MedicaidAdministrativeHigh impact
Medicaid Alert MA-2023-04
New Jersey Medicaid·NJ · Pharmacy·Coding
Effective date
May 12, 2023
We identified it
Jun 20, 2026
Summary
Effective May 12, 2023, New Jersey Medicaid is discontinuing pharmacy billing accommodations that were implemented during the federal Public Health Emergency. Practices must reinstate pre-PHE billing procedures, including reactivating prescription signature requirements and reverting 90-day supply dispensing and early refill allowances to standard limits.
Action Required
By May 12, 2023: Billing team and pharmacy staff must immediately revert to pre-PHE pharmacy billing procedures. (1) Reinstate signature requirements for all dispensed prescriptions in the Point-of-Sale (POS) system. (2) Stop dispensing 90-day supplies of maintenance medications; revert to standard supply limits. (3) Disable early prescription refill accommodations in billing software. (4) Update pharmacy workflow documentation and staff training to reflect standard billing practices. (5) Communicate changes to all prescribing providers. Failure to implement these changes will result in POS claims processing errors and potential claim denials for non-compliant prescriptions.