MedicaidPrior AuthHigh impact
Newsletter Vol. 9, No. 02
New Jersey Medicaid·NJ · Pharmacy·Prior Authorization
Effective date
Jan 1, 1999
We identified it
Jun 20, 2026
Summary
New Jersey's Newark and East Orange General Assistance programs are expanding prior authorization (PA) requirements to additional pharmaceutical drugs and entire therapeutic drug classes, effective January 1, 1999. Pharmacies must obtain PA from the DFD PA Unit (1-800-609-0106) for these newly covered drugs during business hours 8:30 A.M. to 4:30 P.M., Monday through Friday. A revised complete list of drugs requiring PA is attached to this newsletter.
Action Required
By December 31, 1998: Pharmacy billing team and providers must obtain and review the attached revised drug list identifying which pharmaceuticals now require prior authorization. Update billing system, pharmacy software, and internal procedures to flag all newly added drugs and therapeutic drug classes for PA requirement before processing claims. Train all pharmacy staff and billing personnel on the expanded PA requirements. Beginning January 1, 1999: All claims for service dates on or after this date must include prior authorization before submission. Implement workflow to route newly covered drugs through PA process with DFD PA Unit. Contact DFD PA hotline at 1-800-609-0106 with questions. Failure to obtain prior authorization for expanded drug classes will result in claim denials.