MedicaidPrior AuthMedium impact
Newsletter Vol. 5, No. 43
New Jersey Medicaid·NJ · Pharmacy·Prior Authorization
Effective date
Aug 1, 2024
We identified it
Jun 20, 2026
Summary
The Newark General Assistance (GA) program is expanding prior authorization (PA) requirements to include additional prescription drugs effective August 2024. Billing teams must identify which new drugs from the attachment list require PA and implement these requirements for all solid dosage forms and strengths of the listed medications.
Action Required
By August 1, 2024: (1) Billing team must obtain and review the complete drug list attachment from Newsletter Vol. 5, No. 43 (new drugs indicated in bold). (2) Update billing system and pharmacy verification software to require prior authorization for all newly listed drugs in solid dosage forms. (3) Notify all providers dispensing pharmaceuticals under Newark GA program of the expanded PA requirements. (4) For claims with service dates on or after August 1, 2024, obtain PA before submitting claims for the newly added drugs or claims will be denied. (5) Retain this newsletter numerically behind the blue-tabbed Newsletter tab for reference.