All Insurance Policy Changes (Page 805)

Continuing from page 804. Showing older policy changes tracked across all payers. Use the filters in the related-hubs section below to narrow by provider, state, or specialty.

High impact
Newsletter Vol. 9, No. 63
New Jersey Medicaid·Effective Oct 1, 1999
New Jersey Medicaid and NJ KidCare fee-for-service programs are adding five pharmaceutical manufacturers to their drug rebate program and removing three manufacturers effective October 1, 1999. Drugs from the three deleted manufacturers (PKD Labs, Golden State Medical Supply, and Rexall Sundown) will no longer be reimbursed, while products from the five new manufacturers (OMNII Products, Topix Pharmaceuticals, Ther-Rx Corporation, Walsh Distribution, and Rising Pharmaceuticals) become eligible for coverage.
Medium impact
Medicaid Alert - MA-1999-08
New Jersey Medicaid·Identified Jun 20, 2026
Medicaid has updated their recommendations for newborn hepatitis B immunizations. This may affect billing procedures, coverage criteria, or timing requirements for hepatitis B vaccines administered to newborns under Medicaid plans.
Low impact
Medicaid Alert - MA-1999-09
New Jersey Medicaid·Identified Jun 20, 2026
The Camden Medicaid District Office has changed their contact phone number. Healthcare providers who need to contact this specific Medicaid district office for claims, prior authorizations, or other Medicaid-related inquiries must use the new contact information.
Medium impact
Medicaid Alert - MA-1999-10
New Jersey Medicaid·Identified Jun 20, 2026
New Medicaid policy MA-1999-10 establishes screening requirements for lead exposure and toxicity. This fresh policy (1 day old) likely introduces new billing procedures, documentation requirements, or coverage guidelines for lead screening services that may affect pediatric and primary care billing workflows.
Medium impact
Newsletter Vol. 9, No. 55
New Jersey Medicaid·Effective Sep 7, 1999
New Jersey Medicaid and NJ KidCare can now withhold payments from providers when there is reliable evidence of fraud or willful misrepresentation. Providers can request a fair hearing if they disagree with the withholding decision.
High impact
Newsletter Vol. 9, No. 57
New Jersey Medicaid·Effective Oct 1, 1999
New Jersey Medicaid updated HCPCS procedure codes with additions, deletions, and reimbursement rate changes across Medicine, Surgery, Radiology, and Pathology/Laboratory services. Some surgical procedure reimbursement rates were significantly reduced while others had technical and professional components separated.
Low impact
Newsletter Vol. 9, No. 59
New Jersey Medicaid·Identified Jun 20, 2026
This policy notice from New Jersey Medicaid discusses Year 2000 (Y2K) testing procedures. Given the policy age of 1 day old but content referencing Y2K testing from 2000, this appears to be either a republished historical document or system testing notice.
Low impact
Newsletter Vol. 9, No. 60
New Jersey Medicaid·Identified Jun 20, 2026
The policy content appears to be incomplete or corrupted, showing only page markers (1 of 13 through 13 of 13) without any actual policy text or changes.
Low impact
Newsletter Vol. 9, No. 61
New Jersey Medicaid·Identified Jun 20, 2026
New Jersey has updated its debarment directory website which contains information about healthcare providers who are excluded from participating in state programs. Billing teams should be aware of this resource for provider eligibility verification.
Medium impact
Newsletter Vol. 9, No. 62
New Jersey Medicaid·Effective Jul 12, 1999
New Jersey established the Supplementary Prenatal Care Program (NJSPCP) to provide Medicaid-covered prenatal care for legal immigrant pregnant women who are otherwise ineligible due to federal restrictions. Eligible patients receive a special card with a PE Medicaid number and red stamp limiting services to pregnancy-related care only.
High impact
Newsletter Vol. 9, No. 64
New Jersey Medicaid·Effective Jan 1, 2000
Effective January 1, 2000, GA (General Assistance) beneficiaries diagnosed with HIV/AIDS must enroll in the AIDS Drug Distribution Program (ADDP) administered by the New Jersey Department of Health and Senior Services. GA will discontinue direct coverage and reimbursement for HIV/AIDS-specific drugs; all such medications will be covered exclusively through ADDP. Pharmacies must verify ADDP eligibility and exhaust ADDP coverage before submitting claims to GA, with denied claims marked by Edit 402.
Medium impact
Medicaid Alert - MA-1999-11
New Jersey Medicaid·Identified Jun 20, 2026
Medicaid has updated billing procedures for certain mental health services. The policy MA-1999-11 introduces changes that will affect how mental health providers submit claims and may require workflow adjustments for billing teams handling Medicaid patients.
Low impact
Medicaid Alert - MA-1999-12
New Jersey Medicaid·Identified Jun 20, 2026
The Monmouth Medicaid District Office has changed their address and contact number. This is an administrative update that affects provider communication channels for Medicaid-related inquiries and correspondence in the Monmouth district area.
Medium impact
Newsletter Vol. 9, No. 65
New Jersey Medicaid·Effective Dec 1, 1999
New Jersey Medicaid, NJ KidCare, and PAAD pharmacy providers must submit Form FD-70 Pharmacy Provider Certification Statement along with a copy of their valid pharmacy permit by December 1, 1999. Failure to submit will result in placement in the basic dispensing fee category without qualifying for increments.
Low impact
Newsletter Vol. 9, No. 66
New Jersey Medicaid·Effective Mar 9, 1999
New Jersey has added two pharmaceutical manufacturers (Zila Pharmaceuticals and Faulding Pharmaceutical Company) to the PAAD Drug Rebate Program. These additions were effective in March 1999 and allow eligible aged and disabled patients to access medications from these manufacturers through the state assistance program.
High impact
Newsletter Vol. 9, No. 67
New Jersey Medicaid·Effective Dec 1, 1999
New Jersey implemented a Medical Exception Process (MEP) for prescription drug claims that exceed Drug Utilization Review (DUR) standards across Medicaid, NJ KidCare, GA, PAAD, ADDP, and CF programs. Pharmacists must contact First Health Services Corporation to request prior authorization for drugs flagged by 12 specific DUR edits, with most claims allowed an initial 30-day supply during the authorization review period. Claims without approved PA numbers will be denied after the 30-day extension expires.
Low impact
Newsletter Vol. 9, No. 68
New Jersey Medicaid·Identified Jun 20, 2026
Unable to analyze policy change as the policy content appears to be incomplete or corrupted, showing only placeholder text (-- 1 of 4 -- through -- 4 of 4 --) without actual policy details.
High impact
Newsletter Vol. 9, No. 69
New Jersey Medicaid·Effective Dec 1, 1999
Effective December 1, 1999, New Jersey Medicaid is transferring prior authorization (PA) processing for ADD drugs, methadone, protein nutritional supplements, and specialized infant formulas from Medicaid District Offices (MDOs) to First Health Services Corporation (the MEP contractor). Pharmacies must now contact First Health Services at 1-877-888-2939 to request PA for these products; the PA process will be triggered by Edit 535 in the point-of-sale claims system.
Medium impact
Newsletter Vol. 9, No. 70
New Jersey Medicaid·Effective Dec 1, 1999
New Jersey Medicaid requires prior authorization for pharmacy services when beneficiaries exceed 12 prescriptions per month (reducing to 7 over time), effective December 1, 1999. Pharmacists must call First Health Services at 1-877-888-2939 for PA requests when monthly prescription thresholds are exceeded.
Low impact
Newsletter Vol. 9, No. 71
New Jersey Medicaid·Effective Oct 1, 1998
New Jersey Medicaid requires all participating pharmacies to complete and submit a Prospective Drug Utilization Review (PDUR) Certification Statement by December 1, 1999, documenting compliance with OBRA requirements to offer patient consultation on significant medication-related matters. This is a state-mandated compliance reporting requirement for the October 1, 1998 to September 30, 1999 service period.
Low impact
Newsletter Vol. 9, No. 72
New Jersey Medicaid·Effective Oct 28, 1999
Two pharmaceutical manufacturers (Sanofi-Synthelabo and Rising Pharmaceuticals, Inc.) have been added to the New Jersey PAAD (Pharmaceutical Assistance to the Aged and Disabled) Drug Rebate Program. Providers must update their pharmacy systems to recognize these new labeler codes (00955 and 64980) for proper claim processing and drug coverage verification under PAAD.
Medium impact
Newsletter Vol. 9, No. 73
New Jersey Medicaid·Effective Oct 22, 1999
New Jersey Medicaid suspends Federal Upper Limit (FUL) pricing for 8 generic drugs effective October 22, 1999, due to marketplace unavailability. Reimbursement for these drugs will now be based on the lower of AWP minus 10% plus dispensing fee, or the provider's Usual and Customary Charge. This affects erythromycin estolate, folic acid, ibuprofen, lindane, minoxidil, piroxicam, ranitidine hydrochloride, and valproic acid across multiple dosages and package sizes.
Medium impact
Newsletter Vol. 9, No. 74
New Jersey Medicaid·Effective Nov 1, 1999
New Jersey Medicaid now permits off-site partial care/partial hospitalization (PC/PH) mental health services when clinically justified and properly documented. Off-site activities are reimbursable only if they are physician-prescribed, individualized, therapeutic (not recreational), integrated into treatment plans, and limited to less than 10% of a client's annual programming time unless prior authorized. All off-site services require staff supervision, sign-in/sign-out documentation at the clinic, and clear clinical linkage to treatment goals.
High impact
Newsletter Vol. 9, No. 75
New Jersey Medicaid·Effective Oct 1, 1999
New Jersey Medicaid and NJ KidCare reduced maximum fee allowances for 21 specified HCPCS laboratory service codes, effective October 1, 1999, to align with Medicare fee reductions. Billing teams must update their fee schedules and billing systems to reflect the new lower reimbursement amounts for affected laboratory tests.
Low impact
Newsletter Vol. 9, No. 76
New Jersey Medicaid·Effective Dec 28, 1999
This is a Year 2000 (Y2K) readiness notification from New Jersey Medicaid (NJMMIS) informing providers that the state's systems are Y2K compliant and urging providers to ensure their own systems are ready. The policy includes a revised year-end payment schedule for December 1999/January 2000 to minimize Y2K risks, requiring claims to be submitted by December 28, 1999 (electronic) or December 29, 1999 (paper) to be included in the January 5, 2000 payment.

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Newsletter Vol. 9, No. 63

Medicaid Alert - MA-1999-08

Medicaid Alert - MA-1999-09

Medicaid Alert - MA-1999-10

Newsletter Vol. 9, No. 55

Newsletter Vol. 9, No. 57

Newsletter Vol. 9, No. 59

Newsletter Vol. 9, No. 60

Newsletter Vol. 9, No. 61

Newsletter Vol. 9, No. 62

Newsletter Vol. 9, No. 64

Medicaid Alert - MA-1999-11

Medicaid Alert - MA-1999-12

Newsletter Vol. 9, No. 65

Newsletter Vol. 9, No. 66

Newsletter Vol. 9, No. 67

Newsletter Vol. 9, No. 68

Newsletter Vol. 9, No. 69

Newsletter Vol. 9, No. 70

Newsletter Vol. 9, No. 71

Newsletter Vol. 9, No. 72

Newsletter Vol. 9, No. 73

Newsletter Vol. 9, No. 74

Newsletter Vol. 9, No. 75

Newsletter Vol. 9, No. 76