MedicaidCoverageMedium impact
Newsletter Vol. 9, No. 53
New Jersey Medicaid·NJ·Pharmacy
Effective date
Oct 1, 1999
We identified it
Jun 20, 2026
Summary
Effective October 1, 1999, the CCPED program will begin covering prescription drugs for elderly and disabled beneficiaries, while PAAD coverage for these individuals will end September 30, 1999. This adds pharmaceutical services as the eighth covered service category under CCPED with specific reimbursement rates and prior authorization requirements.
Action Required
By September 30, 1999: Billing team must update systems to process CCPED pharmaceutical claims instead of PAAD for eligible beneficiaries. Verify CCPED eligibility cards show 'prescribed drugs' as eighth service category. Apply same prior authorization requirements as Medicaid-covered drugs. Update reimbursement calculations to AWP less 10% plus dispensing fee of $3.73-$4.07 or usual/customary charge, whichever is less. Contact Patricia Burch at (609) 588-2903 for program questions or UNISYS Provider Services at 1-800-776-6334 for claims issues.