All PlansPrior AuthHigh impact
Newsletter Vol. 32, No.14
New Jersey Medicaid·NJ·Prior Authorization
We identified it
Jun 20, 2026
Summary
Prior authorization requests that were previously suspended or discontinued are being reinstated. This means services that may have temporarily not required prior auth will now require authorization again before treatment.
Action Required
Immediately: Billing team must review all services that previously required prior authorization to identify which ones are being reinstated. Update billing system flags and staff workflows to ensure prior authorization is obtained before scheduling or providing services. Contact the payer to confirm specific services affected and update encounter forms and scheduling protocols accordingly.