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Newsletter Vol. 5, No. 29
Act
by May 1, 2024
Effective date
May 1, 2024
Identified
Jun 20, 2026
Summary
New Jersey Medicaid (Newark GA program) is expanding prior authorization requirements to include additional prescription drugs in solid dosage forms and strengths, effective with claims dated May 2024 and later. Pharmaceutical service providers must now obtain prior authorization for these newly added drugs before processing claims.
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What to do
by May 1, 2024 · 4 steps
01Billing and pharmacy teams must obtain prior authorization from New Jersey Medicaid before dispensing any newly added prescription drugs covered under the Newark GA program (specific drug list referenced in policy attachment).
02Update billing system workflows to flag all solid dosage forms of listed drugs as requiring prior authorization.
03Reference the March 2024 Newsletter for baseline prior authorization procedures.
04Contact NJ Medicaid Chief Pharmaceutical Services or your District Office for the complete list of additional drugs requiring prior auth.
If missed: Failure to obtain prior authorization will result in claim denials.
Original notice
Newsletter Vol. 5, No. 29
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. 30MediumEffective May 1, 1995 · CodingNewsletter Vol. 5, No. 01MediumNo effective date · Prior AuthorizationNewsletter Vol. 5, No. 02MediumEffective Jan 1, 2024 · ReimbursementBrowse every New Jersey Medicaid change in the policy list