MedicaidCoverageMedium impact
Newsletter Vol. 12, No. 41
New Jersey Medicaid·NJ·Pharmacy
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid and NJ FamilyCare updated their Drug Rebate Programs by adding and removing pharmaceutical manufacturers from the approved labeler code list (Appendix F). This affects which drugs are eligible for rebate programs and may impact coverage and prior authorization requirements for certain medications.
Action Required
Review the updated Appendix F manufacturer labeler code list at https://www.njmmis.com/documentDownload.aspx?document=12-41.pdf to identify which pharmaceutical products may have changed coverage status. Billing team should verify current formulary status and prior authorization requirements for medications from affected manufacturers before submitting claims.