Manufacturer Withdrawal from the Medicaid Drug Rebate Program (MDRP)

The Centers for Medicare and Medicaid Services (CMS), in compliance with Social Security Law Sec. 1927 [42 U.S.C. §1396r–8(a)], requires drug manufacturers to participate in the Medicaid Drug Rebate Program (MDRP) for their drugs to be eligible for coverage under the Medicaid program.

Effective January 1, 2026, several drug manufacturers have voluntarily withdrawn from participation in the Medicaid Drug Rebate Program (MDRP). In accordance with federal requirements, NYRx will no longer provide Medicaid coverage for drugs manufactured by the companies listed below.

Provider Action Required

Prescribers and pharmacies should assist members by:

• Transitioning to a therapeutically equivalent covered alternative, or
• Obtaining a new prescription for a covered product
• Providers are encouraged to verify drug coverage prior to prescribing or dispensing
• Physician administered service for these Drugs will be covered under the members Medical Benefit for Medicaid/ HARP

Manufacturers withdrawing from MDRP include:

Examples of impacted products include, but are not limited to:

• Labetalol HCL Tablet*
• Haloperidol Tablet*
• Mupirocin 2% Cream*
• Adapalene 0.3% Gel*
• Adapalene-Benzoyl Peroxide 0.1%–2.5% Cream*
• Diclofenac Sodium 1% Gel*
• Fraiche 5000 1.1% Dental Gel*
• Zemdri® 500 mg/10 mL vial
• Ixinity (Aptevo Biotherapeutics / Biothera)

Additional Resources

• Medicaid Pharmacy List of Reimbursable Drugs
• Practitioner Administered Drug (PAD) Search Tool
• Medicaid List of Covered Drugs and Over The Counter (OTC) Products
• New/Reinstated & Terminated Labeler Information

Questions?

For claims processing questions, call the eMedNY Call Center at 1-800-343-9000.

For NYRx coverage or policy questions call 1-518-486-3209 or email NYRx@health.ny.gov

For all other questions, please contact your network account manager, or Healthfirst Provider Services at 1-888-801-1660, Monday to Friday, 8:30am–5:30pm.