MedicaidCoverageMedium impact

Newsletter Vol. 28, No.11

Q: Who is affected by this change?

This affects New Jersey Medicaid Gastroenterology, Infectious Disease, Internal Medicine, Family Medicine providers in NJ on Medicaid plans.

New Jersey Medicaid·NJ · Gastroenterology, Infectious Disease, Internal Medicine +1 more·Medical Policy

Effective date

Not stated

We identified it

Jun 20, 2026

Days to comply

—

Summary

New Jersey FamilyCare (NJ Medicaid) has updated their coverage policy for Hepatitis C treatment. This affects billing and coverage determination for Hepatitis C medications and related services for Medicaid patients in New Jersey.

Action Required

Action needed

Immediately: Review the complete policy document at https://www.njmmis.com/documentDownload.aspx?document=28-11.pdf to understand specific coverage criteria, prior authorization requirements, and billing guidelines for Hepatitis C treatment. Billing team should update system notes for NJ Medicaid patients requiring Hepatitis C treatment and verify current coverage requirements before submitting claims.

Related policy hubs

New Jersey Medicaid policies NJ policy changes Gastroenterology Infectious Disease Internal Medicine Family Medicine