A678/S3236, legislation that allows pharmacy technicians to practice in any pharmacy under the supervision of a pharmacist, has been passed by both chambers. The bill now moves to the Governor for signing. NACDS and the Community Pharmacy Association of New York have advocated for this bill all session, having directly lobbied both chambers and the administration.
Also in New York, the State Department of Health held its monthly pharmacy call to discuss NYRx, the New York state Medicaid pharmacy benefit program. The agenda included two items: a change in covered diabetic supplies (see below) and a reminder that electronic prior authorizations will start this summer through CoverMyMeds.
- As a reminder, NYS Medicaid is the payor of last resort and providers are required to bill all applicable third-party payors before Medicaid. For additional information about the coordination of benefits, refer to NYRx Third Party Liability and Coordination of Benefits.
- If a member cannot switch from a LifeScan product to a Preferred Diabetic Supply, the pharmacy can request a review of the claim for payment by NYRx by following the steps outlined below. Consideration will be made if there are formulary limitations with the primary payor and it is not possible to switch the member to a preferred product.
- The pharmacy provider may fill out this form and submit it to eMedNY Claims Processing for review. Responses will be faxed back to the pharmacy within three business days. Providers may also call the eMedNY Call Center at 1-800-343-9000 to request a review of the claim.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.