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1/24/23 ACTION ALERT (NY): ACT to Counter Repeal of Medicaid Pharmacy Benefit Expansion
Yet again, we’ve learned opponents are actively working behind the scenes to convince New York state leaders to repeal or delay the pro-patient and pro-pharmacy NYRx Medicaid pharmacy benefit expansion set for April 1, 2023. To counter this, NACDS RxIMPACT is calling on YOU to use our online letter-writing system to remind Governor Kathy Hochul and state legislators the program will be of great benefit to New York patients and that it would create a system that is fairer for the pharmacies on whom New York patients rely!

With the new 2023 legislative session just starting this month, NACDS RxIMPACT needs your help to bring the NYRx Medicaid Pharmacy Benefit expansion back into focus with the New York Governor, Senate, and Assembly – the newly elected and re-elected alike. Although the pharmacy community has maintained strong advocacy for this policy over the last several months, more work needs to be done if the community will be effective in its efforts.

April 1st is just over two months away. Whether you have engaged in this campaign before or not, NACDS RxIMPACT is calling on YOU to send letters using our online letter-writing system.

New York is seeking to join other states that have moved or are planning to move prescription drug coverage from Managed Care plans which are administered by pharmacy benefit managers (PBMs) back to Medicaid Fee for Service (FFS), so they are directly administered by the State. For the past three years, the State has been staging its “NYRx” April 2023 reform and has the operational systems and vendors in place to help ensure a smooth and positive change for Medicaid patients.

Put simply, this means:
1. The NY Health Department will administer all enrollee pharmacy benefits as it did before the shift to Managed Care Medicaid;
2. Funds going to health insurers/PBMs will be redirected to support NY Medicaid beneficiary care; and
3. Expansion of patient access, care quality improvement, and process simplification with one payer (FFS) and one formulary.

This is the right time to put the necessary reforms in place for New York Medicaid’s pharmacy program so resources currently used to pay health plans and PBMs go to actual care. These reforms will provide expanded and equitable care for all enrolled in Medicaid without restrictive pharmacy networks, limiting patient choice, and limited drug formularies.

Join this NACDS RxIMPACT effort to remind Governor Hochul and state legislators the program will be of great benefit to New York patients and that it also helps to treat pharmacies more fairly. To act, please type in your contact information, and click "Send Message" to send separate messages to your legislators and Governor Hochul.

If you have any questions or would like any assistance, please contact Heidi Ecker via telephone at 703-837-4121 or email hecker@nacds.org.

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