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All PlansReimbursementMedium impact

Newsletter Vol. 2, No. 66

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

Summary

New additions have been made to the Maximum Allowable Cost (MAC) Drug Listing with updated upper payment limits for covered pharmaceutical products. This affects reimbursement rates for MAC-listed medications dispensed by healthcare providers.

Action Required

Action needed
Immediately: Billing team must download the updated MAC Drug Listing from the policy source to review new additions and revised upper payment limits. Update billing system with new reimbursement rates for affected medications. Verify current MAC drug claims are being billed at or below the new upper limits to avoid payment reductions.