All PlansPrior AuthMedium impact

Newsletter Vol. 11, No. 49

Q: Who is affected by this change?

This affects New Jersey Medicaid Gastroenterology, Family Medicine, Internal Medicine, General Practice providers in NJ on All Plans plans.

New Jersey Medicaid·NJ · Gastroenterology, Family Medicine, Internal Medicine +1 more·Prior Authorization

Effective date

Not stated

We identified it

Jun 20, 2026

Days to comply

—

Summary

New prior authorization standards are being implemented for concurrent utilization of acid-related disorder drugs (PDUR). This affects practices prescribing multiple acid reflux/GERD medications simultaneously and requires compliance with new utilization management criteria.

Action Required

Action needed

Immediately: Review new PDUR standards for acid-related disorder drugs at https://www.njmmis.com/documentDownload.aspx?document=11-49.pdf. Providers must ensure concurrent prescriptions for acid reflux medications meet new utilization criteria. Update EMR alerts for potential drug interactions or duplications. Failure to comply may result in prior authorization denials for overlapping acid-related disorder medications.

Related policy hubs

New Jersey Medicaid policies NJ policy changes Gastroenterology Family Medicine Internal Medicine General Practice