MedicaidReimbursementMedium impact
Newsletter Vol. 12, No. 18
New Jersey Medicaid·NJ · Pharmacy, Ophthalmology, Cardiology +3 more·Provider Notice
Effective date
Mar 5, 2002
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid is suspending Maximum Allowable Cost (MAC) pricing for two drug products (Hydrocortisone/Neomycin/Polymyxin B ophthalmic suspension and Propranolol 60mg tablets) effective March 5, 2002, and updating MAC prices for 11 additional generic medications. Billing teams must update pharmacy billing records and reimbursement rates to reflect the new MAC prices and remove suspended drugs from MAC billing.
Action Required
By March 5, 2002: Billing team must update pharmacy billing system to (1) remove Hydrocortisone 1%; 3.5mg/10000U/mL ophthalmic suspension 10mL and Propranolol HCl 60mg tablet 100-count from MAC pricing—these products will no longer be reimbursed at Federal Upper Limits; (2) update MAC prices in billing software for the 11 listed drugs (Albuterol, Allopurinol, Amitriptyline, Amoxicillin, Atenolol, Benztropine, Cimetidine, Furosemide, Isosorbide Mononitrate, Naproxen, Primidone) to match the new rates provided; (3) correct Methenamine product reference from 'Methenamine Hippurate 1gm' to 'Methenamine Mandelate 1gm' with FUL $0.2923 in Appendix B. Verify all changes are in place before processing claims with service dates on or after March 5, 2002. Claims using old suspended MAC prices or incorrect rates will be denied or require rebilling.