COVID-19 Guidance for Medicaid Providers

  • Guidance is also available in Portable Document Format (PDF)

Medicaid Pharmacy Guidance Regarding the End of the Declared Disaster Emergency in the State of New York - COVID-19

As announced in Executive Order 210, the New York State Declared Disaster Emergency has ended, effective June 25, 2021. Consequently, the Medicaid Pharmacy Program will return to pre-emergency policies effective July 9, 2021, as outlined below.

Following the Declared Disaster Emergency, the Medicaid Pharmacy Program created allowances and distributed guidance regarding 90-day supplies, medication deliveries, drug supplies and shortages, and early refills. The previously distributed guidance may be found here, last updated April 6, 2020.

90 Day Supplies
  • Medicaid will continue to cover a 90-day supply for most prescription and over the counter (OTC) maintenance medications, in accordance with State and federal laws.
Medication Deliveries
  • Confirmation of delivery via phone call, text or email, in lieu of signature, has been discontinued. Pharmacies that choose to provide delivery must confirm receipt of medications by obtaining a signature at the time of delivery from the Medicaid member, their caregiver or their designee as required per Medicaid Policy.
Early Refills
  • Previous guidance allowing the use of the early refill override has been discontinued. Pharmacies responding to an early refill request from a member due to quarantine or outbreak should direct their inquiries to the Medicaid Pharmacy Program (518) 486- 3209. Use of the early refill override for a patient´s COVID-19 quarantine or outbreak must now be authorized by the Medicaid Pharmacy Program and be documented within the pharmacy´s processing system.
  • Note, pharmacy claims utilizing the early refill override for any reason require NYS Department of Health (DOH) approval.
  • The DOH continues to monitor override utilization. Claims submitted with the override without authorization are subject to audit and recovery by the NYS Office of Medicaid Inspector General.
Drug Supplies and Shortages
  • During the Declared Disaster Emergency, the Medicaid Pharmacy Program monitored prescription drugs supplies and OTC products for back orders and removed certain prior authorization requirements in order to improve access.
  • As of June 2021, there are no reported drug shortages. Therefore, on June 17, 2021, prior authorization requirements were reinstated for drugs previously reported in shortage.
  • For a complete listing of drugs in the Medicaid Fee-for-Service Preferred Drug Program please visit: here.

The above updates have been communicated to the Medicaid Managed Care plans.

Medicaid Managed Care plan questions may be directed to the specific plan. A complete list of Medicaid Managed Care plans can be found here.

For questions regarding this communication providers may e-mail the pharmacy mailbox at: or call (518) 486-3209.