NYRx Cost Optimization Program Update
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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 authorization requirements for physician-administered drugs (PADs) will take effect for Medicaid fee-for-service patients. The NYRx standardized prescription PA form is available for reference, while clarification on PAD-specific forms remains pending.
A separate MCO radiology claims issue involving HCPCS denials has been resolved.
