On March 21, 2023, NACDS will be joining the Pharmacists Society of the State of New York (PSSNY (Pharmacists Society of the State of New York)) in a rally in support of the Medicaid transition to fee-for-service. Beginning April 1, 2023, all Medicaid members enrolled in Mainstream Managed Care will receive their prescription drugs through NYRx, the Medicaid Pharmacy Program. The rally is to advocate to the legislature so no action would alter the planned transition.
On March 21 at 1:00 p.m., the New York State Department of Health will be holding its next online seminar for all stakeholders about the pharmacy benefit transition. Members, providers
and all interested stakeholders are welcome to attend regarding the transition.
The New York Deparment of Financial Services’ Pharmacy Benefits Bureau is requesting comments directly from pharmacies about the usefulness of PBM audits. Specifically, the requested comments are about whether and how the Department should exercise its authority about audits of pharmacies conducted by PBMs. New York Insurance Law §§ 2905-2906 empowers the Department to establish, by regulation, minimum standards for the issuance of a license to a PBM, including both prerequisites for the issuance of a license and requirements for maintenance of a license. Among the questions for pharmacies are: “In what way, if any, does an auditing PBM communicate its audit policies and procedures to your pharmacy?”, “What types of audits have you experienced in the past five (5) calendar years?”, “How many times per year for the past five (5) calendar years have PBM audits occurred for your pharmacy?”, “During the most recent audit conducted by a PBM for your pharmacy, was the purpose or subject of the audit identified prior to the audit occurring?”, “Was the same identified purpose or subject included as part of the PBM’s draft and/or final audit report?”, etc. Comments should be sent directly to the Department at PBM@dfs.ny.gov by March 24, 2023, with “PBM2022-07” included in the subject line.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.