Effective July 15, NYRx, the Medicaid Pharmacy Program, will accept electronic prior authorization (ePA) requests via CoverMyMeds® in addition to the current phone and fax submission methods.
To learn more about CoverMyMeds® Electronic Prior Authorization for Medicaid Prescribers, please attend one of the webinars which occur on Tuesdays and Thursdays from 12:00 pm – 1:00 pm ET. View the calendar with upcoming dates and registration links.
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.
In addition, the following changes will be made to the Dispense Brand Name Drug When Less Expensive Than the Generic Program:
"NuvaRing® will be REMOVED from the program, as the new manufacturer of NuvaRing® does not participate in the Medicaid Drug Rebate Program (MDRP)." In conformance with State Education Law, a pharmacist shall dispense a less expensive, therapeutically equivalent drug containing the same active ingredients, dosage form and strength as the drug prescribed/ordered. This includes substituting the brand name drug when NYRx has determined it to be the less expensive alternative for the patient. Brand name drugs included in this program:
- Do not require "Dispense as Written" (DAW) or "Brand Medically Necessary" on the prescription.
- Have a generic copayment.
- Are paid at the Brand Name Drug reimbursement rate or usual and customary price, whichever is lower (SMAC/FUL are not applied).
- Do not require a new prescription if the drug is removed from this program.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.