MedicaidAdministrativeHigh impact
Newsletter Vol. 21, No.13
New Jersey Medicaid·NJ·Eligibility
Effective date
Jul 1, 2011
We identified it
Jun 20, 2026
Summary
New Jersey is mandating enrollment of most Medicaid recipients into managed care plans starting July 1, 2011, with expanded services now covered by Medicaid HMOs including home health, pharmacy, and therapy services. Non-emergent medical transportation will no longer be provided by HMOs and will be handled by LogistiCare Solutions instead.
Action Required
By July 1, 2011: Billing team must verify which Medicaid managed care plans the practice participates in and inform all Medicaid patients of their plan options. Update billing processes to route home health, pharmacy, physical therapy, occupational therapy, speech therapy, and medical day care claims to the patient's assigned Medicaid HMO instead of fee-for-service. Stop billing Medicaid HMOs for non-emergent transportation - redirect these to LogistiCare Solutions. Stop processing Medicare Part D co-payment claims through Medicaid.