MedicaidReimbursementMedium impact
Newsletter Vol. 27, No.02
New Jersey Medicaid·NJ · Geriatrics·Provider Notice
Effective date
Jan 1, 2017
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid is implementing a 0.3% Social Security Cost of Living Adjustment (COLA) effective January 1, 2017, which will increase resident cost-share amounts by an estimated $2-$7 per month at nursing homes and assisted living facilities. Nursing home and assisted living providers must notify residents or their representatives of this increase and choose between two collection options: billing the COLA amount immediately or notifying residents to save excess income pending their case redetermination.
Action Required
By January 2017: Nursing home and assisted living facility billing teams must: (1) Implement one of two collection methods for the COLA increase—either begin billing residents/representatives the estimated $2-$7 monthly increase immediately, or notify them in writing that cost share will increase upon redetermination and excess income should be retained; (2) Update resident accounts in billing system to reflect the 0.3% income adjustment; (3) Communicate the change to residents or their authorized representatives with clear written notice; (4) Track the adjustment retroactively to January 1, 2017 for reconciliation when 2017 Personal Responsibility Forms (PR-1 and PR-2) are processed; (5) Coordinate with Managed Care Organizations (MCOs) and Molina regarding payment cutback adjustments. Failure to implement one of these notification methods may result in delayed collection and reconciliation issues when redeterminations are processed.