All Insurance Policy Changes (Page 822)

Continuing from page 821. Showing older policy changes tracked across all payers. Use the filters in the related-hubs section below to narrow by provider, state, or specialty.

Low impact
Newsletter Vol. 12, No. 13
New Jersey Medicaid·Effective Jan 24, 2002
3M Pharmaceuticals (Labeler Code 55298) has been added to the New Jersey PAAD (Pharmaceutical Assistance to the Aged and Disabled) Drug Rebate Program, effective January 24, 2002. Providers must recognize that PAAD, Medicaid, and Senior Gold programs have different drug coverage based on manufacturer participation in their respective rebate programs.
Medium impact
Newsletter Vol. 12, No. 14
New Jersey Medicaid·Effective Jan 22, 2002
New Jersey Medicaid has suspended Maximum Allowable Cost (MAC) pricing for several generic drugs due to marketplace unavailability, and updated MAC prices for 15 other medications. This affects reimbursement rates for pharmacy services under Medicaid.
Low impact
Newsletter Vol. 12, No. 15
New Jersey Medicaid·Identified Jun 20, 2026
New Jersey Medicaid and NJ FamilyCare have added three pharmaceutical manufacturers to their drug rebate programs: Upstate Pharma LLC (effective 01/17/2002), PediaMed Pharmaceuticals Inc. (effective 01/04/2002), and Lek Pharmaceuticals Inc. (effective 12/31/2001). Billing teams must ensure claims for drugs from these manufacturers are processed under the correct rebate program, as coverage may differ between Medicaid/NJ FamilyCare fee-for-service, PAAD, and Senior Gold programs.
High impact
Newsletter Vol. 12, No. 16
New Jersey Medicaid·Effective Mar 1, 2002
New Jersey Medicaid, NJ FamilyCare, PAAD, ADDP, and CF pharmacy programs are implementing updated Prospective Drug Utilization Review (PDUR) standards effective March 1, 2002. Changes include revised maximum daily dosage limits for Rofecoxib (Vioxx) and non-weight-based oral chemotherapy drugs, new drug-drug interaction rules for HIV/AIDS medications and ACE inhibitors, age/sex restrictions for Serafem, and retrospective review standards for specific drug combinations. Pharmacy claims submitted with service dates on or after March 1, 2002 will be subject to these new automated edits and may be rejected if dosages exceed the updated standards.
Low impact
Newsletter Vol. 12, No. 17
New Jersey Medicaid·Effective Feb 6, 2002
Gilead Sciences, Inc. (Labeler Code 61958) has been added to the New Jersey PAAD (Pharmaceutical Assistance to the Aged and Disabled) Drug Rebate Program effective February 6, 2002. This addition affects pharmacy billing for PAAD beneficiaries in New Jersey and may impact drug coverage eligibility compared to Medicaid and Senior Gold programs.
Medium impact
Senior Services News Vol. 6, No. 01
New Jersey Medicaid·Effective Jan 1, 2002
The New Jersey Department of Health & Senior Services notifies nursing facilities of a 2.6% Social Security Cost of Living (COLA) increase effective January 1, 2002. Facilities must review beneficiary income calculations on the COLA UPDATE REPORT and reconcile discrepancies of $1.00 or more between computed NET INC AFTER amounts and Long Term Care Turnaround Document (MCNH-117) Block #35 PATIENT PAYMENT amounts, updating Unisys records and notifying county welfare agencies as required.
High impact
Senior Services News Vol. 6, No. 02
New Jersey Medicaid·Effective Apr 2, 2002
New Jersey's PAAD program now requires pharmacy providers to comply with Medicare Part B DMEPOS supplier requirements and complete EDI enrollment to continue participation. Pharmacies must obtain ICD-9 diagnosis codes for Medicare-covered drugs and follow specific documentation requirements for diabetic supplies and immunosuppressive drugs.
High impact
CSOCI Newsletter Vol. 02, No. 02
New Jersey Medicaid·Effective Feb 1, 2001
New Jersey's Children's System of Care Initiative (CSOCI) requires CMO (Care Management Organization) providers to submit HCFA 1500 claim forms to Unisys (the fiscal agent) for federal Medicaid reimbursement, effective for services rendered on or after February 1, 2001. Providers must use procedure code Z5008 with applicable ICD-9-CM diagnosis codes and submit claims within one year of service date.
High impact
Medicaid Alert - MA-2002-02
New Jersey Medicaid·Effective Apr 1, 2002
Effective April 1, 2002, New Jersey Medicaid/NJ Family Care is discontinuing the use of span dating (From Date – Through Date) for occupational therapy, physical therapy, speech-language-hearing therapy, and certain mental health services. Claims submitted with span dates for these services will be denied with Error Code 163. Providers must bill these services using individual service dates only.
Medium impact
Medicaid Alert - MA-2002-03
New Jersey Medicaid·Effective Mar 1, 2002
New Jersey Medicaid revised prior authorization forms FD-07 and FD-07A to include Children's System of Care Initiative (CSOCI) mental health services (residential services, behavioral assistance, crisis management, intensive in-home, and care management organization services). Providers must use the revised 09/01 versions of these forms for CSOCI service requests, though implementation is phased and varies by service area. Currently, all CSOCI services are authorized by the child's Care Management Organization (CMO), not through standard prior authorization procedures.
High impact
Medicaid Alert - MA-2002-04
New Jersey Medicaid·Effective Apr 1, 2002
New Jersey Medicaid requires pharmacies to use specific Customer Location Field values (NCPDP Field 307) when billing for pharmaceutical services in different care settings. Most importantly, pharmacies must use value '08' for Assisted Living Residences and Comprehensive Personal Care Homes, and these claims must be submitted via POS (point-of-sale) format only.
Medium impact
Newsletter Vol. 12, No. 18
New Jersey Medicaid·Effective Mar 5, 2002
New Jersey Medicaid is suspending Maximum Allowable Cost (MAC) pricing for two drug products (Hydrocortisone/Neomycin/Polymyxin B ophthalmic suspension and Propranolol 60mg tablets) effective March 5, 2002, and updating MAC prices for 11 additional generic medications. Billing teams must update pharmacy billing records and reimbursement rates to reflect the new MAC prices and remove suspended drugs from MAC billing.
High impact
Newsletter Vol. 12, No. 19
New Jersey Medicaid·Effective Apr 1, 2002
New Jersey Medicaid and NJ FamilyCare are adding 6 new pharmaceutical manufacturers to their drug rebate program (effective immediately in January-February 2002) and deleting 13 manufacturers effective April 1, 2002. Drugs from deleted manufacturers will no longer be reimbursed by these programs. Billing teams must update their pharmacy system records to reflect these manufacturer labeler code changes to avoid claim denials.
High impact
Newsletter Vol. 12, No. 20
New Jersey Medicaid·Effective Apr 15, 2002
Effective April 15, 2002, New Jersey Medicaid will limit coverage of Medicare-covered prescription drugs and diabetic supplies for dual-eligible beneficiaries. These claims must now be submitted to Medicare first as medical supply claims by pharmacies enrolled as Medicare-approved DME providers, then crossover to Medicaid for deductible/coinsurance payment. Pharmacies without Medicare DME approval will have claims denied by Medicaid.
Medium impact
CSOCI Newsletter Vol. 02, No. 03
New Jersey Medicaid·Effective May 1, 2002
New Jersey's Children's System of Care Initiative establishes specific HCPCS procedure codes for billing therapeutic leave and hospital leave services at non-JCAHO accredited residential child care facilities. Facilities can now bill for up to 14 continuous days per episode when residents are temporarily absent, using distinct codes for mental health services and room/board depending on whether the absence is therapeutic or hospital-related and whether the facility contracts with DMHS or DYFS.
Medium impact
Newsletter Vol. 12, No. 21
New Jersey Medicaid·Effective Apr 1, 2002
New Jersey Medicaid has enhanced their provider website (www.njmmis.com) to include secure provider registration, online access to Remittance Advice reports for the past 6 weeks, and an enhanced provider directory with Medicaid ID numbers.
Medium impact
Newsletter Vol. 12, No. 22
New Jersey Medicaid·Identified Jun 20, 2026
Failed to analyze policy change
Low impact
Newsletter Vol. 12, No. 23
New Jersey Medicaid·Effective Apr 1, 2002
New Jersey Medicaid and NJ FamilyCare added four new manufacturer labeler codes for drug coverage and removed one manufacturer (Thames Pharmacal Company) effective April 1, 2002, meaning drugs from Thames will no longer be reimbursed.
High impact
Newsletter Vol. 12, No. 24
New Jersey Medicaid·Effective Jan 1, 2002
New Jersey Medicaid and NJ FamilyCare are updating HCPCS laboratory procedure codes effective immediately, with new code additions (Jan 1, 2002), certain code deletions (June 1, 2002), and reimbursement rate changes (May 1, 2002) to align with Medicare's National Limitation Rate. Independent clinical laboratories must update their billing systems to use the correct codes and fee allowances.
High impact
Newsletter Vol. 12, No. 25
New Jersey Medicaid·Effective Jan 1, 2002
New Jersey Medicaid and NJ FamilyCare have added six new HCPCS procedure codes (96150–96155) for psychological services with specific maximum fee allowances that differ between specialist and non-specialist providers. Billing teams must implement these codes immediately for claims with dates of service on or after January 1, 2002, and ensure correct reimbursement rates are applied based on provider type.
High impact
Newsletter Vol. 12, No. 26
New Jersey Medicaid·Effective Jan 1, 2002
New Jersey Medicaid has added 10 new HCPCS laboratory/pathology codes effective January 1, 2002, deleted 7 codes effective June 1, 2002, and reduced reimbursement rates for 10 existing laboratory codes effective May 1, 2002 to align with Medicare National Limitation Rates. Hospitals must update billing systems to use new codes and apply reduced fee schedules immediately.
Medium impact
Newsletter Vol. 12, No. 27
New Jersey Medicaid·Effective Jan 1, 2002
New Jersey Medicaid and NJ FamilyCare added 13 new HCPCS procedure codes for podiatry services with specific maximum fee allowances, effective for claims with dates of service on or after January 1, 2002. These codes include fine needle aspiration, insertion of drug delivery implants, and injection procedures with separate technical and professional components.
High impact
Newsletter Vol. 12, No. 28
New Jersey Medicaid·Effective Jan 1, 2002
New Jersey Medicaid and NJ FamilyCare have added new HCPCS codes for prosthetic and orthotic services effective January 1, 2002, with maximum fee allowances. Additionally, specific prosthetic codes are being deleted effective June 1, 2002. Billing teams must update their systems to use the new codes and discontinue use of deleted codes on their respective effective dates.
Medium impact
Newsletter Vol. 12, No. 29
New Jersey Medicaid·Identified Jun 20, 2026
The Durable Medical Equipment (DME) Recycling Program has been expanded, though specific details about billing impacts are not available from this summary-only notice. Medical billing teams should review the full policy document to understand changes to DME billing procedures.
Medium impact
Newsletter Vol. 12, No. 30
New Jersey Medicaid·Effective Jan 1, 2002
New Jersey Medicaid and NJ FamilyCare added nine HCPCS procedure codes with corresponding maximum fee allowances for services provided by Certified Nurse Practitioners and Clinical Nurse Specialists, effective January 1, 2002. Billing teams must update systems to use these new codes (96150-96155, 99502, 99539) when submitting claims for CNP/CNS services to ensure proper reimbursement.

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Newsletter Vol. 12, No. 13

Newsletter Vol. 12, No. 14

Newsletter Vol. 12, No. 15

Newsletter Vol. 12, No. 16

Newsletter Vol. 12, No. 17

Senior Services News Vol. 6, No. 01

Senior Services News Vol. 6, No. 02

CSOCI Newsletter Vol. 02, No. 02

Medicaid Alert - MA-2002-02

Medicaid Alert - MA-2002-03

Medicaid Alert - MA-2002-04

Newsletter Vol. 12, No. 18

Newsletter Vol. 12, No. 19

Newsletter Vol. 12, No. 20

CSOCI Newsletter Vol. 02, No. 03

Newsletter Vol. 12, No. 21

Newsletter Vol. 12, No. 22

Newsletter Vol. 12, No. 23

Newsletter Vol. 12, No. 24

Newsletter Vol. 12, No. 25

Newsletter Vol. 12, No. 26

Newsletter Vol. 12, No. 27

Newsletter Vol. 12, No. 28

Newsletter Vol. 12, No. 29

Newsletter Vol. 12, No. 30