Effective April 3, 2020, the New York State budget has been finalized.  The total spending package is reduced from the Governor’s initial proposal and attempts to address the growing budget deficit that the State is experiencing from the COVID-19 pandemic, and the collateral impact it is having on the state economy, which the Comptroller has said could total $15 billion. The final budget items of interest of community pharmacy are:  

• Shift Pharmacy Benefit to FFS: Includes language stating that it is in the best interest of the Medicaid program/patients to move the pharmacy benefit from Medicaid Managed Care back to Fee for Service and Department of Health (DOH) has the administrative authority to do so.  DOH shall not implement the transition sooner than April 1, 2021 and upon federal approval.  DOH is authorized to establish uniform standards, payment policies and reimbursement methodologies based on actual acquisition costs and professional dispensing fee. DOH is required to convene an advisory group of stakeholder representatives for the purposes of providing non-binding recommendations to the department by 10/1/20 on available methods of achieving savings beginning on and after 4/1/21. 
• Extend Immunizer Law: Extends the sunset date on NY’s pharmacist immunizer law two years to July 1, 2022 (despite our strong advocacy efforts we could not achieve expansion this session); 
• Bans the sale of tobacco/vaping products in pharmacies (including pharmacies as departments within stores) effective July 1, 2020; and 
• ATB Cuts: As part of MRT 2 and as published yesterday in a Public Notice by NYSDOH in the State Register for intent to file a SPA, it is our understanding that the state intends to increase the across the board Medicaid provider cut from 1% enacted 1/1/20 to 1.875% effective 4/1/20 (this can be done administratively and with federal approval). More details to follow.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.