MedicaidReimbursementMedium impact
Newsletter Vol. 11, No. 19
New Jersey Medicaid·NJ·Pharmacy
We identified it
Jun 20, 2026
Summary
Medicaid has updated the Federal Upper Limit of Payment (FUL) for Maximum Allowable Cost (MAC) drugs, which affects reimbursement rates for prescription medications covered under Medicaid. This change impacts how much Medicaid will pay for certain generic and brand name drugs listed in Appendix B.
Action Required
Immediately: Review Appendix B of the policy document to identify which specific drugs have updated MAC pricing. Update billing system with new reimbursement rates for affected medications. Verify that current drug billing reflects the new Federal Upper Limits to ensure proper reimbursement from Medicaid.