All Insurance Policy Changes (Page 806)

Continuing from page 805. 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
Newsletter Vol. 9, No. 77
New Jersey Medicaid·Identified Jun 20, 2026
The Monthly Prescription Volume Threshold Process has been updated with a revised effective date and new threshold value. This affects when additional prior authorization or review requirements are triggered based on prescription volume.
Medium impact
Medicaid Alert - MA-1999-13
New Jersey Medicaid·Identified Jun 20, 2026
New Jersey Medicaid is requiring testing of Year 2000 Electronic Media Claims (EMC) systems to ensure billing systems can handle date processing for the year 2000. This appears to be a legacy Y2K compliance testing requirement for electronic claims submission.
Low impact
Newsletter Vol. 9, No. 78
New Jersey Medicaid·Effective Feb 21, 1999
This policy adds four new pharmaceutical manufacturers to the New Jersey PAAD (Pharmaceutical Assistance to the Aged and Disabled) Drug Rebate Program. Billing teams must recognize these newly added manufacturer labeler codes (58468, 59291, 63395, 64065) for claim processing and ensure proper coverage determination under PAAD, noting that PAAD coverage may differ from Medicaid coverage for the same drugs.
Low impact
Newsletter Vol. 9, No. 79
New Jersey Medicaid·Identified Jun 20, 2026
This is a Year 2000 readiness disclosure statement from Newsletter Vol. 9, No. 79. It appears to be a legacy administrative notice regarding Y2K compliance rather than a current policy change affecting medical billing operations.
High impact
Newsletter Vol. 9, No. 80
New Jersey Medicaid·Effective Dec 1, 1999
New Jersey Medicaid, NJ KidCare, and WFNJ/GA require dentists and independent clinics to submit renewed general anesthesia permits from the New Jersey State Board of Dentistry to Unisys (the Division Fiscal Agent) by February 3, 2000, via certified mail with return receipt. Claims for general anesthesia services processed after this date will not be reimbursed until the renewed permit is received and on file.
Low impact
Newsletter Vol. 9, No. 81
New Jersey Medicaid·Effective May 28, 1999
New Jersey PAAD program has retroactively activated three manufacturer labeler codes (McNeil Consumer Healthcare, Carlsbad Technology, and InterMune Pharmaceuticals) effective May-June 1999. Providers must resubmit previously denied claims for dates of service on or after the activation dates for these manufacturers' drugs.
Medium impact
Newsletter Vol. 9, No. 82
New Jersey Medicaid·Effective Dec 1, 1999
New Jersey is rescinding a previously announced policy change that would have discontinued Medicaid coverage for HIV/AIDS drugs and required beneficiaries to enroll in a separate AIDS Drug Distribution Program. Providers should continue following current coverage and reimbursement policies for HIV/AIDS medications.
Medium impact
Medicaid Alert - MA-2000-01
New Jersey Medicaid·Identified Jun 20, 2026
New policy clarifies the difference between Medicaid eligibility cards and Families First eligibility identification cards. Billing teams must learn to distinguish between these two types of cards to ensure proper eligibility verification and accurate claim submission.
Medium impact
Newsletter Vol. 10, No. 01
New Jersey Medicaid·Identified Jun 20, 2026
This is a correction newsletter to Vol. 9, No. 57 regarding updates to the HCFA Common Procedure Coding System (HCPCS). The specific corrections or changes are not detailed in the summary provided, requiring review of the full document for implementation details.
High impact
Newsletter Vol. 10, No. 02
New Jersey Medicaid·Effective Oct 1, 1999
New Jersey Medicaid corrected reimbursement rates for 150+ laboratory and pathology HCPCS codes, with most rates decreasing significantly to align with Medicare fee schedules. This correction supersedes the original September 1999 newsletter and affects all lab service billing.
Low impact
Newsletter Vol. 10, No. 03
New Jersey Medicaid·Identified Jun 20, 2026
New manufacturer labeler codes have been added to the PAAD Drug Rebate Program list in Appendix F. This update expands the pharmaceutical manufacturers participating in New Jersey's prescription assistance program for aged and disabled patients.
High impact
Newsletter Vol. 10, No. 04
New Jersey Medicaid·Effective Jan 15, 2000
New Jersey Medicaid is implementing two pharmacy policy changes effective January 15, 2000: (1) reducing the Monthly Prescription Volume Threshold Process (MPTP) limit from 12 to 10 prescriptions per calendar month, and (2) activating maximum daily dosage edits (Edit 535) for pharmaceutical inhalers with a Medical Exception Process (MEP) available for overrides.
Medium impact
Newsletter Vol. 10, No. 05
New Jersey Medicaid·Effective Jan 1, 1999
New Jersey Medicaid and NJ KidCare programs are adding 5 pharmaceutical manufacturers to their drug rebate program (effective 01/01/99) and removing 1 manufacturer. Drugs from deleted manufacturers will no longer be reimbursed. Billing teams must update their approved manufacturer lists to reflect these changes.
Medium impact
Newsletter Vol. 10, No. 06
New Jersey Medicaid·Effective Jan 1, 2000
New Jersey Medicaid and NJ KidCare fee-for-service programs have delisted two pharmaceutical manufacturers (Komax Pharmaceuticals and Care Technologies, Inc.) from their drug rebate programs. Effective immediately, drugs manufactured by these companies will no longer be reimbursed by these programs.
High impact
Newsletter Vol. 10, No. 07
New Jersey Medicaid·Effective Jan 1, 2000
New Jersey Medicaid and NJ KidCare fee-for-service programs are adding six new pharmaceutical manufacturers to their drug rebate program and terminating coverage for six existing manufacturers effective January 1, 2000. Drugs from terminated manufacturers will no longer be reimbursed by these programs.
Medium impact
Newsletter Vol. 10, No. 10
New Jersey Medicaid·Effective Feb 1, 2000
New Jersey is expanding prior authorization (PA) requirements for certain pharmaceutical services to Paterson and Camden city General Assistance (GA) beneficiaries, effective February 1, 2000. Pharmacies must obtain PA approval before dispensing listed drugs and products (including refills), with a 72-hour emergency supply exception. PA requests must be submitted to the hotline at 1-800-609-0106 during business hours (8:30 AM–4:30 PM weekdays).
Medium impact
Medicaid Alert - MA-2000-02
New Jersey Medicaid·Identified Jun 20, 2026
New Medicaid policy provides Q&A guidance for Medical Exception Process (MEP) and Monthly Prescription Volume Threshold Process (MPTP) for pharmacy billing. This clarifies procedures for handling prescription exceptions and volume thresholds under Medicaid pharmacy benefits.
High impact
Newsletter Vol. 10, No. 08
New Jersey Medicaid·Effective Dec 7, 1998
New Jersey will offset hospital debts owed to the Department of Health and Senior Services against Disproportionate Share Hospital (DSH) and Medicaid/NJ KidCare beneficiary care payments. Acute care hospitals with outstanding statutory debts may receive reduced or offset payments from state programs.
High impact
Newsletter Vol. 10, No. 11
New Jersey Medicaid·Effective Jan 1, 1999
Procedure code K0164 for oropharyngeal suction catheters has been discontinued and is no longer valid for billing. Home health agencies must immediately replace all claims using K0164 with procedure code A4628 instead. This correction applies retroactively to claims with service dates on or after January 1, 1999.
Medium impact
Newsletter Vol. 10, No. 12
New Jersey Medicaid·Effective Nov 1, 1999
New Jersey's DME Recycling Program mandates that medical suppliers must contact InterHealth LLC to retrieve recycled durable medical equipment for Medicaid, General Assistance, and NJ KidCare fee-for-service beneficiaries in seven counties before dispensing new equipment. Specific HCPCS procedure codes identified in previous guidance are eligible for recycling. The program applies only to fee-for-service claims with service dates on or after November 1, 1999 (with enforcement beginning November 10, 1999), and does not apply to managed care enrollees.
Medium impact
Newsletter Vol. 10, No. 13
New Jersey Medicaid·Effective Jul 26, 1999
New Jersey Medical Assistance & Health Services activated 12 HCPCS procedure codes for cardiac and pulmonary services that Certified Nurse Practitioners (CNPs) and Clinical Nurse Specialists (CNSs) can now bill for reimbursement. This includes electrocardiogram services, cardiac monitoring, and pulmonary function tests with specific maximum fee allowances ranging from $5.00 to $53.00 per service.
Low impact
Newsletter Vol. 10, No. 14
New Jersey Medicaid·Identified Jun 20, 2026
New pharmaceutical manufacturers have been added to the New Jersey PAAD Drug Rebate Program's approved labeler codes list. This affects billing for prescription drugs covered under the PAAD program for eligible aged and disabled patients.
Medium impact
Newsletter Vol. 10, No. 15
New Jersey Medicaid·Effective Jul 1, 1999
New Jersey Medicaid and NJ KidCare-Plan A are increasing Personal Care Assistant (PCA) service reimbursement rates effective July 1, 1999. Individual hourly weekday rates increase from $14.00 to $14.50, and individual half-hour weekday rates increase from $7.00 to $7.25. Claims submitted and paid before February 7, 2000 will be reprocessed to reflect the new rates.
High impact
Newsletter Vol. 10, No. 16
New Jersey Medicaid·Effective Mar 1, 2000
New Jersey Medicaid is expanding prior authorization (PA) requirements for specific pharmaceutical services to Camden City WFNJ/GA beneficiaries, effective March 1, 2000. Pharmacies must obtain PA approval before dispensing listed drugs and related products (including refills), with a 72-hour emergency supply exception. Beneficiaries are identified by eligibility IDs beginning with '5748'.
Medium impact
Newsletter Vol. 10, No. 17
New Jersey Medicaid·Effective Sep 1, 1999
New Jersey Medicaid/NJ KidCare now recognizes specific HCPCS cytopathology codes (PAP smear testing) as family planning services when provided by Title X grantees or in conjunction with family planning visits. Billing teams must properly identify these claims using family planning indicator fields (HCFA 1500 Item 24H or UB-92 Condition Code A-4) to ensure correct reimbursement at the specified fee schedule.

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Newsletter Vol. 9, No. 77

Medicaid Alert - MA-1999-13

Newsletter Vol. 9, No. 78

Newsletter Vol. 9, No. 79

Newsletter Vol. 9, No. 80

Newsletter Vol. 9, No. 81

Newsletter Vol. 9, No. 82

Medicaid Alert - MA-2000-01

Newsletter Vol. 10, No. 01

Newsletter Vol. 10, No. 02

Newsletter Vol. 10, No. 03

Newsletter Vol. 10, No. 04

Newsletter Vol. 10, No. 05

Newsletter Vol. 10, No. 06

Newsletter Vol. 10, No. 07

Newsletter Vol. 10, No. 10

Medicaid Alert - MA-2000-02

Newsletter Vol. 10, No. 08

Newsletter Vol. 10, No. 11

Newsletter Vol. 10, No. 12

Newsletter Vol. 10, No. 13

Newsletter Vol. 10, No. 14

Newsletter Vol. 10, No. 15

Newsletter Vol. 10, No. 16

Newsletter Vol. 10, No. 17