MedicaidAdministrativeHigh impact
Newsletter Vol. 7, No. 70
New Jersey Medicaid·NJ · Pharmacy·Provider Notice
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid and PAAD pharmacy providers must annually submit a completed Form FD-70 Pharmacy Provider Certification Statement with a valid pharmacy permit copy to qualify for dispensing fee increments (24-hour emergency service, patient consultation, impact allowance). Failure to submit by the deadline results in automatic placement in the basic dispensing fee category without increments.
Action Required
By December 15, 1997: Pharmacy providers must complete and return Form FD-70 Pharmacy Provider Certification Statement with a copy of valid pharmacy permit to Unisys, P.O. Box 4804, Trenton, NJ 08650-4804, Attn: Form FD-70. All questions on the form must be answered or the form will be returned. Pharmacy billing teams must ensure: (1) all required fields on Form FD-70 are completed, (2) valid pharmacy permit is attached, (3) documentation of 24-hour emergency service, patient consultation, and impact allowance services are included if seeking fee increments. Consequences: Non-submission or incomplete submission automatically places the pharmacy in the basic dispensing fee category, eliminating eligibility for dispensing fee increments until a properly completed statement is received. Changes to fee tier cannot be effective until proper certification is received by Unisys.