what pharmacies accept medicaid nyrx

Providers who have submitted enrollment applications may check the status of their application in the Medicaid Pending Provider Listing file, updated weekly on the eMedNY "Medicaid Managed Care Network Provider Enrollment" web page. The DVS system can be accessed through ePACES, a web-based application that allows providers to request and receive Health Insurance Portability and Accountability Act (HIPAA)-compliant transactions. NYS Medicaid will allow a one-time transition fill from April 1, 2023, through June 30, 2023, for non-preferred diabetic supplies that are not part of the PDSP and will honor PAs already provided by MMC Plans. Claims Processing for LINETPharmacies will submit the claim to LINET for reimbursement. The CIN is always represented in the following form at "XX00000X", and in some cases, the CIN may be embedded in the MMC Plan ID Number of the enrollee. Effective, May 1, 2021, prescriptions are valid and may be filled for up to one year from the date issued. Prescription drugs require a prescription order with appropriate required information. Dispensing provider (DME or Pharmacy) calls and completes the authorization process. Revised Guidelines will be available with the next Manual Update. Medical billing is not impacted by the pharmacy benefit transition. In January 2023, the New York State Department of Health (DOH) provided valuable information in the form of a New York State Medicaid Update. HCPCS code is preceded by a pound sign (#). Please visit eMedNY Provider Enrollment to enroll. There will not be designated specialty pharmacies within the Medicaid NYRx Pharmacy Program nor are there any presently. Providers can also check enrollment through the Medicaid Enrolled Provider List. MLTC Plans are not impacted by the Pharmacy Benefit Transition. External ambulatory infusion pumps for insulin are not part of the pharmacy benefit transition and will remain the responsibility of the Managed Care Plans (MCPs). Additional information is available at the on the eMedNY website. By phone: The Medicaid Helpline can help you in your preferred language: 1-855-648-1909. A prescription or fiscal order is required for non-prescription OTCs. Importantly, the patient-physician relationship will go unimpeded under this new program. For more information on the transition fill period please reference FAQ 051, FAQ 113, and FAQ 124. When billing electronically for medical supplies: Incorrect Product/Service ID for Processor/Payer, When billing by paper, providers can refer to the, Professional/ Medical Claim Format 837 (Professional 837-P) or 150003, When billing by electronic or paper, providers should refer to the, When submitting claims, providers should refer to the, Claims Electronic Provider Assisted Claim Entry System (ePACES): Real Time DMEPOS Claims Submissions. pharmacy benefits transitioned to NYRx, the NY Medicaid Pharmacy program supported by eMedNY. Providers, including prescribers, pharmacies and DMEPOS providers, must be enrolled in NYS Medicaid to receive reimbursement for services provided to Medicaid members. Appendix A: Additional PA Guidance The List of Medicaid Reimbursable Drugs has been established by the New York State Commissioner of Health. Prescribers and Dispensers may also use the web portal to request or complete authorizations. Policy Clarification for Practitioner Dispensing] so that practitioners can use the existing medical claims format to be reimbursed for drugs furnished to Medicaid Fee-For-Service patients. Sections 4.1, 4.2, and 4.3 are subject to the NYRx transition. The All Stakeholder meetings have been established to update stakeholders and to gather input from all stakeholders, including individuals and families, and those that represent them. Hornberg is a town in the Ortenaukreis, in western Baden-Wrttemberg, Germany. To ensure a smooth transition for MMC enrollees, Items billed to NYRx using the HCPCS code from the, NCPDP Field Names: Product/Service ID- 407-D7 and Product/Service ID Qualifier- 436-E1 (valid values. The transition was delayed by the FY 2022 Budget, which pushed implementation until today, April 1, 2023. The resource is accessible here. No. Clinical liaisons are trained to support and help solve complex pharmacy cases for: To contact the Education and Outreach team call (833) 967-7310. For the most updated information, please refer to the NYRx Formulary File. Bassiri reiterated the patient-centered benefits of the transition in an opinion piece published this week in the Buffalo News. Information for DMEPOS Providers If there are changes, they will be communicated to providers via a Medicaid Update article. Pharmacies enrolled in Medicaid Fee-For-Service (FFS) may dispense and bill for covered outpatient drugs. If you are interested in receiving MRT email alerts, visit the MRT LISTSERV web page to subscribe. Pharmacies that are not enrolled in the VFC program and choose to provide vaccines for children younger than 19 years of age, at no charge to the member or Medicaid program, can be reimbursed for the administration only. Your pharmacy benefit is the part of your Medicaid health insurance that helps you pay for your prescription drugs and supplies. NYS DOH has provided a data claims file to the Managed Care Plans (MCP) beginning April 1, 2023. NYRx, the New York Medicaid Pharmacy Program PA criteria. This includes outpatient prescription drugs and clotting factor. Cough and Cold. $1.00 for Generic Drugs, preferred Brand Name Drugs, and Brand Drugs included in the Brand Less than Generic Drugs Program. Yes, for more information please refer to the Scope of Benefits, Chart #2. No. The NYRx Pharmacy Provider Manual has guidance for override situations, including lost or stolen prescriptions (page 8) and obtaining Prior Authorization for 72-hour emergency supply (page 13). Kathy Hochul has launched NYRx, the state's new pharmacy benefit program, which is designed to improve prescription drug access and coverage for the 8 million New Yorkers enrolled in Medicaid . Managed Care Plans (MCPs) will continue to be responsible for providing other benefits, such as medical benefits, etc.FAQ 019, federal regulations require that all Medicaid MC rates be actuarially sound. For information, please see the Pharmacy Manual (pages 45-46). The Pharmacy Benefit Transition does not require 340B entities to carve in pharmacy/clinic/physician administered Medicaid claims at either the Covered Entity or its contract pharmacies. If DMEPOS providers submit claim using an NDC number, the claim will deny with reject messages indicated below: Dispensing Validation System (DVS) used for automated PAs; Interactive Voice Response System (IVR)/Web Portal for enteral formula. Additionally, the MRT LISTSERV is a valuable resource for staying up to date and informed about website updates and resource postings. Health & Safety in the Home, Workplace & Outdoors, Clinical Guidelines, Standards & Quality of Care, All Health Care Professionals & Patient Safety. A member will need to use an NYRx enrolled provider. More guidance will be forthcoming regarding DME supplies found within the Pharmacy Procedures & Supply Codes as review and analysis is in progress. This includes outpatient prescription and over-the-counter drugs, diabetic, incontinence and other supplies. The NYRx program covers all of these items, some of which are part of the Preferred Diabetic Supply Program (PDSP), located on the Magellan Health, Inc. "NYRx, the Medicaid Pharmacy Program - Preferred Diabetic Supply Program" web page. For override guidiance on early fills pertaining to lost or stolen medication, please refer to the Provider Manual (page 8). James McDonald, M.D., M.P.H.Acting CommissionerNew York State Department of Health, Amir BassiriMedicaid DirectorOffice of Health Insurance Programs, New York State Medicaid Update - March 2023 NYRx Pharmacy Benefit Transition - Part Three: Special Edition Volume 39 - Number 4, Health & Safety in the Home, Workplace & Outdoors, Clinical Guidelines, Standards & Quality of Care, All Health Care Professionals & Patient Safety, January 2023 DOH Medicaid Updates - Volume 39, Medicare Limited Income Newly Eligible Transition Program (LINET), Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Providers, NYS Department of Health (DOH) "Drugs Covered by NYRx for Dual Eligible Members Effective 10/22/2020" web page, Medicaid Member Dashboard "Search for OTC and Prescription Drugs" web page, Drugs Covered by NYRx for Dual Eligible Members, Humana "LINETPharmacy resources" web page, NYRx, Medical Supply Codes Billable by a Pharmacy, Medicaid Centers for Medicare and Medicaid Services "Affordable Care Act Program Integrity Provisions" web page, NYS "Medicaid Enrolled Provider Lookup" web page, eMedNY "Medicaid Managed Care Network Provider Enrollment" web page, eMedNY "Provider Enrollment and Maintenance Durable Medical Equipment Supplier" web page, Magellan Health, Inc. "NYRx, the Medicaid Pharmacy Program - Preferred Diabetic Supply Program" web page, ePACES Professional Real Time Claim Reference Guide, New York State Medicaid Program Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Procedure Codes and Coverage Guidelines, New York State Medicaid Program Durable Medical Equipment, Prosthetics, Orthotics, and Supplies - Procedure Codes and Coverage Guidelines, eMedNY "Submit Electronic Transactions to New York Medicaid (Free of Charge) via ePACES" web page, Magellan Health, Inc. NYRx, the Medicaid Pharmacy Program "Current Pharmacy Programs and Updates" web page, Magellan Health, Inc. NYRx, the Medicaid Pharmacy Program "E-mail Notifications" web page, Magellan Health, Inc. NYRx, the Medicaid Pharmacy Program "Preferred Diabetic Supply Program" web page, Humana "LINET Pharmacy resources" web page, NYS DOH "Welcome to the NY Medicaid Pharmacy Program (NYRx)" web page, NYS DOH "Transition of the Pharmacy Benefit from Managed Care (MC) to the Medicaid Pharmacy program, NYRx FAQs" web page, Local Department of Social Services (LDSS), Magellan Inc. NYRx, the Medicaid Pharmacy Program homepage, eMedNY "Medicaid Pharmacy List of Reimbursable Drugs" web page, NYS DOH "Welcome to NYRx, Medicaid Pharmacy Program" web page, eMedNY "Provider Enrollment & Maintenance" web page, eMedNY "Information for All Providers" web page, James V. McDonald, M.D., M.P.H., Commissioner, The Latest on New York's Response to COVID-19, Multisystem Inflammatory Syndrome in Children (MIS-C), Health Care and Mental Hygiene Worker Bonus Program, Lyme Disease & Other Diseases Carried By Ticks, Maternal Mortality & Disparate Racial Outcomes, NY State of Health (Health Plan Marketplace), Help Increasing the Text Size in Your Web Browser, Not enrolled for NYRx billing (MCO billing only), Not enrolled for NYRx billing (MCO credentialed as a non-billing provider), Enroll with Medicaid as billing provider or if eligible as a OPRA provider. Managed Long-Term Care plans (e.g., PACE, MAP, MLTC) and the Essential Plan are not included. Folic acid - oral. The technician will collect relevant information and ask the appropriate criteria questions. In addition, the change establishes one comprehensive list of the brand-name and generic medications covered under the program, including all FDA-approved medications, which will broaden prescription drugs coverage for Medicaid recipients. NYS DOH believes the transition of the pharmacy benefit from Managed Care (MC) to the Medicaid NYRx Pharmacy program is in the best interest of the Medicaid program and Medicaid beneficiaries, and that it will achieve the objectives outlined in FAQ 001 . For questions related to the Pharmacy Program, 340B Billing, Drug Pricing, Lost or Stolen Medications, etc. Prescribers should use the override guidance provided below for the above exceptions specific to NYRx, the Medicaid Pharmacy Program. A pharmacy is not required to enroll in VFC, but New York State (NYS) Medicaid should never be billed for the cost of any vaccine for persons under 19 years of age when it is available through the VFC Program. April 2, 2023 Governor Hochul announces "NYRx," the new and largest pharmacy benefit program in NY Change Invests $705 Million in Medicaid Funding Directly to 340b providers, including Ryan White HIV/AIDS programs, Federally Qualified Health Centers and Hospitals Beginning April 1, 2023, all Medicaid members enrolled in EmblemHealth Enhanced Care (Medicaid) and Enhanced Care Plus (HARP) will receive their prescription drugs through NYRx, the Medicaid Pharmacy Program. DME is also covered by DME distributors. IVR/Web Portal Automated Enteral AuthorizationsThe IVR/Web Portal is the automated system utilized by ordering prescribers and dispensing providers (pharmacies or DMEPOS dealers) for enteral formulas. NYRx has pharmacies enrolled that dispense limited distribution drugs, most of which are currently servicing Managed Care enrollees. Additional information about topical compounds can be found in the November 2018 Medicaid Update article Update on Medicaid Fee-for-Service Prior Authorization of Topical Compounded Drug Products. For more information, you may call the NYRx Medicaid Helpline at 855-648-1909 (800-662-1220 TTY), Mon Fri 8 am 8 pm and Sat 9 am 1 pm or email NYRx@health.ny.gov. For more information, please visit the eMedNY Practitioner Group Enrollment page. Vitamin K - oral. After receiving a one-time temporary fill for a non-preferred drug or supply, you must talk to your prescribing doctor or pharmacist about either submitting a request for PA to NYRx or switching to an alternate drug or supply that does not require PA. Information regarding future stakeholder meetings will be sent out via the MRT LISTSERV. It's time to try good panna cotta, che and tiramisu.The whole impression won't be complete without margaritas that is delicious here.. Gasthaus Krokodil is famous for its great service and . The NYS benefits card looks like this: No, your co-payments will not change. The NYRx PDL contains a full listing of drugs/classes subject to the NYS Medicaid NYRx Pharmacy Programs. Over 5,000 pharmacies across the state participate with NYRx, making it the largest pharmacy network in New York. Such decisions are left to 340B Covered Entities. OG, BH, KEL, LR, WOL. for each provider type). According to the visitors' comments, Italian dishes here are tasty and the menu is well-organized. Yes, members can use one of the 5,700+nparticipating pharmacy or DME supplier enrolled in NYRx. Please visit the Provider Manual for guidance on unlicensed residents, interns, and foreign physician in training programs (page 24), and Out-of-State (OOS) Licensed Prescribers (page 25). Only pharmacy supply and procedure codes are subject to the pharmacy benefit transition unless otherwise stated within the Pharmacy Scope of Benefits. Information for submitting applications can be found on page 10 within the October 2020 Medicaid Update Article entitled Attention: Pharmacies, Durable Medical Equipment, Prosthetics, Orthotics and Supply Providers, and Prescribers That are Not Enrolled in Medicaid Fee-for-Service. These include: Pharmacies and practitioners must be enrolled in NYS Medicaid Fee-For-Service (FFS), to service Medicaid members. While there are still many barriers that need to be addressed as we work together to achieve health equity, today we would like to take the opportunity thank the Governor's office for their support and taking crucial steps to ensure continuity of care and access to services for medically vulnerable and underserved New Yorkers. Presentation copies for All Stakeholder meetings are posted on the NYS DOH MRT II NY Medicaid Pharmacy Program (NYRx) website under the "Stakeholder Engagement" section and are organized by date. See FAQ 017. Delivery of prescription drugs, over-the-counter products, medical/surgical supplies, and medical equipment (DME) is an optional service that can be provided to Medicaid member's home or current residence including facilities and shelters. Additionally, during the transition period, from April 1, 2023, to June 30, 2023 (90 days), NYS DOH will be conducting outreach to prescribers to inform them of the members receiving non-preferred products in order to familiarize with Preferred Drug Program. The Transition and Communication Activities Timeline has been developed and reviewed collaboratively with the Managed Care Plans at recurring Technical Workgroup meetings. Clinical liaisons are trained to support and help solve complex pharmacy cases for: To contact the Education and Outreach team call (833) 967-7310. More than 50% of total QARR measures use pharmacy data in the measurement calculation (e.g., denominator, numerator, or both) - pharmacy data will continue to be important. Call centers are familiar with the needs of Medicaid members, have the skills and training to prevent disruption, and NYS DOH have prepared trainings in anticipation of new call center staff being added. Through the Technical Workgroup, NYS DOH has collaborated with MCPs to obtain consensus on the data file that has been created. The call center is available Monday through Friday 8am until 5pm ET. See provider enrollment for more information. Transitioning pharmacy services from MC to NYRx will, among other things: NYS DOH implemented the transition all at once, effective April 1, 2023. TTY 1-800-662-1220. The upcoming Medicaid Update will include more information regarding the RRP and billing guidelines for restricted recipients. The Elderly Pharmaceutical Insurance Coverage (EPIC) program is separate from the NYS Medicaid Program. CGMs and disposable insulin pumps will be authorized if they meet program criteria. This will create both transparency and efficiency that will work to the benefit our members and ensure access to patient-centered, high-quality health care.". Syringes and needles are subject to the Pharmacy Benefit Transition and therefore will be covered under the Medicaid NYRx Pharmacy Program. NYS DOH will be utilizing existing call centers, in which processes are already in place that serve the current diverse population of NYS Medicaid members. Lastly, NYS DOH is working closely with the Managed Care Plans to ensure that they (MCPs) will be able to provide members continued access to those drugs. NYRx enrolls pharmacies that dispense limited distribution drugs to ensure members have access Prescribers can work those pharmacies to provide the limited distribution drug to the member. Beginning April 1, 2023, all Mainstream MC Medicaid members will get their drugs through NYRx, the Medicaid Pharmacy Program. As addressed in FAQ 116 Following the pharmacy benefit transition, will there still be Medicaid Managed Care Plans (MCPs) in New York State Medicaid? NYS Medicaid does not require a prescription to filled within 60 days of the date written. The Medicaid Update is a monthly publication of the New York State Department of Health. Drugs covered by NYRx subject to limit distribution will be available from Medicaid enrolled limited distribution pharmacies. You can locate NYRx-participating pharmacies here. Information on how to enroll in NYS Medicaid (FFS) can be found here. Disposable insulin pumps should be billed via an NDC as a pharmacy claim to FFS. If the product is not on the. As the pharmacy benefit has transitioned to the Medicaid NYRx Pharmacy program on April 1, 2023, NYS DOH will use the eMedNY system for point-of-sale claims adjudication. The pharmacy benefit transition to NYRxdoes not apply to NYS Medicaid members enrolled in Managed Long-Term Care (MLTC) Plans [e.g., MLTC, Programs of All-Inclusive Care for the Elderly (PACE), Medicaid Advantage Plus (MAP), the Essential Plan, or Child Health Plus (CHP)]. Changes related to your restriction to a pharmacy, if appropriate, will be processed by the HRA RR staff. Pharmacy Billing Guidance Exceptions for Non-Enrolled Prescribers in Medicaid. MCPs will continue to make practitioner administered oncology medications available when they are billed as a medical or institutional claim. Claim capture is available. Foster Care parents should contact the Voluntary Foster Care Agencies (VCFA) for assistance with obtaining necessary billing information. NYS DOH is evaluating MCP pharmacy claim encounters to determine potential differences in coverage areas for medications. Medicaid Fee-For-Service includes all benefits. 07833. Once the prescription expires, a new prescription from the prescriber would be required. No, the Pharmacy Benefit Transition will not result in moving contracted pharmacies out of clinics. These conversations and activities have informed and continue to guide DOH's approach in implementation of the transition. The MRT Team will be able to verify your subscription or manually subscribe you. Based on this evaluation, NYS DOH does not view the transition of the Pharmacy Benefit to Medicaid Fee-for-Service (FFS) as a barrier for existing or future VBP arrangements. If you require legal assistance with your individual case, you may call The Legal Aid Societys Access to Benefits helpline at 888-663-6880. For New York's eight million Medicaid patients, NYRx is the right prescription to meet their pharmacy care needs. Additionally, medical supplies are available at a DME Supplier. Only those prescription and non-prescription drugs which appear on the List are reimbursable under NYRx . Providers must have an ePACES account and the member's CIN to check their eligibility status. In January 2023, the New York State Department of Health (DOH) provided valuable information in the form of a New York State . More information on how to check a provider's enrollment status can be found with in the June 2022 Medicaid Update Article: Reminder: Medicaid Enrollment Requirements and Compliance Deadlines for Managed Care Providers. Information for DMEPOS Providers and Pharmacies dispensing Medical Supplies for Members affected by the Managed Care NYRx/ Fee for Service Benefit Transition beginning April 1, 2023 . No. Effective April 1, 2023, New York State (NYS) Medicaid members enrolled in mainstream Medicaid Managed Care (MMC) Plans, Health and Recovery Plans (HARPs), and HIV-Special Needs Plans (SNPs) will receive their pharmacy benefits through NYRx, the Medicaid Pharmacy Program [formerly known as Medicaid fee-for-service (FFS)], instead of through their MMC Plan. More information regarding what drugs and products are included in the NYRx Medicaid Pharmacy Program can Implementing a member transition period that allows members to receive a one-time fill of a non-formulary/non-preferred product. Gov. Durable Medical Equipment, Prosthetics, Orthotics, and Supplies not found within in the Pharmacy Procedures and Supplies Manual are not subject to the transition and will remain the responsibility of the Managed Care Plans (MCPs). Medicaid Managed Care Plans (MCPs) must continue to comply with federal and State requirements to monitor and report all cases of potential fraud, waste, and abuse. Before April 1, 2023, Medicaid members enrolled in a Medicaid Managed Care (MC) plan access their pharmacy benefit through their health plan. Vivitrol is subject to the transition and will be covered under the Medicaid NYRx pharmacy benefit. NYRx Pharmacy Benefit Transition Wenn Sie Fragen haben, wenden Sie sich. and Billing Guidelines. member information) that are needed. Gov. November 2018 Medicaid Update article Update on Medicaid Fee-for-Service Prior Authorization of Topical Compounded Drug Products. For more information for pharmacy providers, please refer to the Pharmacy Quick Reference guide. (2022, July). No, NYS DOH does not intend to engage in exclusive contracts with particular specialty pharmacy providers, as part of the pharmacy benefit transition. NYS Medicaid consumers have comprehensive drug coverage and equitable access to an extensive network of over 5,000 pharmacy providers. Please refer to Member Notice of Change Mailing Tracker for a schedule of the mailings. The current risk adjustment methodology utilizes both Managed Care (MC) encounters and Fee-For-Service (FFS) claims as grouper inputs. Effective June 24, 2021, prescriptions are valid and may be filled for up to one year from the date issued. Long Acting 2nd generation antipsychotics, when administered by a physician or other practitioner in a clinic setting and billed on an institutional or medical claim form will continue to be covered by the member's managed care plan. If a Covered Entity does choose to move their contracted pharmacy out of their clinics, NYS DOH would not anticipate any negative impacts to Medicaid members accessing their medications. Information about the DME Supplier application process can be found on the eMedNY "Provider Enrollment and Maintenance Durable Medical Equipment Supplier" web page. All OTC products covered by NYRx with a prescription or fiscal order can be found using the search tool, located on the. There will be an approved response message sent alerting the pharmacy that the claim paid as a transition fill. Questions regarding the Preferred Diabetic Supply Program may be submitted via the contact form. These policy goals are outlined in slide # 4 of the August 17th, 2020 All Stakeholder meeting. Limited Distribution drugs remain available following the Pharmacy Benefit Transition on April 1, 2023. Claim submission is not proof that the prescription or fiscal order was actually furnished. The Scope of Benefits document includes a high-level summary of the NYS Medicaid outpatient pharmacy benefit and denotes whether the benefit is subject to the transition and whether the MMC Plan should also continue to make the benefit available when provided by a non-pharmacy provider. What pharmacies will accept NYRx? Prior Authorizations that were issued by Medicaid Managed Care (MMC) plans prior to April 1, 2023 (that are active/valid after April 1, 2023) have been honored by the Medicaid Pharmacy program, NYRx. The shift to NYRx today will greatly enhance patient access to lifesaving medications and other pharmacy services in both rural and urban areas across the state. Vitamin B12 - injection/nasal. If there is an issue at the pharmacy with obtaining the fill, you should ask the pharmacist to call the Magellan call center at 877-309-9493. If your pharmacy does not take Medicaid Fee for Service, you may: Ask your doctor to send a new prescription to a pharmacy that takes Medicaid Fee for Service, or Ask your pharmacist to transfer a refill to a pharmacy that takes Medicaid Fee for Service. NYS Medicaid members have comprehensive drug coverage and equitable access to an extensive network of over 5,000 pharmacy providers. For Durable Medical Equipment (DME) PA guidelines, providers should refer to the, For ePACES PA guidelines, providers should refer to the, PA forms (EMEDNY-361502 for paper submission) are available by contacting eMedNY by telephone at. Please refer to the January 2023 Medicaid Update Special Addition Part Two for more information. If there is an issue at the pharmacy for a drug or supply that has already been approved, ask the pharmacist to call the Magellan call center at 877-309-9493. NYS DOH will work closely with the MCPs to provide access to pharmacy data that is necessary to support the activities for which they are responsible. Prior approval is also required if the fiscal order written by the ordering provider exceeds the quantity or frequency limits found in the New York State Medicaid Program Durable Medical Equipment, Prosthetics, Orthotics, and Supplies - Procedure Codes and Coverage Guidelines. Pharmacy Information for Consumers, Pharmacies, Providers, Pharmacy Frequently Asked Questions (FAQs). It is the intent of NYS DOH to continue to utilize that process consistent with how it has been handled in NYRx. Providers must use the Member Fact Sheet to provide members with the resources and information they need regarding the benefit transition. Please refer to the links below for more information: Providers will need to obtain a new prior authorization for oral enteral products. Appendix C: Member Fact Sheet. Provide a single drug formulary with standardized utilization management protocols. For all Medicaid members affected by this change, our goal is to make this transition as seamless as possible by providing you the information and resources you may need in preparation for the move from your MC to NYRx. For provider assistance with prior authorizations, clinical concerns, and the Preferred Drug Program, contact the Magellan Clinical Call Center at (877) 309-9493.

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