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Medicaid Drug Coverage

Formulary & Drug Lists for Medicaid Members

Medication-Assisted Treatment (MAT) Formulary Change

On December 22, 2021, Governor Hochul signed Chapter 720 of the Laws of 2021. This law amends Social Services Law and the Public Health Law, in relation to medication for the treatment of substance use disorders. Effective March 22, 2022, prior authorization will not be required for medications used for the treatment of substance-use disorder prescribed according to generally accepted national professional guidelines for the treatment of a substance-use disorder. Prescriptions written outside of accepted guidelines may be subject to prior authorization.

Medicaid Drug Coverage Policies

Avastin Coverage Policy

Herceptin Coverage Policy

Perjeta Coverage Policy

Xolair Coverage Policy

Drugs to Treat Duchenne Muscular Dystrophy (DMD) Coverage Policy