Traditional MedicareReimbursementMedium impact
Newsletter Vol. 5, No. 74
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, affecting reimbursement rates for specific pharmaceutical products. This change impacts how much providers will be reimbursed for dispensing certain medications covered under federal programs.
Action Required
Immediately: Billing team must review Appendix B of Newsletter Vol. 5, No. 74 to identify specific MAC drugs with revised payment limits. Update billing system with new reimbursement rates for affected pharmaceutical products. Verify current medication inventory pricing against new federal limits to ensure accurate billing and avoid potential overpayment recoveries.