MedicaidAdministrativeMedium impact
Medicaid Alert - MA2016-02
New Jersey Medicaid·NJ · Pharmacy·Provider Notice
Effective date
Jun 1, 2016
We identified it
Jun 20, 2026
Summary
This is a mandatory training invitation for New Jersey Medicaid pharmacy providers regarding fraud detection and prevention. The training covers Medicaid regulatory requirements, documentation standards, billing practices, and fraud/waste/abuse obligations. While informational in nature, it signals increased scrutiny of pharmacy billing practices by NJ Medicaid agencies and MCOs.
Action Required
By June 1, 2016: Pharmacy providers should register key personnel (pharmacists, technicians, owners, loss prevention staff) to attend the mandatory fraud detection and prevention training. Submit completed registration form to Provider Education Committee (Marc A. Wallace) via fax (609-826-4801) or email (provider-education@osc.nj.gov). This is not optional for NJ Medicaid pharmacy providers. Attendees must bring government-issued ID and plan to arrive by 9:30 am for registration. After training: Implement the preventative measures discussed, ensure documentation compliance, verify Third Party Liability requirements are met, and establish internal monitoring for fraud, waste, and abuse reporting obligations. Failure to comply with Medicaid documentation and billing requirements will result in claim denials and potential fraud investigations.