Changes to NJ Medicaid Pharmacy Reimbursement and 340B

August 9, 2017

New Jersey Medicaid issued two Newsletters describing a change to reimbursement at actual acquisition cost (AAC) for fee-for-service (FFS) Medicaid claims, a new professional fee applicable to retail and long-term-care pharmacy services, and required claim level identification of drugs purchased at the 340B discount (the “Newsletters”).[1]

Also, in response to recent communications from certain Medicaid managed care plans (MCOs), we have clarified with NJ Medicaid officials that managed care plans have not been directed by Medicaid to reimburse providers at AAC for 340B or otherwise.

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[1]  DMAHS Newsletters, Volume 27, Nos. 03 and 04, dated March 2017. The Newsletters can be found at:  https://www.njmmis.com/documentDownload.aspx?fileType=076B9D7D-96DC-4C8A-B9CE-BA46F47DDE1F.

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