All PlansPrior AuthMedium impact
Newsletter Vol. 11, No. 48
New Jersey Medicaid·NJ · Oncology, Hematology, Nephrology +1 more·Provider Notice
We identified it
Jun 20, 2026
Summary
New Prior Drug Utilization Review (PDUR) standards have been implemented for three specific medications: Epoetin (used for anemia), Filgrastim (used for neutropenia), and Linezolid (antibiotic). These changes likely involve new prior authorization requirements or coverage criteria that will affect billing and prescribing for these drugs.
Action Required
Immediately: Review the full policy document at the provided URL to understand specific PDUR requirements for Epoetin, Filgrastim, and Linezolid. Billing team must identify affected HCPCS codes for these medications and update prior authorization workflows accordingly. Notify providers who commonly prescribe these medications about potential new coverage criteria or documentation requirements.