Traditional MedicareReimbursementMedium impact
Newsletter Vol. 33, No.05
New Jersey Medicaid·NJ·Reimbursement
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid will now provide Fee-For-Service payment of Medicare Part A/Part B deductibles, coinsurance, and copayments to providers enrolled in Medicaid/NJ FamilyCare for Qualified Medicare Beneficiary (QMB) individuals. This affects billing for dual-eligible Medicare-Medicaid patients.
Action Required
Immediately: Billing team should review the full policy document at the provided URL to understand specific billing procedures for QMB patients. Update billing workflows to ensure proper coordination of benefits between Medicare and NJ Medicaid for dual-eligible patients. Verify patient QMB status before billing to determine if NJ Medicaid will cover Medicare cost-sharing amounts.