NYRx, the State Medicaid Prescription Drug Program, posted a Pharmacy Prior Authorizations Programs Update. This update is effective August 1, 2024.
Also in New York, the Office of Health Insurance Programs of the State Department of Health has approved the release of the May 2024 Medicaid Update. This update includes a pharmacy reminder that Medicaid providers are required to bill applicable third parties that may be liable for a claim before billing Medicaid. Medicaid is always the payor of last resort and federal regulations require that all other available resources be used before Medicaid considers payment.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.