharmacies As of 6/17/20 - June 17, 2020 (PDF 323 KB)

New York State (PDF NYS) Medicaid Fee-for- Service (PDF FFS) Policy and Billing Guidance for COVID-19 Testing and Specimen Collection at Pharmacies As of 6/17/20 - June 17, 2020 (PDF 218 KB)

Retroactive Repricing Update - June 16, 2020 (PDF 326 KB)

Updated Criteria for HCPCS Code A4670-Automatic Blood Pressure Monitor - June 3, 2020 (PDF 103KB)

New York State (PDF NYS) Medicaid Fee-for- Service (PDF FFS) Policy and Billing Guidance for COVID-19 Testing at Pharmacies - May 29, 2020 (PDF 320 KB)

Attention Pharmacy Providers- Important Information Regarding Drug Shortages as of 5/22/20 - May 22, 2020 (PDF 364 KB)

Attention Pharmacy Providers: Issue That Caused Some Pharmacy Claims to Incorrectly Deny has been Resolved - May 18, 2020 (PDF 340 KB)

Attention Pharmacy Providers- Important Information Regarding Drug Shortages as of 5/08/20 - May 8, 2020 (PDF 361 KB)

Attention Pharmacy Providers- Important Information Regarding Drug Shortages as of 4/30/20 - May 1, 2020 (PDF 333 KB)

Attention Medicaid Fee-for-Service (PDF FFS) Prescribers Important Message about Prior Authorization (PDF PA) Fax Requests - April 22, 2020 (PDF 313 KB)

Attention Medicaid Fee-for-Service (PDF FFS) Prescribers Important Message about Prior Authorization (PDF PA) Fax Requests - April 13, 2020 (PDF 314 KB)

Medicaid Pharmacy Guidance Regarding the Declared Disaster Emergency in the State of New York - COVID-19 As of 4/6/2020 - April 7, 2020 (PDF 272 KB)

Attention Pharmacy Providers- Important Information Regarding Drug Allocation/Shortages - April 1, 2020 (PDF 315 KB)

Medicaid Pharmacy Guidance Regarding the Declared Disaster Emergency in the State of New York - COVID-19 As of 3/21/2020 - March 31, 2020 (PDF 197 KB)

Medicaid Pharmacy Guidance Regarding the Declared Disaster Emergency in the State of New York - COVID-19 As of 3/20/2020 - March 20, 2020 (PDF 187 KB)

Additional Medicaid Pharmacy Guidance Regarding the Declared Disaster Emergency in the State of New York over COVID-19 - March 12, 2020 (PDF 139 KB)

Clarification of Medicaid Coverage for Over the Counter (PDF OTC) Drugs - March 6, 2020 (PDF 360 KB)

Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - February 27, 2020 (PDF 344 KB)

Pharmacy Update on Dose Optimization Program - February 27, 2020 (PDF 389 KB)

Enhanced Dispense as Written (PDF DAW) Code Logic+ - February 20, 2020 (PDF 381 KB)

REMINDER: Substance Use Disorder Drug Treatment, Medicaid Managed Care (PDF MMC) and Fee-for Service (PDF FFS) Coverage - February 14, 2020 (PDF 353 KB)

Medicaid Pharmacy Prior Authorization Programs Update - February 13, 2020 (PDF 300 KB)

Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - February 6, 2020 (PDF 151 KB)

Prescription Contraceptive Drugs for Family Planning - November 18, 2019 (PDF 147 KB)

Use of Antipsychotic Medications in Children Related to the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (PDF SUPPORT) for Patients and Communities Act - October 21, 2019 (PDF 165 KB)

Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - October 3, 2019 (PDF 327 KB)

Medicaid Pharmacy Prior Authorization Programs Update - September 19, 2019 (PDF 307 KB)

NYS Medicaid FFS Program Pharmacists as Immunizers Fact Sheet - September 13, 2019 (PDF 419 KB)

New System Edit to be Implemented to Validate the Ingredient Cost for 340B drugs - September 12, 2019 (PDF 358 KB)

Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - July 25, 2019 (PDF 114 KB)

PHARMACY FEE-FOR-SERVICE BILLING GUIDANCE: LONG TERM CARE (PDF LTC) & FOSTER CARE (PDF CHILD CARE) FACILITIES - June 13, 2019 (PDF 380 KB)

Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - June 6, 2019 (PDF 103 KB)

Medicaid Pharmacy Prior Authorization Programs Update - May 16, 2019 (PDF 77 KB)

Tighten Editing on Pharmacy Claims When Prescribed by Non-Enrolled Prescribers - May 16, 2019 (PDF 313 KB)

New System Editing on Fee-for-Service (PDF FFS) Pharmacy Claims for the Vaccines for Children (PDF VFC) Program - May 14, 2019 (PDF 113 KB)

Retroactive Repricing Update - May 1, 2019 (PDF 82 KB)

Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - April 19, 2019 (PDF 317 KB)

Prescription Contraceptive Drugs for Family Planning - April 8, 2019 (PDF 56 KB)

Repricing – Lump Sum Payments: Update - March 19, 2019 (PDF 74 KB)

Drugs/National Drug Codes (PDF NDCs) sent with claims repriced for the time period of 4/1/2017 through 6/29/2017 - March 13, 2019 (PDF 168 KB)

Pharmacy Update Repricing - March 12, 2019 (PDF 117 KB)

Retroactive Repricing Update - March 1, 2019 (PDF 272 KB)

Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - March 1, 2019 (PDF 91 KB)

Medicaid Pharmacy Prior Authorization Programs Update - February 14, 2019 (PDF 95 KB)

Clarification: NYS Medicaid Fee-For-Service (PDF FFS) Retroactive Repricing per prior changes made to Pharmacy Reimbursement - February 8, 2019 (PDF 287 KB)

ATTENTION: PHARMACISTS REMINDER: MEDICAID BILLING FOR VACCINES FOR CHILDREN - February 7, 2019 (PDF 293 KB)

Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - January 25, 2019 (PDF 311 KB)

NYS Medicaid Fee-For-Service (PDF FFS) Retroactive Repricing per prior changes made to Pharmacy Reimbursement - January 16, 2019 (PDF 282 KB)

New Resource: Medicaid Pharmacy Program Opioid Management webpage and Non-opioid alternative chart - January 9, 2019 (PDF 307 KB)

Important Change: Fidelis to Provide Family Planning and Reproductive Health Benefit - January 1, 2019 (PDF 285 KB)

Changes for Approval of Continuous Glucose Monitoring and Insulin pumps for Individuals with Type 1 Diabetes - December 17, 2018 (PDF 344KB)

Reminder: Ordering, Prescribing, Referring, Attending (PDF OPRA) Prescription Requirements for Unlicensed Providers ONLY - December 13, 2018 (PDF 209 KB)

Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - December 6, 2018 (PDF 316 KB)

Update on Medicaid Fee-for-Service (PDF FFS) Prior Authorization of Topical Compounded Drug Products - November 27, 2018 (PDF 307 KB)

Update to the NYS Medicaid Fee-for-Service (PDF FFS) Preferred Diabetic Supply Program - November 6, 2018 (PDF 86 KB)

Medicaid Fee-for-Service (PDF FFS) Coverage of Topical Compounded Drug Products - October 29, 2018 (PDF 291 KB)

Update to Medicaid FFS Pharmacy Professional Dispensing Fee - October 26, 2018 (PDF 131 KB)

NYS Medicaid FFS Program Pharmacists as Immunizers Fact Sheet - October 25, 2018 (PDF 292 KB)

Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - October 23, 2018 (PDF 152 KB)

Attention Pharmacy Provider Rebate Signer - October 1, 2018 (PDF 121 KB)

Pharmacy Pricing Policy Submission of Usual and Customary (PDF U&C) Price for Pharmacy Claims - October 1, 2018 (PDF 101 KB)

Medicaid Pharmacy Prior Authorization Programs Update - September 20, 2018 (PDF 308 KB)

Repayment of ATB Reductions Has Been Completed - September 17, 2018 (PDF 80 KB)

New Duplicate Editing for Pharmacy and Medical Crossover Claims - September 12, 2018 (PDF 88 KB)

New Edit to Validate Submitted Procedure Codes and Associated National Drug Codes (PDF NDC’s) - Septemeber 12, 2018 (PDF 85 KB)

NYS Medicaid FFS Program Pharmacists as Immunizers Fact Sheet - August 30, 2018 (PDF 137 KB)

Enteral Product Classification List - August 8, 2018 (PDF 78KB)

Pharmacy Update on Dose Optimization Program - August 6, 2018 (PDF 143 KB)

UPDATE: Pharmacy Coverage for Children in Foster Care Facilities - August 1, 2018 (PDF 116 KB)

Update on Medicaid Fee-for-Service (PDF FFS) Pharmacy Billing Instructions for Coordination of Benefits (PDF COB) Submission - July 13, 2018 (PDF 93 KB)

Revision in Hepatitis C Prescriber Requirements - July 9, 2018 (PDF 210 KB)

Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - July 5, 2018 (PDF 152 KB)

Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - May 17, 2018 (PDF 152 KB)

Important Message Regarding Medicare Part B Claims Submitted by Pharmacies - May 16, 2018 (PDF 83 KB)

Update for Reimbursement of Continuous Glucose Monitoring for Individuals with Type 1 Diabetes - May 16, 2018 (PDF 247KB)

Medicaid Pharmacy Prior Authorization Programs Update - April 26, 2018 (PDF 245 KB)

Medicaid Pharmacy Prior Authorization Programs Update - April 24, 2018 (PDF 109 KB)

ATTENTION: PHARMACISTS UPDATE ON PHARMACISTS ADMINISTERING INFLUENZA VACCINES FOR MEDICAID ENROLLEES UNDER THE AGE OF 19 - April 23, 2018 (PDF 96 KB)

Enteral Product Classification List - April 10, 2018 (PDF 88KB)

GOVERNOR EXTENDS EMERGENCY EXECUTIVE ORDER TO PROMOTE VACCINATION AS FLU EPIDEMIC CONTINUES - March 23, 2018 (PDF 123 KB)

GOVERNOR EXTENDS EMERGENCY EXECUTIVE ORDER TO PROMOTE VACCINATION AS FLU EPIDEMIC CONTINUES - February 23, 2018 (PDF 89 KB)

System enhancements to improve the submission of Medicaid FFS pharmacy claims for Long Term Care (PDF LTC) pharmacy providers when reporting Short Cycle Billing - February 22, 2018 (PDF 107 KB)

Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - February 22, 2018 (PDF 153 KB)

ATTENTION: PHARMACISTS EXECUTIVE ORDER 176 EXPANDS ACCESS TO IMMUNIZE CHILDREN AGAINST SEASONAL INFLUENZA - February 1, 2018 (PDF 89 KB)

NYS MEDICAID FEE FOR SERVICE (PDF FFS) NCPDP D.0 SYSTEM EDITING ON 340B DRUG CLAIMS - January 23, 2018 (PDF 124 KB)

Changes to Medicaid FFS Pharmacy Reimbursement - January 23, 2018 (PDF 124 KB)

2018 Procedure Code Changes - December 22, 2017 (PDF 181KB)

Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - December 14, 2017 (233 KB)

DELAYED: System Enhancements to the NCPDP Submission Clarification Field for Long Term Care Pharmacy Providers to Report Short Cycle Billing - December 9, 2017 (52 KB)

Attention 340B Fee-For-Service Medicaid Pharmacy Providers - November 8, 2017 (84 KB)

Changes to Medicaid FFS Pharmacy Reimbursement per CMS Final Rule on Covered Outpatient Drugs and the Enacted 17/18 Budget are Delayed - November 1, 2017 (141 KB)

Reimbursement of Continuous Glucose Monitoring for Individuals with Type 1 Diabetes - October 26, 2017 (PDF 251KB)

ATTENTION Topical Oxygen Wound Therapy (TOWT) Continues to be Covered Until Further Notice - June 26, 2017 (PDF 48KB)

Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - October 19, 2017 (233 KB)

Changes to Medicaid FFS Pharmacy Reimbursement per CMS Final Rule on Covered Outpatient Drugs and the Enacted 17/18 Budget - October 13, 2017 (138 KB)

NYS MEDICAID FEE FOR SERVICE NCPDP D.0 BILLING CLARIFICATION FOR 340B DRUG CLAIMS - October 13, 2017 (59 KB)

Attention Pharmacy Providers: Coordination of Benefits (COB) Processing Change for Other Payer ID and Other Payer ID Qualifier - October 12, 2017 (91 KB)

Changes to Medicaid FFS Pharmacy Reimbursement per CMS Final Rule on Covered Outpatient Drugs and the Enacted 17/18 Budget - October 12, 2017 (93 KB)

Medicaid Pharmacy Prior Authorization Programs Update - September 27, 2017 (159 KB)

NYS Medicaid FFS Program Pharmacists as Immunizers Fact Sheet (Updated August 2017) - September 18, 2017 (134 KB)

NYS Medicaid FFS Program Pharmacists as Immunizers Fact Sheet (Updated August 2017) - September 15, 2017 (224 KB)

REMINDER: PHARMACY PROVIDERS - September 11, 2017 (89 KB)

Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - August 24, 2017 (234 KB)

Reminder: Medicaid Billing for Prescription Drugs when Prescribed by Unlicensed Residents Interns and Foreign Physicians in Training - August 9, 2017 (297 KB)

Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - July 20, 2017 (233 KB)

Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - July 20, 2017 (153 KB)

Medicaid Pharmacy Prior Authorization Programs Update - July 5, 2017 (98 KB)

Medicaid Pharmacy Reminder: Coverage of Outpatient Clotting Factor for Managed Care Enrollees - June 30, 2017 (92 KB)

Update on Medicaid Fee-for-Service (FFS) Pharmacy Billing Instructions for Coordination of Benefits (COB) Submission - June 30, 2017 (155 KB)

Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - June 22, 2017 (233 KB)

Pharmacy Update on Dose Optimization Program - June 22, 2017 (177 KB)

Medical Supply Quantity Update - June 14, 2017 (PDF 93KB)

Incontinence Supply Management Program - May 17, 2017 (PDF 11KB)

Reminder: OPRA Prescription Requirements for Unlicensed Residents Interns and Foreign Physicians in Training - May 12, 2017 (159 KB)

Medicaid Pharmacy Prior Authorization Programs Update - April 27, 2017 (167 KB)

Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - April 20, 2017 (233 KB)

2017 DURABLE MEDICAL EQUIPMENT FEE SCHEDULE CHANGES - March 24, 2017 (PDF 105KB)

Incontinence Supply Management Program Fee Schedule Changes - March 6, 2017 (PDF 14KB)

UPDATE: EMERGENCY CONTRACEPTIVE COVERAGE - March 1, 2017 (112 KB)

Medicaid Pharmacy Prior Authorization Programs Update - February 16, 2017 (111 KB)

Incontinence Supply Management Program Update - February 15, 2017 (PDF 8KB)

Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - January 5, 2017 (210 KB)

2017 DME Procedure Code Changes - December 27, 2016 (PDF 19KB)

Attention Pharmacists and Prescribers: - December 22, 2016 (90 KB)

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 - December 20, 2016 (60 KB)

Incontinence Supply Management Program Update - November 11, 2016 (PDF 13KB)

Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - November 4, 2016 (89 KB)

Medicaid Pharmacy Prior Authorization Programs Update - October 26, 2016 (100 KB)

Incontinence Supply Management Program Fee Schedule Changes - October 25, 2016 (PDF 14KB)

Medicaid Pharmacy Prior Authorization Programs Update - September 15, 2016 (167 KB)

MEDICAID FEE FOR SERVICE (FFS) MOSQUITO REPELLENT COVERAGE - September 6, 2016 (PDF 88KB)

MEDICAID FEE FOR SERVICE (FFS) MOSQUITO REPELLENT COVERAGE - September 1, 2016 (370 KB)

Incontinence Supply Management Program September 1, 2016 - August 17, 2016 (PDF 242KB)

Legislation Enacted Regarding Drugs used for Detoxification or Maintenance Treatment of Opioid Addiction in Medicaid Fee-for-Service (FFS) & Medicaid Managed Care - August 10, 2016 (180 KB)

Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - August 9, 2016 (153 KB)

New Legislation Enacted to Limit Initial Opioid Prescribing to a 7 Day Supply for Acute Pain - July 15, 2016 (42 KB)

Matching Origin Codes to Correct Prescription Serial Number in Medicaid Fee-for-Service (FFS) - July 14, 2016 (188 KB)

Reminder: Medicaid Fee-for-Service (FFS) Emergency Services Only Coverage - July 7, 2016 (130 KB)

Medicaid Fee-For-Service (FFS) Reimbursement of Medicare Part B Pharmacy Claims - July 5, 2016 (111 KB)

OPRA Prescription Requirements for Unlicensed Residents Interns and Foreign Physicians in Training - June 10, 2016 (27 KB)

Important Message Regarding Medicare Part B Claims Submitted by Pharmacies - June 1, 2016 (40 KB)

Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program *REVISED* - May 26, 2016 (233 KB)

Medicaid Pharmacy Prior Authorization Programs Update - May 26, 2016 (146 KB)

Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - May 25, 2016 (102 KB)

2016 DURABLE MEDICAL EQUIPMENT FEE SCHEDULE CHANGES - May 25, 2016 (PDF 70KB)

Medicaid Fee for Service (FFS) Reimbursement of Medicare Part B Pharmacy claims - April 21, 2016 (52 KB)

Newly Calculated Federal Upper Limits for Fee for Service Covered Outpatient Drugs Effective April 1 2016 - April 1, 2016 (189 KB)

REMINDER: Electronic Prescribing Mandate - March 27, 2016 (166 KB)

DPPL Limited Software Functionality - March 16, 2016 (93 KB)

Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - February 18, 2016 (153 KB)

REMINDER: Electronic Prescribing Mandate - February 1, 2016 (68 KB)

Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - January 21, 2016 (230 KB)

2016 DME PROCEDURE CODE CHANGES - December 31, 2015 (PDF 19KB)

Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - November 19, 2015 (233 KB)

Medicaid Pharmacy Prior Authorization Programs Update - November 19, 2015 (302 KB)

Medicaid Pharmacy Changes for Behavioral Health Medications - October 30, 2015 (52 KB)

New York State Medicaid Managed Care Pharmacy Benefit Information Center Behavioral Health Update - October 29, 2015 (72 KB)

Medicaid FFS Pharmacy Prior Authorization Programs Update - October 27, 2015 (256 KB)

NYS Medicaid FFS Program Pharmacists as Immunizers Fact Sheet (Updated October 2015) - October 20, 2015 (146 KB)

Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - October 16, 2015 (92 KB)

Medicaid FFS Pharmacy Changes for Behavioral Health Medications - October 9, 2015 (261 KB)

ICD Changes Effective October 1, 2015 for Durable Medical Equipment Orthotics, Prosthetics and Medical Supplies, Hearing Aid, and Private Duty Nursing Prior Approval - September 29, 2015 (PDF 23KB)

Practitioners Ordering Incontinence Products - September 22, 2015 (PDF 51KB)

Medicaid FFS Pharmacy Prior Authorization Programs Update - September 17, 2015 (371 KB)

Medicaid Pharmacy Program Prior Authorization (PA) Update - September 1, 2015 (110 KB)

Retroactive Prior Authorization (PA) for Point-of-Service (POS) Medicaid Fee-for-Service Pharmacy claims - August 25, 2015 (109 KB)

New Edit on Orally Prescribed Controlled Substances to be Implemented in Medicaid Fee-for-Service - July 30, 2015 (167 KB)

ATTENTION: 340B COVERED ENTITIES AND THEIR CONTRACT PHARMACIES BILLING INSTRUCTIONS FOR 340B DRUG CLAIMS - July 24, 2015 (130 KB)

UPDATED Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - July 23, 2015 (153 KB)

UPDATED Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - July 14, 2015 (153 KB)

Medicaid FFS Pharmacy Prior Authorization Programs Update - June 25, 2015 (208 KB)

UPDATED: Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - June 11, 2015 (233 KB)

Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - April 17, 2015 (192 KB)

Reminder: Reporting of the National Drug Code (NDC) is required for all Physician Administered Drugs for Medicaid Managed Care Plans - March 27, 2015 (150 KB)

New guidance for Pharmacists on Handling Prescription Transfers and Non-Patient Specific Orders in Medicaid Fee for Service (FFS) - March 25, 2015 (106 KB)

ATTENTION: 340B HOSPITALS AND FREESTANDING CLINICS REMINDER: BILLING INSTRUCTIONS FOR 340B DRUG CLAIMS - February 23, 2015 (151 KB)

Medicaid Pharmacy Prior Authorization Programs Update - February 16, 2015 (305 KB)

Guidance for Pharmacies Assisting Medicaid Members during the State of Emergency Declared January 26 2015 - January 26, 2015 (311 KB)

New Medicaid FFS Pharmacy Early Fill Edit - January 22, 2015 (220 KB)

Medicaid Pharmacy Prior Authorization Programs Update - January 9, 2015 (78 KB)

Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - December 22, 2014 (PDF 181KB)

Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - December 19, 2014 (199 KB)

Guidance for Pharmacies Assisting Medicaid Members During the State Disaster Emergency Declared November 18, 2014 in Cattaraugus, Chautauqua, Erie, Franklin, Genesee, Herkimer, Jefferson, Lewis, Oswego, Wyoming and contiguous counties - November 24, 2014 (PDF 388KB)

Medicaid Pharmacy Prior Authorization Programs Update - November 5, 2014 (PDF 145KB)

Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - October 30, 2014 (90 KB)

Medicaid Pharmacy Program Prior Authorization (PA) Update - October 17, 2014 (PDF 111KB)

Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - September 23, 20149/23/2014 (89 KB)

Ordering Prescribing Referring Attending (OPRA) Prescription Requirements for Unlicensed Residents Interns and Foreign Physicians in Training - September 12, 2014 (278 KB)

Ordering, Prescribing, Referring, Attending (OPRA) Prescription Requirements for Unlicensed Residents, Interns and Foreign Physicians in Training - September 12, 2014 (PDF 158KB)

Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - September 2, 2014 (PDF 190KB)

Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - September 2, 2014 (95 KB)

Final e-Prescriber Payments to be Issued By eMedNY - August 25, 2014 (158 KB)

Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - July 3, 2014 (190 KB)

Update on Pharmacy Billing for Compounded Prescriptions - June 26, 2014 (PDF 93KB)

Effective July 16 2014 prior authorization (PA) requirements will change for some drugs in the following PDP classes - June 25, 2014 (309 KB)

Update on Pharmacy Billing for Compounded Prescriptions - June 25, 2014 (94 KB)

Effective July 16 2014 prior authorization (PA) requirements will change for some drugs in the following PDP classes - June 16, 2014 (97 KB)

Dispense Brand Name Drug when Less Expensive than Generic Program - June 12, 2014 (PDF 267KB)

Update on Drug Coverage for the Dual Eligible Population - June 2, 2014 (PDF 23KB)

Update on Drug Coverage for the Dual Eligible Population - June 2, 2014 (24 KB)

Update on Drug Coverage for the Dual Eligible Population - June 2, 2014 (24 KB)

Important Notice to Pharmacy Providers Regarding Prescriptions - May 29, 2014 (PDF 231KB)

Update on Medicaid Fee for Service (FFS) Pharmacy Billing Instructions for Coordination of Benefits (COB) Submission - May 28, 2014 (121 KB)

Important Notice to Pharmacy Providers Regarding Prescriptions Written by Ordering/Prescribing/Referring/Attending (OPRA) Providers - May 28, 2014 (245 KB)

Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - May 27, 2014 (190 KB)

Medicaid Pharmacy Prior Authorization Programs Update - May 7, 2014 (97 KB)

Update on Medicaid Fee for Service (FFS) Pharmacy Billing Instructions for Coordination of Benefits (COB) Submission - May 7, 2014 (159 KB)

Update: Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - May 1, 2014 (87 KB)

Important Notice to Pharmacy Providers Regarding Prescriptions Written by Ordering/Prescribing/Referring/Attending (OPRA) Providers - April 29, 2014 (130 KB)

NYS Medicaid Claim Requirements for Unlicensed Prescribers - April 22, 2014 (113 KB)

Update: Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - April 22, 2014 (PDF 197KB)

Update: Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - April 17, 2014 (267 KB)

Electronic Prescribing Incentive Payments Discontinued Effective April 1 2014 - April 9, 2014 (40 KB)

Medicaid Pharmacy Prior Authorization Programs Update - March 20, 2014 (238 KB)

Medicaid Pharmacy Prior Authorization Programs Update - March 20, 2014 (PDF 77KB)

Medicaid Pharmacy Prior Authorization Programs Update - March 18, 2014 (131 KB)

Update: Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - March 3, 2014 (268 KB)

Coverage of Compounded Prescriptions for the Dual Eligible Population - February 19, 2014 (76 KB)

Important Notice to Pharmacy Providers Regarding Prescriptions Written by Ordering/Prescribing/Referring/Attending (OPRA) Providers - February 18, 2014 (231 KB)

Important Information on Ketamine use in Compounded Prescriptions - February 11, 2014 (37 KB)

Urgent Update: Notice to Pharmacy Providers Regarding Prescriptions Written by Ordering/Prescribing/Referring/Attending (OPRA) Providers - February 4, 2014 (42 KB)

Important Notice to Pharmacy Providers Regarding Prescriptions Written by Ordering/Prescribing/Referring/Attending (OPRA) Providers - January 29, 2014 (138 KB)

Update: Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - January 23, 2014 (234 KB)

Medicaid Fee for Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - January 21, 2014 (PDF 89KB)

Attention Pharmacies - January 3, 2014 (109 KB)

Delay in Ordering/Referring Editing Implementation in FFS Medicaid Pharmacy Claims Only - December 24, 2013 (103 KB)

Medicaid Prescription Footwear and Stocking Benefit Update - December 18, 2013 (PDF 161KB)

Change in Coverage of Barbiturates for Dual Eligible Population - December 9, 2013 (23KB)

Medicaid Pharmacy Prior Authorization Programs Update - November 19, 2013 (119 KB)

Medicaid Pharmacy Prior Authorization Programs Update - November 19, 2013 (PDF 84KB)

Update: Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - November 7, 2013 (64 KB)

Pharmacy Update Dose Optimization Initiative - November 6, 2013 (235 KB)

Pharmacists as Immunizers Fact Sheet - October 2, 2013 (PDF 121KB)

NYS Medicaid FFS Program Pharmacists as Immunizers Fact Sheet (Updated 10-2-13) - October 2, 2013 (122 KB)

NYS MEDICAID FFS PROGRAM PHARMACISTS AS IMMUNIZERS MENINGOCOCCAL VACCINE - September 26, 2013 (52 KB)

ATTENTION MIDWIVES NURSE PRACTITIONERS ORDERED AMBULATORY PROVIDERS PHARMACISTS and PHYSICIANS - September 23, 2013 (37 KB)

Attention: Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - September 9, 2013 (183 KB)

Medicaid Pharmacy Prior Authorization Programs Update - September 9, 2013 (141 KB)

Attention: Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - July 31, 2013 (88 KB)

Clarification: Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - July 18, 2013 (65 KB)

Practitioners Ordering Incontinence Products (ICD-9 Quantity Tool) - June 28, 2013 (PDF 70KB)

NYS Medicaid Ordering/Prescribing/Referring/Attending (OPRA) Provider Enrollment Impact on Pharmacy Claims - June 25, 2013 (PDF 51KB)

NYS Medicaid Ordering/Prescribing/Referring/Attending (OPRA) Provider Enrollment Impact on Pharmacy Claims - June 24, 2013 (24 KB)

Standard Prior Authorization Form in Medicaid Managed Care/Family Health Plus and Medicaid Fee-for-Service (FFS) - June 7, 2013 (39 KB)

NYS Medicaid Ordering/Prescribing/Referring/Attending (OPRA) Provider Enrollment Impact on Pharmacy Claims - June 6, 2013 (254 KB)

Expanding Prescriber Prevails in Medicaid Managed Care in Certain Drug Classes - June 4, 2013 (31 KB)

Specialty Mail Order Pharmacy in Medicaid Managed Care - June 4, 2013 (24 KB)

Guidance for Pharmacies on New Prospective Drug Utilization Review (DUR) Edit - May 10, 2013 (102 KB)

Medicaid Pharmacy Prior Authorization Programs Update - May 3, 2013 (90 KB)

Attention: Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - April 25, 2013 (87 KB)

Clarification on Medicaid Fee-for- Service (FFS) Emergency Services Coverage - April 18, 2013 (94 KB)

Medicaid Fee-for- Service (FFS) Emergency Services Coverage - April 16, 2013 (63 KB)

Guidance for Pharmacies on New Prospective Drug Utilization Review (DUR) Edit - April 10, 2013 (126 KB)

Minimum Breast Pump Specifications Established for Medicaid Reimbursement Effective April 1, 2013 - March 22, 2013 (PDF 31KB)

Attention: Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program - March 21, 2013 (185 KB)

ATTENTION: PHARMACISTS AS IMMUNIZERS EXECUTIVE ORDER EXTENDED ADDITIONAL 30 DAYS CHANGE IN MEDICAID FEE FOR SERVICE BILLING FOR FLU VACCINE ADMINISTRATION FOR CHILDREN BETWEEN THE AGES OF SIX MONTHS AND 18 YEARS - March 20, 2013 (29 KB)

ATTENTION: Pharmacists and Prescribers - February 21, 2013 (52 KB)

ATTENTION: PHARMACISTS AS IMMUNIZERS EXECUTIVE ORDER EXTENDED ADDITIONAL 30 DAYS CHANGE IN MEDICAID FEE FOR SERVICE BILLING FOR FLU VACCINE ADMINISTRATION FOR CHILDREN BETWEEN THE AGES OF SIX MONTHS AND 18 YEARS - February 15, 2013 (1664 KB)

REMINDER: Both Prescription and Over-the-Counter Emergency Contraception is a Covered Benefit for Medicaid Medicaid Managed Care and Family Health Plus - February 4, 2013 (73 KB)

ATTENTION: PHARMACISTS AS IMMUNIZERS EXECUTIVE ORDER EXTENDED ADDITIONAL 30 DAYS CHANGE IN MEDICAID FEE FOR SERVICE BILLING FOR FLU VACCINE ADMINISTRATION FOR CHILDREN BETWEEN THE AGES OF SIX MONTHS AND 18 YEARS - January 17, 2013 (66 KB)

ATTENTION: PHARMACISTS AS IMMUNIZERS CHANGE IN MEDICAID BILLING FOR VACCINE ADMINISTRATION FOR DATES OF SERVICE ON AND AFTER JANUARY 1 2013 - January 8, 2013 (35 KB)

Change in Medicaid Billing for Vaccine Administration for Dates of Service on and after January 1, 2013 - January 8, 2013 (PDF 38KB)

REMINDER: Change in Coverage of Benzodiazepines and Barbiturates for Dual Eligible Population - December 31, 2012 (85 KB)

Prescriber Prevails in Medicaid Managed Care for Atypical Antipsychotics - December 24, 2012 (PDF 49KB)

Guidance for Pharmacies Assisting Medicaid Members During the Current State of Emergency Due To Hurricane Sandy* - November 30, 2012 (507 KB)

Pharmacy Providers Billing for Incontinence Products - November 15, 2012 (PDF 26KB)

In light of the storm, Fee for Service Medicaid will allow early fills for patients that have lost medications as a result of Hurricane Sandy - October 30, 2012 (PDF 19KB)

Request for NY State Maximum Allowable Cost (SMAC) List - October 16, 2012 (PDF 84KB)

SMAC Research Request Form - October 16, 2012 (PDF 102KB)

Ostomy and External Urinary Supplies - October 1, 2012 (PDF 56KB)

Reminder for the Ordering and Billing of Incontinence Products - August 30, 2012 (PDF 25KB)

Pharmacy reimbursement for OMH RTH prescription drugs September 1, 2012 - July 26, 2012 (PDF 41KB)

E2100 – Blood Glucose Monitor with Integrated Voice Synthesizer Update - May 15, 2012 (PDF 17KB)

Reminder DME Providers Pharmacists And Prescribers - December 6, 2011 (PDF 38KB)

Prior Authorization for Enteral and Parenteral Pumps - November 1, 2011 (PDF 26KB)

Medicaid Pharmacy Retroactive Adjustments Letter - October 6, 2011 (PDF 24KB)

Stockings Benefit Update - May 25, 2011(PDF 32KB)

Pharmacy Provider (DUR) Letter - May 25, 2011 (PDF 36KB)

Lost/Stolen Edit Update - May 25, 2011 (PDF 23KB)

Enteral Nutritional Formula Benefit Update - April 18, 2011 (PDF 20KB)

Prescription Footwear Benefit Update - April 5, 2011 (PDF 26KB)

Hospital Bed and Mattress Coding and Payment Update - March 30, 2011 (PDF 34KB)

2011 DME Code Authorization Update - March 30, 2011 (PDF 15KB)

NYS Medicaid Preferred Diabetic Supply Program Fact Sheet - February 3, 2011 (PDF 20KB)

Diabetic Supply Interested Parties Notification - February 3, 2011 (PDF 18KB)

Enhancements To Interactive Voice Response Enteral Formula Telephone Prior Authorization - August 17, 2010 (PDF 66KB)

Incontinence Supply Utilization Review - December 28, 2009 (PDF 26KB)

NYS Medicaid Preferred Diabetic Supply Program Pharmacy Billing Information - September 14, 2009 (PDF 559KB)

Diagnosis Code Required for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fiscal Orders - September 8, 2009 (PDF 68KB)

Enteral Product Classification List - August 24, 2009 (PDF 572KB)

Synagis Final Prescriber Letter August 17, 2009 (PDF 53KB)

Synagis Provider Final Letter August 17, 2009 (PDF 54KB)

Diaper Liner Claims Edit Update June 15, 2009 (PDF 21KB)

Disposable Diapers and Liners for Incontinence May 6, 2009 (PDF 20k)

Enteral Formula Prior Authorization Dispenser Worksheet - April 13, 2009 (PDF 16KB)

Frequency Guidelines for Blood Glucose Testing - March 26, 2009 (PDF 76KB)

Enteral Product Classification List - February 17, 2009 (PDF 121KB)

Automatic Blood Pressure Machines - December 31, 2008 (PDF 79KB)

New Labeler Codes - December 29, 2008 (PDF 13KB)

New_Procedure_Code_For_Pharmacy - July 11, 2008 (PDF 47KB)

Updated Fiscal Order Requirements - June 27, 2008 (PDF 73KB)

February 1, 2008 Supply Update - January 25 2008 (PDF 769KB)

Medicaid Wrap-around Benefit for Dual Eligible Enrollees 2008 - January 18 2008 (PDF 769KB)

Important Information for Pharmacists Regarding the Limited Wrap-Around Benefit - January 18 2008 (PDF 55KB)

Pharmacy Reimbursement Letter.pdf - May 22 2007 (PDF 121KB)

2007 Supply Procedure Code Change - Jan. 03 2007 (PDF 9KB)

Enteral Product Classification List - 5/11/06 (PDF 43KB)

Medical-Surgical Supply Code Changes - 01/01/06 (PDF 14KB)

Enteral Formula Dispenser Worksheet - October 2005 (PDF 21KB)