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MedicaidReimbursementMedium impact

Newsletter Vol. 12, No. 38

New Jersey Medicaid·NJ·Pharmacy
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply
—

Summary

This notification announces updated Federal Upper Limits of Payment for Maximum Allowable Cost (MAC) drugs under Medicaid, which affects reimbursement rates for prescription medications. The policy appears to reference Appendix B containing the specific drug list and payment limits.

Action Required

Action needed
Immediately: Review the complete policy document at the provided URL to identify specific MAC drug list changes and updated reimbursement limits. Pharmacy billing team should update drug pricing files in billing system to reflect new Federal Upper Limits. Verify current drug claims against new MAC limits to ensure proper reimbursement.

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