All PlansReimbursementMedium impact
Newsletter Vol. 10, No. 50
New Jersey Medicaid·NJ·Reimbursement
We identified it
Jun 20, 2026
Summary
Federal Upper Limits of Payment for Maximum Allowable Cost (MAC) drugs have been revised, affecting reimbursement rates for specific pharmaceutical products. This update changes the maximum allowable payment amounts that will be reimbursed for covered prescription drugs.
Action Required
Immediately: Review Appendix B of Newsletter Vol. 10, No. 50 to identify specific drugs with revised MAC limits. Update billing system with new maximum allowable cost amounts for affected pharmaceutical products. Verify current billing rates against new federal limits to ensure compliance and avoid claim rejections.