The transition of the Pharmacy Benefit from Managed Care to Fee-for-Service
Starting from May 1, 2021, Medicaid Managed Care (MMC) plans will move the pharmacy benefit into the NYS Fee-for-Service (FFS) program. In preparation for this change, on March 1, 2021, Healthfirst transitioned select physician-administered drugs paid under the pharmacy benefit to the Healthfirst medical benefit. To find out more, read along!
Applies to: Healthfirst Medicaid and Personal Wellness Plan (PWP)
Effective May 1, 2021, at the direction of the New York State Department of Health (NYSDOH), Medicaid Managed Care (MMC) plans will move the pharmacy benefit into the NYS Fee-for-Service (FFS) program. To prepare for this change, on March 1, 2021, Healthfirst will transition select physician-administered drugs paid under the pharmacy benefit to the Healthfirst medical benefit.
