MedicaidAdministrativeMedium impact
Newsletter Vol. 15, No. 15
New Jersey Medicaid·NJ · Pharmacy·Eligibility
Effective date
Feb 15, 2006
We identified it
Jun 20, 2026
Summary
New Jersey pharmacy providers participating in Medicaid/NJ FamilyCare and state pharmaceutical assistance programs (PAAD, Senior Gold, ADDP, CF) must annually certify their pharmacy services using Form FD-70 to qualify for dispensing fee increments. Providers can earn fee increases of $0.15 (impact allowance), $0.11 (24-hour emergency service), or $0.08 (patient consultation) by meeting specific service requirements and submitting proper certification.
Action Required
By February 15, 2006: Pharmacy providers must complete and submit Form FD-70 (Pharmacy Provider Certification Statement) with a copy of valid pharmacy permit to Unisys, P.O. Box 4804, Trenton, NJ 08650-4804. ALL questions on the form must be completed or the form will be returned. Billing teams should verify: (1) Impact Allowance eligibility—confirm Medicaid/NJ FamilyCare/PAAD/ADDP/CF/Senior Gold prescription volume is ≥50% of total Rx volume; (2) 24-Hour Emergency Service availability and local phone number posting; (3) Patient Consultation agreement per N.J.A.C. 13:39-7.14 and OBRA 1993 requirements. Failure to submit by deadline results in automatic assignment of base dispensing fee WITHOUT any increments. If any service condition changes (e.g., discontinuing 24-hour service), notify Unisys in writing within 30 days (or 72 hours for 24-hour service discontinuation) or face retroactive reimbursement recovery. Update internal fee schedules to reflect applicable increments only after proper certification is received and processed.