Mark Malahosky
“It’s not hyperbole to say if this is put into place, we’re going to have to cut services and cut staffing," Mark Malahosky of Trillium Health says of New York State's plan to shift Medicaid managed care prescription drug benefits into Medicaid fee for service.

New York State Medicaid Drug Benefit Transfer, on Ice for Two Years, Is Back

With a two-year implementation delay nearly over, New York State is poised to fold its Medicaid managed care prescription drug benefits into its Medicaid fee for service system on April 1. State 340B health care providers that serve high volumes of Medicaid beneficiaries say they still hope to stop the transfer, which they say would be catastrophic for them and their patients.

Under Medicaid FFS, providers must bill at acquisition cost for 340B-acquired drugs. Under Medicaid managed care, they can bill plans for 340B drugs at negotiated rates above their purchase costs. Providers say these margins pay for essential services to vulnerable New Yorkers.

With a two-year implementation delay nearly over, New York State is poised to fold its Medicaid managed care prescription drug benefits into its Medicaid fee for service system on April 1.

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