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) 

2021 Drug Formulary (PDF)

2021 Formulary Quick Reference Guide (PDF)


HealthierLife (HARP) and Medicaid Managed Care

2021 Drug Formulary (PDF)

2021 Formulary Quick Reference Guide (PDF)


Qualified Health Plans (Metal-Level Products)

2021 Formulary (PDF)


Essential Plan

2021 Formulary (PDF)


Fidelis Medicare Advantage and Dual Advantage Plans 

2021

2021 Formulary (PDF)

Changes to Fidelis Care’s Medicare Formulary (PDF)

2021 Step Therapy Criteria (PDF)

2021 Prior Authorization (PA) Criteria (PDF)


Provider Access Online

Verify member eligibility, check claims, and more.

Manuals and Forms

Provider manuals, tip sheets, important forms, and applications. 

Authorization Grids

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