In April 2017, the Medicaid fee-for-service pharmacy reimbursement was adjusted to NADAC plus a $10.02 professional dispensing fee. This month, the Department of Health will start the process to retroactively adjust pharmacy claims that were adjudicated effective April 1, 2017 through February 21, 2018. The Department expects this repricing to take place over the course of several months and anticipates that it will be completed by the end of December 2019. Janet Elkind, pharmacy director for Medicaid, has stated that 77 percent of pharmacies will see an increase, six percent will see no change, and 16 percent see a reduction during this readjustment period.
New York…Gov. Andrew Cuomo (D) recently released his budget. Additionally, 30-day budget amendments will be released on Thursday, February 14. Among the various provisions are a series of PBM proposals and a prohibition on selling any tobacco products by pharmacies. The legislature will debate the budget and complete the budget process by Monday, April 1.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.