NEW YORK SUMMARY OF EXISTING LAW

As of June 2021, Medicaid explicitly permits white bagging, providing that practitioner-administered drugs dispensed as a Pharmacy Benefit must be delivered by the pharmacy directly to the site of administration. Must meet the following requirements:

1. Drugs should only be dispensed by the pharmacy directly to the patient when they are to be self-administered.
2. Prior to delivery of a practitioner-administered drug the dispensing pharmacy must confirm the delivery address, that the member still requires the drug, that an appointment has been scheduled and confirmed for its administration. Automatic refills are not permitted.
3. Delivery charges may not be billed to the member or Medicaid.
4. The pharmacy is responsible for preparing and delivering the drug in accordance with administration guidelines in the package insert, as well as the replacement of improperly stored, lost, or stolen drugs until confirmed receipt by the authorized agent.
5. The pharmacy must confirm an appropriate administration plan is in place for home deliveries.
6. The pharmacy is required to obtain documentation of delivery by the receipt of a signature of a recipient or an authorized agent at the site of administration.
7. All Medicaid claims for drugs that were not deliverable must be reversed within 60 days.
8. Once delivered and signed for, the site of administration is responsible for replacement of improperly stored, handled, lost, or stolen practitioner-administered drugs.

Brown bagging is not accepted under NYS Medicaid.

Links to Proposed Laws: Medicaid FFS Pharmacy Manual Policy Guidelines

PRACTICAL NOTE FOR EXISTING LAW

The New York Medicaid Manual specifically permits white bagging, provided it meets certain requirements. However, physicians can closely scrutinize the requirements and potentially use them to refuse acceptance of white bagged medications if they do not meet the requirements.