All PlansAdministrativeMedium impact
Newsletter Vol. 22, No.03
New Jersey Medicaid·NJ · Orthopedics, PM&R (Physical Medicine & Rehab), Wound Care·Provider Notice
We identified it
Jun 20, 2026
Summary
A new audit contractor has been assigned to review medical supply services claims. This contractor will likely conduct post-payment reviews and audits of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) billing.
Action Required
Immediately: Review and ensure all medical supply services documentation is complete and compliant. Billing team should verify that all DMEPOS claims have proper physician orders, certificates of medical necessity, and supporting documentation readily available for potential audit requests.