Mandatory Generic Drug Program Update

The New York State Medicaid Mandatory Generic Drug Program requires prior authorization
for brand-name prescriptions with an A-rated generic equivalent.

Effective November 15, 2009, new prescriptions for the brand-name drugs listed below will require prior authorization:
Bleph-10 10% eye dropsPamine 2.5 mg tablet
Fioricet-Codeine 30-50-325-40 capsulePamine forte 5 mg tablet
Keppra 100 mg/ml oral solutionVicodin 5-500 tablet
Keppra 250 mg, 500 mg, 750 mg, 1000 mg tabletWellbutrin XL 150 mg tablet
Lamictal 5 mg, 25 mg dispersible tabletZantac 15 mg/ml syrup
Lamictal 25 mg, 100 mg, 150 mg, 200 mg tabletZerit 1 mg/ml solution
Neocidin eye dropsZerit 15 mg, 20 mg, 30 mg, 40 mg capsule
Nitro-Dur 0.1 mg/hr, 0.4 mg/hr patch  

Prescriptions written prior to November 15, 2009, but filled on or after this date, including refills, will not require prior authorization. However, when the current prescription expires, a prior authorization will be required for the patient to continue to receive the brand-name drug.

  • PLEASE NOTE: Brand-name drugs that are on the Medicaid Preferred Drug List do not require prior authorization and are not subject to the Medicaid Mandatory Generic Drug Program prior authorization requirements.

For pharmacy billing questions, please call (800) 343-9000. For Medicaid pharmacy policy questions, please call (518) 486-3209