All PlansReimbursementMedium impact
Newsletter Vol. 4, No. 31
New Jersey Medicaid·NJ·Reimbursement
We identified it
Jun 20, 2026
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 payment ceiling amounts that will be used for drug reimbursement calculations.
Action Required
Immediately: Review Appendix B of Newsletter Vol. 4, No. 31 for updated MAC drug payment limits. Billing team should verify current reimbursement rates in system match the revised Federal Upper Limits. Update fee schedules and expected reimbursement amounts for affected generic medications to reflect new payment ceilings.