Traditional MedicareReimbursementMedium impact
Newsletter Vol. 7, No. 05
New Jersey Medicaid·NJ·Reimbursement
We identified it
Jun 20, 2026
Summary
Federal Upper Limits of Payment for Maximum Allowable Cost (MAC) drugs have been revised in Appendix B. This affects reimbursement rates for specific pharmaceutical products covered under government programs.
Action Required
Billing team should review Appendix B of Newsletter Vol. 7, No. 05 to identify specific MAC drugs with revised payment limits. Update billing system fee schedules for affected pharmaceutical products to ensure claims are submitted at correct reimbursement rates. Verify that drug billing reflects new federal upper payment limits to avoid claim rejections.