NY S07894

Creates a new "qualified prescription drug system" for managed care providers under Medicaid, Family Health Plus, and Child Health Insurance programs, allowing them to manage prescription drug formularies and prior authorization processes

Requires managed care providers to include prescription drug payments in capitation payments only if they operate an approved qualified prescription drug system; otherwise, drugs are provided through the state's preferred drug program

Establishes criteria for qualified prescription drug systems including 24/7 phone and fax support for prior authorization requests, with decisions required within 24 hours or automatic approval granted

Exempts from prior authorization requirement atypical anti-psychotics, anti-depressants, anti-retrovirals for HIV/AIDS or Hepatitis C, anti-rejection drugs for transplants, and other mental illness or HIV/AIDS treatments approved by the commissioner

Takes effect 180 days after enactment, with repeal of prior managed care provider payment provisions taking effect one year later