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Newsletter Vol. 5, No. 43
Act
by Aug 1, 2024
Effective date
Aug 1, 2024
Identified
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.
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What to do
by Aug 1, 2024 · 6 steps
01Billing team must obtain and review the complete drug list attachment from Newsletter Vol.
025, No. 43 (new drugs indicated in bold).
03Update billing system and pharmacy verification software to require prior authorization for all newly listed drugs in solid dosage forms.
04Notify all providers dispensing pharmaceuticals under Newark GA program of the expanded PA requirements.
05For 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.
06Retain this newsletter numerically behind the blue-tabbed Newsletter tab for reference.
Original notice
Newsletter Vol. 5, No. 43
njmmis.com · Always check the source before changing claims.
Related changes
See all New Jersey Medicaid changes →Newsletter Vol. 5, No. 28MediumNo effective date · Provider NoticeNewsletter Vol. 5, No. 29HighEffective May 1, 2024 · Prior AuthorizationNewsletter Vol. 5, No. 30MediumEffective May 1, 1995 · CodingNewsletter Vol. 5, No. 01MediumNo effective date · Prior AuthorizationBrowse every New Jersey Medicaid change in the policy list