MedicaidAdministrativeHigh impact
Newsletter Vol. 20, No.22
New Jersey Medicaid·NJ·Provider Notice
Effective date
Oct 1, 2010
We identified it
Jun 20, 2026
Summary
New Jersey providers and HMOs must verify all employees and contractors are not excluded, unlicensed, or uncertified by searching mandatory federal and state databases monthly. The state will deny payments and seek recovery for services provided by excluded individuals.
Action Required
Immediately: HR and compliance teams must establish monthly verification procedures to check all current and prospective employees/contractors against 5 mandatory databases: Federal exclusions, NJ Treasury exclusions, NJ Consumer Affairs licensure, NJ Health Department licensure, and certified nurse aide registry. Document verification process in written fraud prevention policies. Report any excluded individuals to NJ Medicaid Fraud Division in writing.