NYRx, a new pharmacy benefit program for Medicaid recipients, is launched

Gov. Kathy Hochul announced the launch of NYRx, the state’s new pharmacy benefit program that is designed to improve prescription drug access and coverage for the eight million New Yorkers enrolled in Medicaid statewide.

According to a statement from Hochul”™s office, the new program will “enable Medicaid recipients to access more prescription medications with fewer restrictions, reduce confusion over the brand-name and generic drugs covered by the program, and create the largest pharmacy network in New York State.” Under the NYRx model, New York State’s Medicaid program will pay pharmacy costs directly, eliminating the need for managed care organizations to administer this benefit through pharmacy benefit managers.

The new program also expands access to a statewide network of more than 5,000 pharmacies while establishing a single list of the brand-name and generic medications that are covered, including all FDA-approved medications.

“The transition to NYRx today is in the best interest of those New Yorkers relying on Medicaid for affordable prescription medication,” Governor Hochul said. “In addition to expanding coverage and access through this program, we are also committing hundreds of millions of additional Medicaid dollars to reinvest in critical providers, including Ryan White programs and Federally Qualified Health Centers, to ensure this change is seamless and has positive impacts across our state.”

The new program was initially adopted in 2020 in the Fiscal Year 2021 Budget but was delayed by the Fiscal Year 2022 Budget that pushed implementation until April 1, 2023.