MedicaidPrior AuthHigh impact
NYRx Transition Fill Period Ending
Healthfirst·NY·Provider Update
Effective date
Jul 1, 2023
We identified it
Jun 20, 2026
Summary
NYRx transition fill period for Medicaid pharmacy benefits ends July 1, 2023, meaning the one-time 30-day transition fills for non-preferred drugs requiring prior authorization will no longer be available. All claims will be subject to NYRx Preferred Drug List requirements and prior authorization processes.
Action Required
By July 1, 2023: Providers must review the NYRx Preferred Drug List and either switch Medicaid patients to preferred products or obtain prior authorizations for non-preferred drugs by calling 1-877-309-9493. Billing team should update workflow to verify drug coverage against NYRx PDL before prescribing. Failure to obtain required prior authorizations will result in claim denials.