MedicaidPrior AuthHigh impact
Newsletter Vol. 12, No. 57
New Jersey Medicaid·NJ · Family Medicine, Internal Medicine, General Practice +5 more·Provider Notice
Effective date
Jul 15, 2002
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid is reinstating Edit 577 effective July 15, 2002, requiring prior authorization for specific medications prescribed to Work First New Jersey/General Assistance single adults. Pharmacists must contact First Health Services at 1-877-888-2939 for prior authorization, which is limited to 30 days maximum.
Action Required
By July 15, 2002: Pharmacy staff must obtain prior authorization from First Health Services (1-877-888-2939) before dispensing any medications on the attached list to WFNJ/GA single adults. Update pharmacy systems to flag these claims with Edit 577 and Edit 423. Note that prior authorizations cannot exceed 30 days and early refill threshold increases to 90%. Claims without proper prior authorization will be rejected.