MedicaidAdministrativeMedium impact
Newsletter Vol. 20, No.21
New Jersey Medicaid·NJ·Prior Authorization
We identified it
Jun 20, 2026
Summary
New Jersey has awarded a contract to Permedion for conducting Medicaid utilization reviews, DRG validation, and quality of care standards review. This change affects the third-party review process for Medicaid services and may impact prior authorization workflows and claim review procedures.
Action Required
Monitor future communications from New Jersey Medicaid regarding changes to utilization review processes under Permedion. Update staff on new review contractor if your practice serves New Jersey Medicaid patients. Prepare for potential changes in prior authorization requirements and claim review timelines.