Pharmacy Services

Medicaid and Healthier Life (HARP) Statewide Medication-Assisted Treatment (MAT) Formulary Update

8/30/2021 • Posted by Provider Relations

The New York State Executive Budget for State Fiscal Year 2020-2021, in accordance to § 367-a (7) (e) of Social Services Law, enacts a statewide formulary for Opioid Antagonists and Opioid Dependence Agents for Medicaid Managed Care (MC) Plans and Medicaid Fee for Service (FFS) Program, starting October 1st 2021. Under this statewide formulary (link provided below), Medicaid MC and FFS members will follow a single formulary, where preferred products and coverage parameters are consistent across the Medicaid Program.

For more information, please visit https://newyork.fhsc.com/providers/mat.asp.


 

Click the categories below for important pharmacy documents and resources. 

Formularies

Child Health Plus (CHP) 

2022 Drug Formulary (PDF)


HealthierLife (HARP) and Medicaid Managed Care

2022 Drug Formulary (PDF)


Qualified Health Plans (Metal-Level Products)

2022 Formulary (PDF)


Essential Plan

2022 Formulary (PDF)


Wellcare By Fidelis Care Medicare and Dual Advantage Plans 

2022 Formulary

Notice of Changes

    Covered Diabetes Meters and Testing Supplies

    2022 Wellcare By Fidelis Care Step Therapy (ST) Criteria (PDF)

    2022 Wellcare By Fidelis Care Prior Authorization (PA) Criteria (PDF)

    2022 Wellcare By Fidelis Care Medication Request Form (PDF)


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    Authorization Grids

    Authorization Grids for Medicare, Medicaid, CHP, and NYSOH Marketplace plans.