MedicaidReimbursementMedium impact
Newsletter Vol. 12, No. 14
New Jersey Medicaid·NJ·Pharmacy
Effective date
Jan 22, 2002
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid has suspended Maximum Allowable Cost (MAC) pricing for several generic drugs due to marketplace unavailability, and updated MAC prices for 15 other medications. This affects reimbursement rates for pharmacy services under Medicaid.
Action Required
Pharmacy billing teams must update their systems to reflect suspended MAC pricing for 9 generic drug products (including brompheniramine/codeine combinations, diltiazem, isosorbide dinitrate, loperamide, nitroglycerin patches, perphenazine, and prazosin) and apply new MAC prices for 15 medications listed in the policy. Review current inventory and billing rates to ensure compliance with updated Medicaid reimbursement limits.