MedicaidCoverageMedium impact
Newsletter Vol. 7, No. 54
New Jersey Medicaid·NJ·Pharmacy
Effective date
Oct 1, 1997
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid and pharmacy assistance programs will no longer reimburse for DESI (Drug Efficacy Study Implementation) drugs that lack FDA evidence of effectiveness. An updated list of non-covered drugs includes both previously identified medications and newly added drugs that will be denied for claims with service dates on or after October 1, 1997.
Action Required
Before October 1, 1997: Pharmacy and billing staff must obtain and review the updated DESI drug list (Appendix A) to identify newly added non-covered medications. Update pharmacy systems and billing processes to flag these drugs for New Jersey Medicaid, PAAD, GA, and CFD program patients. Replace the January 1994 DESI list with the new version. Claims for DESI drugs will be denied by the state.