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Our attorneys stay on top of changes in legislation, agency regulations, case law, and industry trends—then craft timely legal alerts to keep clients up to date on legal developments important to their business.

March 17, 2020

NYS DOH Issues Emergency Medicaid Pharmacy Guidance

In response to the novel coronavirus (COVID-19) emergency, the NYS Department of Health issued guidance for the Medicaid program related to pharmacies, including deliveries, refills, priorities in the event of a supply chain failure or shortage, and other issues.

The guidance contains specific instructions regarding edits and documentation that are required to properly submit claims, and careful attention is necessary to ensure a clean claim. Pharmacies should confirm with all payors how dispensing should be documented if a state of emergency is enacted in your state.

Barclay Damon’s Health Care Controversies Team assists and guides independent pharmacies across the United States and has significant experience handling claims audits. We understand the unprecedented nature of this pandemic, but remind pharmacies that proper documentation is critical to avoiding recoupments and network terminations. Our highly experienced team is here to help.

If you have any questions regarding the content in this alert, please contact Linda Clark, Health Care Controversies Team leader, at lclark@barclaydamon.com; Brad Gallagher, counsel, at bgallagher@barclaydamon.com; or another member of the firm’s Health Care Controversies Team.

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