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New York State Visit us online: www.health.ny.gov
ATTENTION PROVIDERS & PHARMACISTS: See pages 19-21 for important information
for Medicaid Managed Care and Family Health Plus beneficiaries!
September 2011 Medicaid Update page 2
September 2011 Medicaid Update page 3
September 2011 Medicaid Update page 4
September 2011 Medicaid Update page 5
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September 2011 Medicaid Update page 7
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September 2011 Medicaid Update page 8
September 2011 Medicaid Update page 9
PHARMACY UPDATE
September 2011 Medicaid Update page 10
PHARMACY UPDATE
September 2011 Medicaid Update page 11
PHARMACY UPDATE
September 2011 Medicaid Update page 12
Please visit the following site for more information:
http://oneandonlycampaign.org/content/healthcare-provider-information.
September 2011 Medicaid Update page 13
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September 2011 Medicaid Update page 15
Office of the Medicaid Inspector General:
Provider Manuals/Companion Guides, Enrollment Information/Forms/ Training Schedules:
Do you have questions about billing and performing MEVS transactions?
Provider Training:
Enrollee Eligibility:
Address Change?
Fee-for-Service Providers:
Rate-Based/Institutional Providers:
Does your enrollment file need to be updated because you've experienced a change in ownership?
Do you have comments and/or suggestions regarding this publication?
September 2011 Medicaid Update page 18
You must use your health plan card to receive your prescriptions, not your Medicaid benefit card, effective October 1, 2011.
During August 2011, your health plan sent you information about your pharmacy benefit and what drugs are included under your health plan. If you have any questions, please contact your health plan directly.
Health plans each have their own list of drugs. If a drug is not on your health plan’s list, you or your pharmacist may need to talk to your doctor about changing to a drug on your health plan’s list, or your doctor can ask the plan to let you continue taking the same drug. Information regarding what drugs are on your health plan’s list were sent to you by your health plan at the end of August.
If you are taking a drug that is not on your plan’s list and you are unable to contact your doctor to change to a covered drug, your health plan will allow a one-time only fill of your medication.
You must use a pharmacy that takes your health plan. If your pharmacy does not take your health plan, you may need to obtain new prescriptions from your doctor to bring to a plan pharmacy. More information regarding your plan’s participating pharmacies will be sent to you at the end of August.
Your co-payments for drugs will not change.
ATTENTION: PROVIDERS AND PHARMACIES Please assist us in notifying beneficiaries of this upcoming program change by displaying this poster and Frequently Asked Questions (FAQs) document
in your practice. Feel free to copy and distribute.
ATTENTION: MEDICAID MANAGED CARE AND FAMILY HEALTH PLUS MEMBERS
EFFECTIVE OCTOBER 1, 2011, PHARMACY BENEFITS WILL BE PROVIDED BY YOUR HEALTH PLAN
Frequently Asked Questions (FAQ)
ATTENTION: MEDICAID MANAGED CARE AND FAMILY HEALTH PLUS MEMBERS
EFFECTIVE OCTOBER 1, 2011, PHARMACY BENEFITS WILL BE PROVIDED BY YOUR HEALTH PLAN
Frequently Asked Questions (FAQ)
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