Welcome to the NY Medicaid Pharmacy Program (NYRx)

Information about Medicaid´s Prescription Drug Benefit and Changes Coming April 2023

Member Quick Links

All Stakeholders Meetings
NYSDOH hosts a monthly All Stakeholders webinar about the pharmacy benefit transition. Members, providers, and all interested stakeholders are welcome to attend. Registration information will be posted one week prior to each webinar date.

Upcoming webinars:

    • December 20, 2022 at 1:00 PM - Updated
      • To streamline the Q&A process, stakeholders may submit questions ahead of the webinar by using the Slido form and passcode: rxtransition2023.
      • Click “Add label” to categorize your question. This helps with organization and efficiency.
      • Please submit questions no later than Tuesday, December 13, 2022.
      • The NYRx team will review questions received in Slido and answer them at the All Stakeholders Meeting. They will also answer questions received during the meeting, but please bear in mind that not all questions may be answered due to time constraints.
    • January 17, 2023 at 1:00 PM
    • February 21, 2023 at 1:00 PM

    Presentations from past meetings are available in the Document Repository.

Beginning April 1, 2023, all Medicaid consumers enrolled in Mainstream Managed Care will receive their prescription drugs through NYRx, the Medicaid Pharmacy Program. NYRx allows New York State to pay pharmacies directly for the drugs and supplies of Medicaid consumers.

Prior to April 1, 2023, Mainstream Medicaid consumers accessed their pharmacy benefits through a health plan, rather than Medicaid Fee-For Service (NYRx). This includes anyone in Managed Care (MC) plans, Health and Recovery Plans (HARPs) and HIV-Special Needs Plans (HIV-SNPs). In this case, the state reimburses the health plan rather than the pharmacy.

Moving all Medicaid consumers under the NYRx Program allows for a single, uniform list of covered drugs and standardized, consistent rules and regulations. Thus, New York State is able to offer an improved, simplified process for Medicaid consumers to get the medicines and supplies they need. Medicaid consumers have comprehensive drug coverage and equitable access to an extensive network of over 5,000 pharmacy providers.

This transition does not apply to Managed Long Term Care plans (e.g., PACE, MAP, MLTC) or the Essential Plan.

We are committed to providing effective communication in preparation of this change to all Medicaid consumers, pharmacies and providers.

Please see Navigation Bar to the left for more information, FAQs, guidance and resources.

Contact Information

mail icon
phone icon
listserv icon
By email: NYRx@health.ny.gov. By phone:
The Medicaid Helpline can help you in your preferred language: 1-800-541-2831
Open Monday - Friday, 8 am - 8pm and Saturday, 9am - 1 pm
If you are interested in receiving MRT email alerts, visit the MRT LISTSERV web page to subscribe.