MedicaidAdministrativeMedium impact
Senior Services News Vol. 8, No. 01
New Jersey Medicaid·NJ · Pharmacy·Prior Authorization
Effective date
Jul 1, 2003
We identified it
Jun 20, 2026
Summary
New Jersey eliminated funding for the Drug Utilization Review Council (DURC) effective July 1, 2003. The DURC Formulary remains in effect until May 17, 2004, after which the state will transition to using the FDA's Electronic Orange Book as the official list of interchangeable drug products for generic substitution. Pharmacists must now verify generic substitutions against both the existing DURC formulary and the FDA Electronic Orange Book, obtaining prescriber permission when products appear on neither list.
Action Required
By May 17, 2004: Pharmacy and billing teams must prepare to transition from the DURC Formulary to the FDA Electronic Orange Book for verifying interchangeable drug products. Update pharmacy verification procedures to reference www.fda.gov/cder/ob for all new generic product approvals. Until the transition date, continue using the DURC Formulary (current through July 7, 2003) as the primary reference. Train pharmacy staff that when a potential generic substitute does not appear on either the DURC Formulary or Electronic Orange Book, prescriber consultation and written permission must be obtained before dispensing per N.J.S.A. 24:6E-8. Failure to follow substitution protocols may result in claim denials or regulatory violations.