MedicaidAdministrativeHigh impact
Medicaid Alert - MA-2002-06
New Jersey Medicaid·NJ·Provider Notice
Effective date
May 1, 2002
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid is automatically enrolling Aged, Blind and Disabled (ABD) beneficiaries in Camden County into HMOs starting May 1, 2002. Most prescription drugs will now be managed by HMOs, but certain psychiatric medications and methadone remain covered under fee-for-service Medicaid.
Action Required
Immediately: Pharmacy providers must follow HMO formulary and prior authorization procedures for all drugs except clozapine, risperidone, olanzapine, ziprasidone, quetiapine, and methadone (which remain fee-for-service). Contact appropriate HMO provider services for prior authorization - determinations must be made within 24 hours. Update billing systems to route prescription claims to HMOs rather than fee-for-service Medicaid for ABD beneficiaries in Camden County.