MedicaidCoverageMedium impact
Newsletter Vol. 20, No.23
New Jersey Medicaid·NJ · Psychiatry·Pharmacy
Effective date
Sep 25, 2010
We identified it
Jun 20, 2026
Summary
New Jersey General Assistance (GA) program immediately discontinued coverage for most Eli Lilly drug products (Labeler Code 00002), with limited exceptions for Zyprexa and Symbyax requiring prior authorization until November 1, 2010. This change does not affect Medicaid/NJ FamilyCare coverage of Eli Lilly products.
Action Required
Immediately: Billing team must update pharmacy billing system to deny General Assistance claims for all Eli Lilly products (Labeler Code 00002) except Zyprexa and Symbyax. Configure system to generate Error Code 570 for denied claims. For Zyprexa and Symbyax GA claims, require prior authorization (Error Code 577) only for existing patients with service dates before November 1, 2010. Stop processing all Eli Lilly GA claims after November 1, 2010.