New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 167C - PROVISION OF PHARMACEUTICAL SERVICES UNDER THE SENIOR GOLD PROGRAM
Subchapter 1 - REQUIREMENTS FOR PROVISION OF PHARMACEUTICAL SERVICES
Section 10:167C-1.12 - Covered pharmaceutical services
Universal Citation: NJ Admin Code 10:167C-1.12
Current through Register Vol. 56, No. 18, September 16, 2024
(a) All covered pharmaceutical services shall be provided within the scope of the Medicaid or Senior Gold programs, and billed to the fiscal agent on the claim form or other approved billing method (see N.J.A.C. 10:51, Appendix D, incorporated herein by reference, Fiscal Agent Billing Supplement).
(b) Covered pharmaceutical services include:
1. Prescribed legend drugs (for their
medically accepted indication) as defined in Section 1927(k)(6) of the Social Security Act. "Legend drugs"
mean those drugs whose labels include the legend statement "Caution: Federal Law Prohibits Dispensing without
a prescription."; and
2. Non-legend drugs, as follow:
i. Diabetic testing materials;
ii. Insulin needles;
iii.
Insulin; and
iv. Syringes and needles for injectable medicines
for the treatment of multiple sclerosis.
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