MedicaidReimbursementMedium impact
Newsletter Vol. 7, No. 58
New Jersey Medicaid·NJ · Pharmacy·Reimbursement
Effective date
Oct 1, 1997
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid and related programs (GA, ADDP, CF, PAAD) have updated their Maximum Allowable Cost (MAC) drug list effective October 1, 1997. Pharmaceutical service providers must replace the previous MAC drug list (Rev. 1/97) with the new revised list (Rev. 10/97) to ensure accurate reimbursement limits for generic and brand-name drugs.
Action Required
By October 1, 1997: Pharmaceutical service providers must remove the old MAC drug list (Rev. 1/97) from their Pharmaceutical Services Manual and insert the new MAC drug list (Rev. 10/97) as APPENDIX B. HMOs should discard the old listing. Billing teams must update internal reference materials and pharmacy systems to reflect the new maximum allowable cost limits for all covered medications under Medicaid, GA, ADDP, CF, and PAAD programs. Failure to update MAC limits may result in claim overpayments or underpayments. Contact DMAHS Pharmaceutical Services at (609) 588-2724 or UNISYS Pharmacy Consultant at (609) 588-6039 with questions.