ALBANY, N.Y. (NEWS10)— Under NYRx, pharmacies are now being paid directly for prescriptions of 8 million New Yorkers enrolled in Medicaid.
“It cuts out the middleman, it takes out the inefficiencies,” said Amir Bassiri, New York’s Medicaid Director. “There used to be us paying a health plan, paying a PBM to pay the pharmacy, now the Medicaid program is paying the pharmacy directly.”
Bassiri said this provides a lower cost for the Medicaid program as a whole.
“Members will not see any change with respect to what drugs they can receive or what costs they have to pay.”
NYRx has been in effect for about a week.
Zarina Jalal, a pharmacist in Albany said this has been a welcomed change and so far it has been a smooth transition. She shared some advice for New Yorkers enrolled in Medicaid.
“Pharmacies may ask for their insurance card again,” explained Jalal. “In order for us to process your prescriptions at the pharmacy we need to have a call your client ID number which is the number that’s on your New York State Benefit Card. It should also be printed on your managed care card, we need that number in order to process your prescriptions for Medicaid.”
Governor Hochul proposed in the state budget that the money the state saves will go towards providers impacted by the transition to this new program.
“We are reinvesting about $425 million dollars to hospitals, $250 million to federally qualified health centers and community health clinics, and $30 million dollars to Ryan White Centers,” said Bassiri.