NEW YORK STATE TO SIGNIFICANTLY EXPAND PHARMACY BENEFITS IN JUST 15 DAYS
Yet One-House Budgets Put PBM Interests before Patients-Calling for Repeal
“On behalf of community pharmacies across the state, collectively represented by our associations, we were very disappointed to see the Senate and Assembly budget bills repeal the scheduled shift of the Medicaid pharmacy benefit from Medicaid Managed Care to NYRx taking effect in just 15 days on April 1, 2023.”
“While repeal may serve managed care plan and pharmacy benefit manager (PBM) interests and allow them to continue to serve as middlemen administering pharmacy benefits for those enrolled in Medicaid which only blocks and hinders patients access to care. Further, repeal would continue to squander state resources which should instead go directly to patient care for the nearly 8 million individuals in the State with Medicaid.”
“We urge State Legislators to join with Governor Kathy Hochul in embracing this critical reform to:
· Remove PBMs and Health Plans from Patient Pharmacy Care
· Enable Patients to Use their Local Pharmacy that is Most Accessible
· Expand Drug Coverage to One Statewide Formulary that Covers 100% of FDA-Approved Medications
· Improve Care for Individuals with HIV, Hepatitis C, Diabetes, Asthma, Substance Use Disorders and Other Serious and Chronic Conditions
· Stop Paying Unnecessary “Middlemen” to Administer the Pharmacy Benefit
· Reinvest Hundreds of Millions of Dollars to Safety Net Providers through Supplemental Payments Not Subject to Annual Appropriations or Negotiations, which are More Reliable than the Federal 340B Program which is in flux.”
“Like other states (including California over a year ago), New York has rightly determined that it does not need to continue to pay MMC plans and PBMs to administer pharmacy benefits for Medicaid. These are the same plans which were found to be ripping off New York and other states’ Medicaid programs with dishonest and self-serving “spread pricing,” overcharging states and underpaying pharmacies to feed their own profits. By eliminating MMC plans and PBMs, New York can spend these resources on actual care for patients expanding covered medications and enabling patients to use the community pharmacy that is most accessible to them without network restrictions. This is how the planned transition of the Medicaid pharmacy benefit to NYRx on April 1st will put the nearly 8 million New Yorkers with Medicaid first through an equitable and transparent care model.”
“New York has been preparing for this shift for more than three years and has our full confidence and support that everything is in place to ensure a smooth and positive transition for patients in just two weeks.”
“Trust Your Local Pharmacist: NYS must stay the course to April 1st and enact this lifesaving reform.”
For more information on the Pharmacists Society of the State of New York (PSSNY), please visit https://www.pssny.org/
For more information on the Community Pharmacy Association of New York State (CPANYS), please visit https://www.cpanys.org/
