MedicaidCoverageHigh impact
Newsletter Vol. 13, No. 53
New Jersey Medicaid·NJ · Pharmacy·Pharmacy
Effective date
Oct 1, 2003
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid and NJ FamilyCare are delisting six pharmaceutical manufacturers (Bayer Corporation, Purdue, Solvay Pharmaceuticals, Weeks & Leo, and Syntex Laboratories) effective October 1, 2003. Any drugs manufactured by these companies will no longer be reimbursed by these programs as of that date. Billing teams must identify affected drugs and implement claim denial protocols.
Action Required
By September 15, 2003: Billing team must identify all drugs in the practice's formulary manufactured by delisted manufacturers (Labeler Codes: 00118, 00152, 00192, 00665, 11383, 18393). Update billing software to flag or deny claims for these manufacturers when billed to NJ Medicaid or NJ FamilyCare fee-for-service. Notify clinical staff to avoid prescribing these manufacturers' products to Medicaid/NJ FamilyCare patients or prepare alternative medication recommendations. Verify that PAAD Drug Rebate and Senior Gold Prescription Discount programs maintain separate coverage rules. Retain this newsletter for compliance documentation. Contact Division of Medical Assistance (609-588-2724) or Unisys Provider Services (800-776-6334) with questions. Failure to implement will result in claim denials and patient billing issues.