MedicaidAdministrativeMedium impact
Newsletter Vol. 32, No.15
New Jersey Medicaid·NJ · Family Medicine, Internal Medicine, Geriatrics·Eligibility
We identified it
Jun 20, 2026
Summary
Nursing Facility Fee-For-Service members are being transitioned to enroll in Managed Care Organizations. This change affects how these patients' coverage is administered and may impact billing processes for practices treating nursing facility residents.
Action Required
Billing team should verify current enrollment status of nursing facility residents before submitting claims. Check patient eligibility to confirm whether they are enrolled in FFS or MCO coverage and route claims to appropriate payer. Update patient insurance information in billing system when enrollment changes occur.