Amida Care Celebrates Delay Of Medicaid Pharmacy Carve-Out In New York State Budget

Amida Care, New York State’s largest not-for-profit Medicaid Special Needs Health Plan (SNP) designed for New Yorkers living with complex conditions like HIV.

Has issued the following statement from President and CEO Doug Wirth following the news that the Medicaid pharmacy carve-out has been delayed by two years in the final New York State budget:

“Amida Care celebrates the two-year delay of the Medicaid pharmacy carve-out, which preserves our whole-person model of care. The proposed reform would have harmed millions of New Yorkers by changing how they access their prescription drugs. Instead of the pharmacy benefit being managed by community health plans like Amida Care, who work closely with safety-net providers and the patients they serve, the pharmacy benefit would have been managed by a single State contractor. This change would have left the New Yorkers who need the most care to contend with a one-size-fits-all bureaucracy.”



“The delay also protects our provider network by preserving millions of dollars in annual 340B program savings that permit providers to focus on medically underserved New Yorkers. Their services are essential to addressing long-standing health inequities–particularly pronounced among New Yorkers of color, people of transgender experience, and other underserved populations.”

“This policy achievement would not have been possible without the dedication of individual New Yorkers and committed coalitions who stood steadfast throughout the past year. With a unified voice, beneficiaries (or consumers), health plans, community health centers, HIV community-based organizations, Ryan White providers, and safety-net hospitals rallied together. We lobbied elected officials, held press conferences, published op-eds, signed petitions, and personally testified before anyone willing to listen. We thank Senate Majority Leader Andrea Stewart-Cousins, Speaker Carl Heastie, and the New York State Legislature for delaying the pharmacy carve-out in the final budget.”

“It is important to breathe a sigh of relief, but the work is not done. Amida Care stands ready to work with the State Department of Health and with the Legislature on other means of achieving the policy objectives intended by the carve-out that will not disrupt the safety-net and the HIV SNP model of care. As always, we look forward to partnering with the State on policies that will help end the HIV epidemic in New York, eliminate disparities in health care access and outcomes, and improve the health of all New Yorkers.”

Amida Care Inc. is a not-for-profit health plan that specializes in providing comprehensive health coverage and coordinated care to New Yorkers with complex conditions, including HIV and behavioral health disorders, and people who are of transgender experience or homeless (regardless of HIV status).

Amida Care has a wide network of health care providers throughout New York City and is the largest Medicaid Special Needs Health Plan (SNP) in New York State.

For more information, visit www.amidacareny.org

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