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Newsletter Vol. 19, No. 41

New Jersey Medicaid·NJ·Reimbursement
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply
—

Summary

Federal Upper Limits of Payment for Maximum Allowable Cost (MAC) drugs have been revised, affecting reimbursement rates for specific pharmaceutical products. Billing teams should review the updated Appendix B for new payment limits that may impact drug billing and reimbursement.

Action Required

Action needed
Immediately: Review Newsletter Vol. 19, No. 41 Appendix B to identify specific MAC drugs with revised federal upper payment limits. Update billing system fee schedules for affected pharmaceutical products. Verify current reimbursement rates against the new federal limits to ensure proper claim processing.

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