All PlansAdministrativeMedium impact
Newsletter Vol. 15, No. 05
New Jersey Medicaid·NJ·Provider Notice
We identified it
Jun 20, 2026
Summary
This policy update introduces enhanced coordination of benefits procedures for pharmacy claims. The change affects how billing teams must handle prescription drug coverage when patients have multiple insurance plans, requiring updated workflows for determining primary and secondary payers for pharmaceutical benefits.
Action Required
Review the full policy document at https://www.njmmis.com/documentDownload.aspx?document=15-05.pdf to understand specific coordination of benefits requirements for pharmacy claims. Update billing procedures to ensure proper primary/secondary payer determination for prescription medications. Train staff on new pharmacy benefit coordination workflows.