MedicaidReimbursementMedium impact
Newsletter Vol. 13, No. 68
New Jersey Medicaid·NJ · Pharmacy·Pharmacy
Effective date
Nov 2, 2003
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid is updating Maximum Allowable Cost (MAC) pricing for multiple pharmaceutical products effective November 2, 2003. Three drugs have MAC suspended (Fluocinolone Acetonide, Pindolol), two drugs have price decreases (Acetaminophen/Propoxyphene Napsylate, Ipratropium Bromide), and two new drugs are added to the MAC list (Aspirin/Butalbital/Caffeine, Lovastatin). Billing teams must update pharmacy reimbursement rates in their systems to avoid claim denials or improper payments.
Action Required
By November 2, 2003: Billing team must update the pharmacy billing system with the following MAC pricing changes: (1) Suspend MAC for Fluocinolone Acetonide 0.01% Solution 60mL and Pindolol 5mg and 10mg tablets; (2) Update MAC prices to $0.1800 for Acetaminophen/Propoxyphene Napsylate (Darvocet) and $0.2340 for Ipratropium Bromide (Atrovent); (3) Add new MAC entries at $0.2400 for Aspirin/Butalbital/Caffeine (Floricet) and $3.2012 for Lovastatin 40mg (Mevacor). Providers must verify pharmacy claims system reflects new rates before service dates on or after November 2, 2003. Contact DMAHS at (609) 588-2724 with implementation questions. Failure to update rates will result in overpayments, underpayments, or claim rejections.