MedicaidAdministrativeLow impact
Newsletter Vol. 9, No. 56
New Jersey Medicaid·NJ·Provider Notice
Effective date
Oct 1, 1999
We identified it
Jun 20, 2026
Summary
New Jersey is implementing a pharmacy lock-in program for Work First New Jersey/General Assistance beneficiaries who have misused pharmaceutical services, effective October 1, 1999. These beneficiaries will be restricted to a single selected pharmacy, with emergency coverage limited to 72-hour supplies at non-restricted pharmacies.
Action Required
No immediate action required for most medical billing teams as this policy affects New Jersey pharmacy services for General Assistance beneficiaries only. Pharmacy providers in New Jersey must verify beneficiary eligibility and lock-in status using the Point-of-Sale system or REVS at 1-800-676-6562, maintain Pharmacy Selection Forms on file, and submit emergency claims as hard-copy with 'Emergency' noted in Field 18 of MC-6 forms.