MedicaidReimbursementHigh impact
Newsletter Vol. 12, No. 08
New Jersey Medicaid·NJ · Pharmacy·Reimbursement
Effective date
Nov 20, 2001
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid updated the Maximum Allowable Cost (MAC) drug reimbursement list effective November 20, 2001. Pharmaceutical providers must replace the prior MAC drug list (dated December 7, 2000) with the revised list (dated November 11/20/2001) containing updated federal upper limits for generic drugs across multiple NJ programs including Medicaid FFS, NJ FamilyCare FFS, General Assistance, PAAD, and others. Changes from the prior list are highlighted in bold.
Action Required
By November 20, 2001: Pharmacy billing team must immediately replace the December 7, 2000 MAC drug list (APPENDIX B) with the revised November 20, 2001 MAC drug list in the Pharmaceutical Services Manual. Update all pharmacy billing software and systems to reflect the new maximum allowable cost limits for all generic drugs listed in the new APPENDIX B. Verify that claims for MAC drugs submitted on or after November 20, 2001 use the updated pricing limits; claims using old pricing will be subject to adjustment or denial. Key contact: Chief, Pharmaceutical Services, DMAHS at (609) 588-2724 for questions.