Date: May 27, 2008
The Chair adopted a new pharmacy fee schedule by emergency regulation effective July 11, 2007, and codified as Part 440 of the New York Code of Rules and Regulations. Pursuant to Section 440.5, the Pharmacy Fee Schedule is based on the New York State Medicaid Pharmacy Fee Schedule. The Board publishes the fee schedule using pricing data supplied by the New York State Department of Health. Recently, it was brought to the Board's attention that numerous brand name drugs listed on the fee schedule have incorrect prices which has resulted in substantial cost disparities between the drug acquisition price and the reimbursement price. The Department of Health confirmed that the data provided to the Board contained errors.
In order to resolve this issue, the Board has obtained the correct information. The Pharmacy Fee Schedule provided by the Department of Health will continue to contain the incorrect information until July 1, 2008. In the meantime, a list of corrected drug prices is available on the Board website in an Excel Spreadsheet format and as an Adobe Reader .pdf file. In order to access the files, click on the link for "Corrected Brand Drug Prices" to obtain the list. Payers must continue to use the Pharmacy Fee Schedule for drugs not contained within the corrected price list. Payers must use the amounts provided in the corrected price list for those drugs that are on the list.
Questions regarding any of these issues should be referred to the Office of General Counsel at (518) 486-9564.
Zachary S. Weiss