MedicaidAdministrativeHigh impact
Newsletter Vol. 26, No. 14
New Jersey Medicaid·NJ·Provider Notice
Effective date
Sep 1, 2016
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid requires providers and MCOs to conduct monthly verification that all employees and contractors are not excluded, unlicensed, or uncertified by searching mandatory state and federal databases. Providers must establish written policies for these background checks and report any excluded individuals to the State Comptroller.
Action Required
Immediately: Establish monthly verification process to check all current and prospective employees/contractors against 6 mandatory databases (NJ debarment list, federal exclusions, NJ Treasurer exclusions, NJ Consumer Affairs licensure, NJ Health licensure, and certified aide registry). Create written policies incorporating these background checks into fraud prevention procedures. Report any excluded individuals in writing to Office of State Comptroller, Medicaid Fraud Division, P.O. Box 025, Trenton, NJ 08625-0025. Failure to comply may result in payment denials, voids, recovery actions, interest and civil penalties.