Member Materials

• Member Fact Sheet: What You Need to Know (Web)
• Dual Eligible Member Notice of Change - (PDF)
• Member Notice of Change - (PDF)
• Mailing Schedule for Member Notice of Change - (PDF)
• Restricted Recipient Program (RRP) Member Notice - (PDF)
• User Guide for Member Tools - (PDF)

Pharmacy Benefit Transition

• Pharmacy Checklist - (PDF) - Updated 03.15.2023
• Pharmacy Quick Reference Guide - (PDF) - Updated 03.23.2023
• Scope of Benefits - (Web) - (PDF) - Updated 12.1.2023
• Transition and Communication Activities Timeline - (Web) - (PDF) - Updated 3.30.2023
• 1557 Non-Discrimination and Language Services Template - (PDF)
• Frequently Asked Questions (FAQs) - (Web) - (PDF) - Updated 6.20.2023
• Roles & Responsibilities - (Web) - (PDF) Updated - 12.1.2023

Practitioner Administered Drugs (PADs) Added to NYRx Formulary - (Web) - (PDF) - Updated 8.2.2023

NYS DOH analyzed PADs that are provided as a Pharmacy Benefit through MMC Plans. As a result of this analysis, NYS DOH has added certain PADs to the NYRx formulary. Please note: PADs dispensed as a Pharmacy Benefit must be delivered by the pharmacy directly to the site of administration. Additional information regarding pharmacy dispensing of PADs and delivery requirements can be found in the NYRx, The NY Medicaid Pharmacy Program - Pharmacy Manual Policy Guidelines, under the following sections: "Pharmacy Dispensing of Drugs That Require Administration by a Practitioner" and "Delivery". These requirements ensure proper storage and handling.

Presentations from All Stakeholder Meetings:

Transition of the Pharmacy Benefit from Managed Care to NYRx:
Implementation Update

• June 21, 2023 - (PDF)
• May 16, 2023 - (PDF)
• April 18, 2023 - (PDF)
• March 21, 2023 - (PDF)
• February 21, 2023 - (PDF)
• January 17, 2023 - (PDF)
• December 20, 2022 - (PDF)
• November 17, 2022 - (PDF)
• October 18, 2022 - (PDF)
• September 20, 2022 - (PDF) (Updated)
• August 16, 2022 - (PDF)