MedicaidReimbursementMedium impact
Newsletter Vol. 18, No. 15
New Jersey Medicaid·NJ · OB-GYN·Provider Notice
Effective date
Jul 1, 2008
We identified it
Jun 20, 2026
Summary
New Jersey FQHCs will receive higher reimbursement rates for deliveries and specified Ob/Gyn surgeries - either their PPS rate or fee-for-service rates, whichever is higher. New quarterly reporting requirements separate delivery and Ob/Gyn services from other managed care wraparound reports.
Action Required
By September 30, 2008: FQHCs must begin filing two separate quarterly managed care wraparound reports instead of one. First report includes Worksheet 2 Support Schedules A and B (excluding delivery/Ob-Gyn services). Second report includes Worksheet 2 Support Schedules C, D, E, and F (delivery and Ob-Gyn services only). Billing team must segregate delivery and Ob-Gyn encounters and revenues by calendar month and HMO. Claims for deliveries and Ob-Gyn surgeries will be automatically recycled and reimbursed at higher rates once fiscal agent system modifications are complete.