PULSE 10/23/2026: Provider-Administered Drugs Webinar Update
Provider-Administered Drugs Webinar Update Click to Enlarge NYRx, the Medicaid Drug Program, will host an additional webinar on PADs (Provider-Administered Drugs) on Monday, November 9 at 10:00 AM. Physicians are welcome to attend. The presentation will share updates and provide
PULSE 10/16/2026: NYRx: PDL & Prior Auth Updates
NYRx Cost Optimization Program Update Click to Enlarge NYRx’s September 10 Cost Optimization update and current Preferred Drug List (PDL) are available. Additional PDL and Brand Less Than Generic (BLTG) changes are scheduled for October 22. Beginning in November, prior
PULSE 7/31/2026: Payment & Practice: Turning Complex Payer Challenges Into $45 Million Recovered Revenue
Payment & Practice: Turning Complex Payer Challenges Into $45 Million Recovered Revenue Click to Enlarge Payer disputes can drain time, revenue, and staff capacity from practices already managing rising costs, workforce pressures, and growing administrative demands. For New York physicians,
PULSE 7/24/2026: NYRx Cost Optimization Program Update
NYRx Cost Optimization Program Update Click to Enlarge The New York State Medicaid Pharmacy Program (NYRx) has expanded its Cost Optimization Program, effective July 16, 2026, by adding additional high-cost drug formulations and dosages that are significantly more expensive than
PULSE Pulse 6/26/2026: NYRx Updates: Resources Available for Review
NYRx Updates: Resources Available for Review Click to Enlarge MSSNY recognizes that keeping pace with Medicaid pharmacy policy changes can be challenging amid growing administrative responsibilities. We encourage physicians, practice managers, billing teams, and clinical staff to review the available
PULSE 5/8/2026: Attention Physicians: Are You Being Underpaid by Optum?
Attention Physicians: Are You Being Underpaid by Optum? Click to Enlarge If you are billing CPT code 95165 and are being underpaid by Optum, please email our Physician Payment and Practice Division, as we may be able to help.
PULSE 4/17/2026: Payment & Practice: Turning Complex Payer Challenges Into $38 Million Recovered Revenue
Payment & Practice: Turning Complex Payer Challenges Into $38 Million Recovered Revenue Click to Enlarge Key Point: MSSNY’s Payment and Practice team has recovered $38 million since 2021, including $10.8 million so far in 2026, directly returning revenue to physician practices.Why It
PULSE 4/3/2026: Important Changes Coming to National Government Services
Important Changes Coming to National Government Services Click to Enlarge A message from National Government Services: National Government Services will begin operating as Wellpoint Federal on April 1, 2026. New name, same trusted partner For decades, we have empowered federal
PULSE 3/20/2026: Introducing the IDR Gateway
Introducing the IDR Gateway Click to Enlarge In the latter half of 2026, the Federal Independent Dispute Resolution (IDR) process will transition from single-use web forms to the new IDR Gateway, which will provide a secure, centralized platform that parties
PULSE 3/13/2026: Workers’ Comp Policy Needs Physicians
Workers’ Comp Policy Needs Physicians Click to Enlarge NY Workers’ Comp treatment guidelines shape care approvals, documentation, and reimbursement. MSSNY seeks physicians to help update these policies and ensure they reflect real clinical practice. Your voice matters. Learn More
