All Insurance Policy Changes (Page 777)

Continuing from page 776. Showing older policy changes tracked across all payers. Use the filters in the related-hubs section below to narrow by provider, state, or specialty.

Medium impact
Medicaid Alert - MA-1992-28
New Jersey Medicaid·Identified Jun 20, 2026
This Medicaid policy provides clarification on billing instructions for reporting durable medical equipment (DME) rental units. The policy update appears to address proper coding and billing procedures for DME rentals under Medicaid coverage.
Medium impact
Medicaid Alert - MA-1992-30
New Jersey Medicaid·Identified Jun 20, 2026
Failed to analyze policy change
Medium impact
Medicaid Alert - MA-1992-31
New Jersey Medicaid·Identified Jun 20, 2026
Medicaid is reprocessing all previously denied inpatient hospital claims under alert MA-1992-31. This appears to be a systematic review that may result in overturned denials and potential payments for claims that were previously rejected.
Medium impact
Newsletter Vol. 2, No. 45
New Jersey Medicaid·Identified Jun 20, 2026
This policy establishes billing procedures for pharmaceutical claims submitted to the New Jersey Cystic Fibrosis Drug Program through ParamaxUnisys. Eligible individuals are identified by a green laminated card issued by the NJ State Department of Health, with approval valid for a specific period. Claims must be submitted on MC pharmacy prescription claim forms (hardcopy or electronic) in accordance with current Medicaid regulations. Coverage includes legend drugs and limited non-legend drugs (antitussives, antihistamines, normal saline solutions, and certain vitamins essential for cystic fibrosis treatment).
Medium impact
Newsletter Vol. 2, No. 46
New Jersey Medicaid·Identified Jun 20, 2026
This policy eliminates prior authorization requirements for multiple vision care services including artificial eyes (when provided no more than once every three years), low vision devices (below certain thresholds), optical appliance replacements due to loss/theft/fire, frames and lenses for individuals with developmental disabilities, intraocular lenses, prescription changes meeting specific thresholds, contact lenses with medical necessity, polycarbonate lenses, and UV filter lenses. Additionally, the policy increases the reimbursement threshold for prior authorization requirements for optical appliance repairs and limits contact lens replacements to once every two years.
Medium impact
Newsletter Vol. 2, No. 47
New Jersey Medicaid·Identified Jun 20, 2026
New Jersey Medicaid changed its reimbursement methodology for hospital outpatient laboratory/pathology services, implementing a new fee schedule instead of using Medicare Part A rates. The new rates will be comparable to amounts paid to independent clinical laboratories for the same services.
High impact
Newsletter Vol. 2, No. 48
New Jersey Medicaid·Identified Jun 20, 2026
New Jersey Medicaid now requires anesthesia services to be billed on NJ claim forms using HCPCS codes with AA modifier (instead of CPT anesthesia codes), with time converted to 15-minute units in field F. CPT anesthesia codes 00100-01999 are no longer recognized and will cause claim denials.
High impact
Newsletter Vol. 2, No. 49
New Jersey Medicaid·Effective Sep 1, 1993
New Jersey Medicaid is establishing a new hospice services program with specific eligibility requirements, covered services, and billing procedures. Hospice agencies must obtain prior approval from the interdisciplinary team for all Medicaid services (except physician services) before providing care, and billing must follow the enclosed Fiscal Agent Billing Supplement. A limited MEI card will be issued to hospice-eligible recipients restricting coverage to hospice and physician services.
Medium impact
Newsletter Vol. 2, No. 50
New Jersey Medicaid·Identified Jun 20, 2026
New Jersey Medicaid has added four pharmaceutical manufacturers (Genesia Laboratories Inc, MOVA Pharmaceutical Corp, TIMECAP Laboratories Inc, AMPHARCO USA) to its approved labeler code list and removed Xactdose Incorporated effective September. Additionally, a previous incorrect addition of Xactdose Incorporated (announced in March) must be corrected by resubmitting previously denied claims through September.
Medium impact
Newsletter Vol. 2, No. 51
New Jersey Medicaid·Identified Jun 20, 2026
This policy reminds healthcare providers that influenza immunization is a covered service under Medicaid, particularly emphasizing vaccination in nursing facilities and long-term care settings. It clarifies billing procedures for vaccine administration in institutional settings where facility staff, not physicians, typically administer the injections.
Medium impact
Newsletter Vol. 2, No. 52
New Jersey Medicaid·Identified Jun 20, 2026
The AIDS Community Care Alternatives Program (ACCAP) has been revised to restrict enrollment eligibility. AIDS-Related Complex (ARC) is no longer an acceptable diagnosis for program entry; only AIDS diagnosis or HIV-positive status in children under a specified age now qualifies. Additionally, re-evaluation of nursing facility care needs and annual program requirements will now be conducted by ACCAP nurse case managers instead of Medicaid District Office Regional Staff Nurses.
Medium impact
Newsletter Vol. 2, No. 53
New Jersey Medicaid·Identified Jun 20, 2026
New Jersey Medicaid has issued changes and clarifications regarding enteral nutritional products coverage and billing requirements. This policy update affects how providers submit claims for nutritional support products under the NJ Health Services Program.
Low impact
Newsletter Vol. 2, No. 54
New Jersey Medicaid·Identified Jun 20, 2026
The New Jersey Medicaid program has added six new pharmaceutical manufacturers to its approved Labeler Code List. Billing teams must recognize these new manufacturer codes when processing pharmaceutical claims to ensure proper reimbursement and claims acceptance under the NJ Medicaid program.
High impact
Newsletter Vol. 2, No. 55
New Jersey Medicaid·Identified Jun 20, 2026
This policy defines covered and non-covered services for Medicaid recipients enrolled in HIP of New Jersey (an HMO) in Burlington, Gloucester, and Hudson counties. Key billing impact: claims for non-emergency HIP-covered services billed to members with restricted HMO cards will be denied with error code; emergency care authorization rules and benefit exhaustion procedures are outlined; dental, orthotics, hearing aids, prescription drugs, and family planning services are NOT covered by HIP and must be billed to Medicaid fiscal agent instead.
Medium impact
Newsletter Vol. 2, No. 56
New Jersey Medicaid·Identified Jun 20, 2026
New Jersey Medicaid is consolidating district offices, closing five MDOs (Cumberland, Gloucester, Union, Hunterdon, Mercer) effective October. Providers must now route Pre-Admission Screening (PAS) assessments, prior authorization requests, and long-term care inquiries to new consolidated MDO locations based on updated county-to-office mappings.
Medium impact
Newsletter Vol. 2, No. 57
New Jersey Medicaid·Identified Jun 20, 2026
This policy notice contains updates regarding hospice services billing and coverage requirements. Based on the limited information available (summary only), this appears to be administrative guidance related to hospice service delivery and documentation.
High impact
Newsletter Vol. 2, No. 58
New Jersey Medicaid·Effective Sep 1, 2004
New Jersey Medicaid now reimburses hospice providers for nursing facility room and board services for Medicaid-only eligible hospice recipients (in addition to dually eligible Medicare/Medicaid patients), effective September. Nursing facilities must submit MCNH forms to transition patients from NF billing to hospice billing, and hospices must contract with NF to provide room and board services. Billing team must update patient status tracking and ensure proper authorization workflows.
Medium impact
Medicaid Alert - MA-1992-32
New Jersey Medicaid·Identified Jun 20, 2026
This is a correction notice for New Jersey Medicaid Program Newsletter Volume 2 No. 56. Without access to the full document content, the specific changes being corrected cannot be determined from the summary provided.
Low impact
Medicaid Alert - MA-1992-33
New Jersey Medicaid·Identified Jun 20, 2026
New Jersey Medicaid has issued alert MA-1992-33 regarding Medicaid Cost Report requirements. This appears to be an administrative notice related to cost reporting procedures for Medicaid providers.
Medium impact
Medicaid Alert - MA-1992-34
New Jersey Medicaid·Identified Jun 20, 2026
New Jersey Medicaid has modified the instructions for completing Field 45 on the UB-82 claim form. This affects how hospital and facility billing teams must complete this specific field when submitting Medicaid claims.
Low impact
Newsletter Vol. 2, No. 59
New Jersey Medicaid·Identified Jun 20, 2026
Medicaid coverage policy for Nutrament Food Supplement has been updated. This affects billing and coverage determination for this specific nutritional supplement product under Medicaid plans.
Medium impact
Newsletter Vol. 2, No. 60
New Jersey Medicaid·Effective Nov 1, 2024
New Jersey Medicaid has eliminated the prior authorization requirement for hospice services provided to Medicaid recipients under the AIDS Community Care Alternatives Program (ACCAP), effective November 1. Hospice agencies no longer need to submit prior authorization forms to the Medicaid District Office, and prior authorization numbers are not required on claims for HCPCS procedure code G0152 (Hospice daily).
High impact
Newsletter Vol. 2, No. 61
New Jersey Medicaid·Effective Nov 1, 2024
New Jersey Medicaid expanded Hepatitis B vaccine coverage from high-risk newborns to universal newborn immunization effective immediately. Billing teams must transition from the old generic HCPCS code to nine new manufacturer and age/risk-specific codes, with claims using the old code denied starting November. Providers billing injection-only services must use modifier 26 with the appropriate new codes.
Medium impact
Newsletter Vol. 2, No. 62
New Jersey Medicaid·Effective Nov 1, 2024
New Jersey Medicaid now allows increased Personal Care Assistant (PCA) services beyond standard limits when medically indicated for specific circumstances (caregiver unavailability, recipient living alone, severe functional limitations, or acute medical deterioration). Providers must notify the Medicaid District Office when PCA services exceed the standard threshold to ensure reimbursement; failure to notify may result in non-payment of excess hours.
Medium impact
Newsletter Vol. 2, No. 63
New Jersey Medicaid·Identified Jun 20, 2026
Newsletter Vol. 2, No. 63 provides updated billing tips specifically for pediatric services. This fresh policy guidance may include changes to coding practices, documentation requirements, or billing procedures for pediatric encounters.

Browse by payer Browse by state Browse by specialty Browse by billing code Browse & filter all changes

Get alerts for changes like this

Save a search and receive a daily digest whenever a new policy change matches your filters.

Create a free alert

Archive by year

2023 2024 2025 2026

Medicaid Alert - MA-1992-28

Medicaid Alert - MA-1992-30

Medicaid Alert - MA-1992-31

Newsletter Vol. 2, No. 45

Newsletter Vol. 2, No. 46

Newsletter Vol. 2, No. 47

Newsletter Vol. 2, No. 48

Newsletter Vol. 2, No. 49

Newsletter Vol. 2, No. 50

Newsletter Vol. 2, No. 51

Newsletter Vol. 2, No. 52

Newsletter Vol. 2, No. 53

Newsletter Vol. 2, No. 54

Newsletter Vol. 2, No. 55

Newsletter Vol. 2, No. 56

Newsletter Vol. 2, No. 57

Newsletter Vol. 2, No. 58

Medicaid Alert - MA-1992-32

Medicaid Alert - MA-1992-33

Medicaid Alert - MA-1992-34

Newsletter Vol. 2, No. 59

Newsletter Vol. 2, No. 60

Newsletter Vol. 2, No. 61

Newsletter Vol. 2, No. 62

Newsletter Vol. 2, No. 63