New York S06164 mandates Medicaid managed care and Child Health Plus plans to adopt the procedural protections of the Preferred Drug Program.

New York S06164 requires Medicaid managed care and Child Health Plus plans to adopt the procedural protections of the Preferred Drug Program, including "prescriber prevails" for all drugs. This means that when a prescriber prescribes a non-preferred drug, reimbursement may be denied unless prior authorization is obtained. However, no prior authorization is required for preferred drugs unless mandated by the clinical drug review program. The commissioner must establish performance standards for drugs, considering clinical significance and cost-effectiveness.

New York S06164 mandates Medicaid managed care and Child Health Plus plans to adopt the procedural protections of the Preferred Drug Program.

New York S06164 requires Medicaid managed care and Child Health Plus plans to adopt the procedural protections of the Preferred Drug Program, including "prescriber prevails" for all drugs. This means that when a prescriber prescribes a non-preferred drug, reimbursement may be denied unless prior authorization is obtained. However, no prior authorization is required for preferred drugs unless mandated by the clinical drug review program. The commissioner must establish performance standards for drugs, considering clinical significance and cost-effectiveness.