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MedicaidPrior AuthMedium impact

Newsletter Vol. 10, No. 56

New Jersey Medicaid·NJ·Prior Authorization
Effective date
Aug 1, 2000
We identified it
Jun 20, 2026
Days to comply

Summary

New Jersey is discontinuing prior authorization processing for a specific list of drugs for Work First New Jersey/General Assistance (WFNJ/GA) beneficiaries in Newark, East Orange, Camden City, and Trenton. These drugs will now be monitored through the Medical Exception Process (MEP) and Monthly Prescription Volume Threshold Process (MPTP) instead.

Action Required

Action needed
By August 1, 2000: Pharmacy billing staff must stop submitting prior authorization requests for the listed drugs when billing for WFNJ/GA beneficiaries in Newark, East Orange, Camden City, and Trenton. Contact First Health Services at 1-877-888-2939 for MEP/MPTP inquiries instead of processing traditional prior auths. Claims previously subject to Error Code 577 will now be processed through MEP/MPTP monitoring.