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Traditional MedicareAdministrativeMedium impact

Newsletter Vol. 34, No.14

New Jersey Medicaid·NJ·Provider Notice
Effective date
Dec 1, 2024
We identified it
Jun 20, 2026
Days to comply

Summary

New Jersey is issuing QMB (Qualified Medicare Beneficiary) Identification Cards to help Medicare providers identify patients who cannot be balance billed for Medicare deductibles, coinsurance, or copays. The pink credit card-sized cards will be required starting June 1, 2025, replacing current 'Dear Provider' letters.

Action Required

Action needed
Immediately: Train front desk staff to recognize pink QMB Identification Cards and 'Dear Provider' letters as proof that patients cannot be charged Medicare deductibles, coinsurance, or copays. By June 1, 2025: Update patient registration workflow to accept only QMB ID cards (no longer accept 'Dear Provider' letters). Update billing system to flag QMB patients to prevent balance billing. Verify QMB status in HETS system when in doubt. Failure to comply subjects practice to federal sanctions.