On August 21, the State Department of Health held its monthly pharmacy call for NYRx transition, the Medicaid Pharmacy Benefit Program. Several relevant agenda items include the following:
- Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) order acceptance policy
- NYRx utilizes the NADAC file which contains historical information for rate/pricing changes. The following provides information on how to read the file:
- The “Effective Date” is the effective date for each rate change. The effective date is designed to avoid overlapping date segments for a specific NDC.
- The “As of Date” indicates the date a rate group first appeared on the NADAC.
- The “Posting Date” is the date in which the NADAC is posted to eMedNY.
- EMedNY cut-off time for file updates occurs every Friday (most NADAC prices show an “As of Date” every Wednesday).
- Information in the pricing file will post to eMedNY every Tuesday.
- NYRx, the Medicaid Pharmacy Program, is making significant changes to the coverage of diabetic testing supplies. These changes align with Medicare coverage criteria.
- NYRx is conducting system enhancements to accommodate vaccine billing by NDC targeted for late October:
- eMedNY systems will automatically apply the administration fee in a single transaction,
- NYRx is committed to making this transition as smooth as possible.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.