MedicaidAdministrativeHigh impact
Newsletter Vol. 24, No.07
New Jersey Medicaid·NJ·Provider Notice
Effective date
Jul 1, 2014
We identified it
Jun 20, 2026
Summary
New Jersey is transitioning certain Medicaid waiver services (ACCAP, CRPD, GO, TBI) to managed care organizations effective July 1, 2014. Providers must now bill MCOs directly for services provided on or after July 1, 2014, instead of the previous fee-for-service system.
Action Required
Immediately: For NJ Medicaid waiver clients (ACCAP, CRPD, GO, TBI), billing team must stop submitting claims to Molina Medicaid Solutions for services on or after July 1, 2014. Instead, submit all MLTSS service claims directly to the member's assigned MCO (Amerigroup, Horizon NJ Health, UnitedHealthcare, or WellCare). Update billing workflows to verify member eligibility and MCO enrollment monthly. Contact MCOs to join provider networks if not already enrolled. Continue providing authorized services until MCO care manager provides new authorization.