Governor Kathy Hochul has announced the launched NYRx, a new pharmacy benefit program that aims to improve prescription drug access and coverage for the state’s eight million Medicaid enrollees.
The new program will provide Medicaid recipients with access to more prescription medications with fewer restrictions, reducing confusion over brand-name and generic drugs and creating the largest pharmacy network in New York State.
The transition will help reduce Medicaid pharmacy costs by eliminating the need for managed care organizations to administer this benefit through pharmacy benefit managers. NYRx also creates transparency in reimbursements to pharmacies and leverages the state’s purchasing power to negotiate with drug manufacturers.
Medicaid recipients will be able to access a statewide network of more than 5,000 pharmacies, and NYRx establishes a comprehensive list of the brand-name and generic medications covered under the program, which will broaden prescription drugs coverage for Medicaid recipients.
The program will streamline the process for practitioners, who will be able to prescribe medication based on a uniform list that is less restrictive and governed by an independent public board of experts. Hochul committed $705 million in Medicaid dollars in her FY 2024 budget to ensure 340b health care providers that received critical funding through their pharmacy programs aren’t negatively impacted by the transition.
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