The Medicaid payment policy Ambulatory Patient Group Weight Adjustment to Dialysis Clinics for Phosphate Binder Costs that bundled phosphate binders into the dialysis clinic APG rate for Medicaid-only patients has been delayed until Jan. 1, 2026. Dialysis patients can continue to have prescriptions for phosphate binders filled at a New York State Medicaid pharmacy (NYRx) until Jan. 1, 2026.
Starting Jan. 1, 2026, phosphate binder prescription drugs for dialysis patients will no longer be covered as a pharmacy benefit and must be provided by the dialysis clinic. Dialysis patients should not be referred to a pharmacy to obtain phosphate binders.