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Newsletter Vol. 14, No. 43

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

Summary

Medicaid has updated the Federal Upper Limits of Payment for Maximum Allowable Cost (MAC) for prescription drugs, affecting reimbursement rates for pharmacy-related services. The specific drug list and new payment limits are detailed in Appendix B of the newsletter.

Action Required

Action needed
Immediately: Billing team should download and review Newsletter Vol. 14, No. 43 from the NJ MMIS website to identify specific drugs affected by the MAC payment limit changes. Update billing system with new reimbursement rates for affected pharmacy services. Verify current drug pricing against the updated Appendix B list to ensure accurate claim submissions.

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