Medicare AdvantageReimbursementMedium impact
Newsletter Vol. 28, No.16
New Jersey Medicaid·NJ·Reimbursement
Effective date
Jul 1, 2018
We identified it
Jun 20, 2026
Summary
MCO capitation rates and member cost-sharing amounts have been adjusted for July and August 2018. This affects how managed care organizations reimburse providers and what patients pay for covered services during these months.
Action Required
By July 1, 2018: Billing team must update patient cost-sharing amounts in billing system to reflect new copayments and deductibles for MCO members. Update fee schedules with revised capitation rates. Verify new rates are applied to all MCO claims for July and August 2018.