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Traditional MedicareReimbursementMedium impact

Newsletter Vol. 5, No. 38

New Jersey Medicaid·NJ·Reimbursement
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply
—

Summary

Federal Upper Limits of Payment for MAC (Maximum Allowable Cost) drugs have been revised, affecting reimbursement rates for generic medications. This update changes the maximum amounts that will be paid for covered generic drugs under federal programs.

Action Required

Action needed
Immediately: Review Appendix B of Newsletter Vol. 5, No. 38 for updated MAC drug pricing limits. Billing team must verify current reimbursement rates against the revised Federal Upper Limits and adjust billing expectations accordingly. Update fee schedules in billing system if automated MAC pricing is used.

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