Manufacturers are often intimidated when directed by New York to participate in Medicaid, due to the uniqueness of their programs. We aim to eliminate confusion in navigating these processes to resolution. In this blog post, we’ll walk you through a summary of the most recent changes to the New York Medicaid programs.

State Medicaid programs’ relationships with managed care organizations that serve Medicaid recipients continue to evolve. Just when it appears that trends are slowing or stabilizing, a new method is introduced. The latest development could overlap existing state controls to bring even more pharmacy control back to state management.

The management and reimbursement of inpatient drug costs in Medicaid programs are pivotal topics, especially with the proliferation of high-cost therapies. The emergence of expensive inpatient drugs, such as cell and gene therapies, have challenged Diagnosis Related Groups (DRGs), the traditional bundled payment system used by hospitals.