MedicaidCoverageHigh impact
Senior Services News Vol. 13, No. 03
New Jersey Medicaid·NJ · Pharmacy, Infectious Disease·Pharmacy
Effective date
Sep 1, 2010
We identified it
Jun 20, 2026
Summary
New Jersey is implementing the Temporary AIDS Supplemental Rebate and Federal Assistance Program effective September 1, 2010, replacing the AIDS Drug Distribution Program (ADDP) for approximately 960 eligible individuals. The new program covers only HIV/AIDS treatment drugs and medications that prevent AIDS complications for beneficiaries at 300-500% of federal poverty level; medications for other conditions (diabetes, hypertension) are no longer covered and will generate error code 2125.
Action Required
REQUIREMENTS:
By August 31, 2010: Pharmacy billing staff must prepare for the transition from ADDP to the new Temporary AIDS Supplemental Rebate and Federal Assistance Program.
Starting September 1, 2010: Billing staff must update pharmacy billing system to recognize that the same ADDP identification number now routes to a LIMITED COVERAGE PROGRAM with restricted drug coverage.
Immediate actions for all pharmacy providers:
- Remove from claims all non-HIV/AIDS medications (e.g., diabetes drugs, hypertension medications) for beneficiaries using the ADDP ID after September 1, 2010
- Expect error code 2125 ("Drug not covered for ADDP Limited Coverage Program") on all ineligible claims
- Verify each medication against the provided covered drug list before submission
- Contact ADDP program at 1-877-613-4533 with billing questions or claim denials
- Retain this policy document for reference during the transition
During August 1-31, 2010 (transition month): Continue billing using ADDP ID for all covered medications under old rules. Switch to new restricted coverage rules on September 1, 2010.