MedicaidReimbursementMedium impact
Newsletter Vol. 10, No. 50
New Jersey Medicaid·NJ · Pharmacy·Reimbursement
Effective date
Aug 1, 2000
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid and related programs are updating their Maximum Allowable Cost (MAC) drug payment limits effective August 1, 2000, based on revised Federal upper limits from HCFA. Providers and HMOs must replace the previous MAC drug list (Rev. 10/98) with the new revised list (Rev. 8/1/2000) in their Pharmaceutical Services Manual to ensure accurate reimbursement for covered drugs.
Action Required
Before August 1, 2000: Pharmaceutical services providers and HMOs must discard the MAC drug list (Rev. 10/98) from Newsletter Volume 8, No. 71 (December 1998) and insert the new MAC Drug List (Rev. 8/1/2000) as APPENDIX B in the Pharmaceutical Services Manual. Update billing system drug pricing tables to reflect new Federal upper limits for all drugs affected by this revision (changes from the October 1, 1998 list are highlighted in bold in the updated APPENDIX B). Verify that all claims with service dates on or after August 1, 2000 use the new MAC limits; claims submitted with old pricing will be subject to recalculation or denial. Contact the Chief of Pharmaceutical Services at (609) 588-2724 or Unisys Pharmacy Consultant at (609) 588-6039 with questions.