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MedicaidAdministrativeMedium impact

Medicaid Alert - MA-2000-02

New Jersey Medicaid·NJ·Pharmacy
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply
—

Summary

New Medicaid policy provides Q&A guidance for Medical Exception Process (MEP) and Monthly Prescription Volume Threshold Process (MPTP) for pharmacy billing. This clarifies procedures for handling prescription exceptions and volume thresholds under Medicaid pharmacy benefits.

Action Required

Action needed
Immediately: Review the MEP and MPTP Q&A guidance document at https://www.njmmis.com/documentDownload.aspx?document=ma2000-02.pdf. Pharmacy billing staff should update workflows for processing medical exceptions and monthly prescription volume thresholds according to the new clarifications. Ensure staff understand updated procedures to avoid claim processing delays.

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