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MedicaidReimbursementMedium impact

Newsletter Vol. 5, No. 25

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

Summary

Federal Medicaid Upper Payment Limits (MAC) list has been updated with deletions of certain drug products. This affects Medicaid reimbursement rates for specific medications that are no longer included in the federal pricing limits.

Action Required

Action needed
Immediately: Review current Medicaid drug billing to identify any medications affected by MAC list deletions. Contact Medicaid billing team to verify reimbursement rates for affected drugs and update billing system with new pricing limits. Monitor claim processing for any reimbursement changes on deleted MAC items.