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Transition of the Pharmacy Benefit from Managed Care to Fee-for-Service

Posted 3/1/2021 at 12:38 PM

Starting March 1st, we're transitioning select physician-administered drugs to the Healthfirst medical benefit

Effective May 1, 2021, at the direction of the New York State Department of Health (NYSDOH), Medicaid Managed Care (MMC) plans will move the pharmacy benefit into the NYS Fee-for-Service (FFS) program. To prepare for this change, on March 1, 2021, Healthfirst will transition select physician-administered drugs paid under the pharmacy benefit to the Healthfirst medical benefit.

For more information, including to view the list of physician-administered drugs, click here.