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Traditional MedicareCoverageMedium impact

Newsletter Vol. 16, No. 14

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

Summary

Medicare Part D prescription drug coverage is entering its final transition phase for dual eligible beneficiaries (patients with both Medicare and Medicaid). This affects how prescription drugs are covered and billed for this specific patient population.

Action Required

Action needed
Review current dual eligible beneficiary prescription drug billing procedures. Verify that Medicare Part D is being billed as primary for prescription drugs instead of Medicaid for patients with both coverages. Contact pharmacy benefit managers if clarification is needed on coverage transitions.