MedicaidReimbursementMedium impact
Newsletter Vol. 8, No. 71
New Jersey Medicaid·NJ · Pharmacy·Reimbursement
Effective date
Oct 1, 1998
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid and related programs (GA, ADDP, CF, PAAD) are updating the Maximum Allowable Cost (MAC) drug list effective October 1, 1998. Pharmacy providers and HMOs must replace the previous MAC drug list (Rev. 10/97) with the new revised list (Rev. 10/98) in their manuals. Changes to MAC limitations are highlighted in the attachment, and some MAC changes may have different effective dates than October 1, 1998.
Action Required
By October 1, 1998: Pharmacy providers and HMOs must discard the MAC drug list (Rev. 10/97) from Newsletter Volume 7, No. 58 and insert the new MAC Drug List (Rev. 10/98) as APPENDIX B in the Pharmaceutical Services Manual. Review the attachment for highlighted changes and note any MAC items with alternative effective dates. Update internal billing and formulary systems to reflect the new MAC limitations for all Medicaid, GA, ADDP, CF, and PAAD claims. Contact the Chief of Pharmaceutical Services at (609) 588-2724 or the Unisys Pharmacy Consultant at (609) 588-6039 with questions. Failure to implement the updated MAC list may result in incorrect reimbursement or claim denials.