MedicaidReimbursementMedium impact
Newsletter Vol. 8, No. 50
New Jersey Medicaid·NJ · Pharmacy·Pharmacy
Effective date
May 12, 1998
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid suspends Federal Upper Limit (FUL) pricing for Hydralazine Hydrochloride (all strengths) and Lindane (lotion and shampoo formulations) effective May 12, 1998. Reimbursement for these drugs will now be based on the lower of AWP minus 10% plus dispensing fee, or the provider's Usual and Customary Charge, rather than the previous FUL methodology.
Action Required
By June 1998: Billing team and pharmacy staff must update pricing tables and reimbursement calculation logic in billing systems for Hydralazine Hydrochloride (10 mg, 25 mg, 50 mg, 100 mg tablets) and Lindane (1% lotion and shampoo, 480 ml). Remove FUL-based pricing and implement AWP minus 10% calculation methodology plus applicable dispensing fees. Verify that system correctly compares calculated reimbursement against provider's Usual and Customary Charge and pays the lower amount. Update internal documentation to reflect new pricing method for future reference. Contact DMAHS Pharmaceutical Services at (609) 588-2724 with any implementation questions.