MedicaidPrior AuthMedium impact
Newsletter Vol. 10, No. 10
New Jersey Medicaid·NJ · Pharmacy·Prior Authorization
Effective date
Feb 1, 2000
We identified it
Jun 20, 2026
Summary
New Jersey is expanding prior authorization (PA) requirements for certain pharmaceutical services to Paterson and Camden city General Assistance (GA) beneficiaries, effective February 1, 2000. Pharmacies must obtain PA approval before dispensing listed drugs and products (including refills), with a 72-hour emergency supply exception. PA requests must be submitted to the hotline at 1-800-609-0106 during business hours (8:30 AM–4:30 PM weekdays).
Action Required
CRITICAL: This policy is from January 2000 and is outdated by 24+ years. Before February 1, 2000 (ALREADY PASSED): Pharmacy staff must update internal procedures to require PA authorization for all drugs on the attached list before dispensing to Paterson GA (ID prefix 5538) and Camden GA (ID prefix 5748) beneficiaries. Staff must contact PA Unit hotline (1-800-609-0106) during business hours for approval. For emergency situations only when the unit is closed, pharmacy may dispense 72-hour supply and submit hard-copy MC-6 claim marked 'Emergency' to Unisys. All other prescriptions must be held until PA approval is obtained. IMPORTANT: Verify current policy status—this newsletter predates modern billing systems and may have been superseded by more recent NJ Medicaid guidance. Contact WFNJ/GA Medical Policy Unit at (609) 588-2718 to confirm if this PA requirement remains in effect.