MedicaidPrior AuthHigh impact
Newsletter Vol. 16, No. 02
New Jersey Medicaid·NJ · Pharmacy·Pharmacy
Effective date
Jul 1, 2005
We identified it
Jun 20, 2026
Summary
Effective immediately (July 1, 2005), New Jersey Medicaid (NJFC, WFNJ/GA) now requires prior authorization for ALL narcotic drug prescriptions written for clients who are receiving methadone maintenance. Pharmacists will receive an edit 423 message at the point of sale and must call 1-877-888-2939 to obtain MEP (Medical Exceptions Process) approval before dispensing.
Action Required
Immediately: Billing and pharmacy teams must implement prior authorization workflow for all narcotic prescriptions for Medicaid clients receiving methadone maintenance. Update pharmacy systems to flag prescriptions with edit 423 requiring prior auth call to 1-877-888-2939 before dispensing. Providers must be notified that narcotic prescriptions for methadone-maintenance patients will trigger automatic prior authorization requirements. Failure to obtain prior authorization will result in claim denials and prescriptions cannot be dispensed.