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Provider Alerts (Policy, Billing, or Coverage Update) - 2021
Pharmacy Billing Guidance for COVID-19 Vaccine Under Healthfirst’s Medicaid Managed Care Plan (MMC) and Personal Wellness Plan

Per New York Governor Cuomo’s Executive Order #202, during the declared disaster emergency, pharmacies may bill for COVID-19 vaccines that have been authorized by the FDA under Emergency Use Authorization (EUA) under Healthfirst’s Medicaid Managed Care Plan and Personal Wellness Plan. As additional COVID-19 vaccines become available under an EUA, or are otherwise approved by the FDA, this billing guidance will be updated as needed.
Medicaid Managed Care
  
Personal Wellness Plan
  
Pharmacy Billing
  
  
Pharmacy Billing Guidance for COVID-19 Vaccine Under Healthfirst’s Medicaid Managed Care Plan (MMC) and Personal Wellness Plan
Provider Alerts (Policy, Billing, or Coverage Update) - 2021
Transition of the Pharmacy Benefit from Managed Care to Fee-for-Service

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.
Medicaid Managed Care
  
  
Transition of the Pharmacy Benefit from Managed Care to Fee-for-Service

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