MedicaidAdministrativeMedium impact
Newsletter Vol. 18, No. 10
New Jersey Medicaid·NJ·Provider Notice
Effective date
Jan 1, 2007
We identified it
Jun 20, 2026
Summary
Healthcare practices receiving $5+ million annually in NJ Medicaid payments must establish written policies covering federal and state false claims laws, including whistleblower protections. These policies must be distributed to all employees, contractors, and agents involved in Medicaid billing or patient care.
Action Required
For practices meeting the $5M annual Medicaid threshold: Immediately create written policies covering Federal False Claims Act, Federal Program Fraud Civil Remedies Act, NJ Medical Assistance Act penalties, Health Care Claims Fraud Act, and Conscientious Employee Protection Act. Distribute policies to all employees, contractors, and agents. Include fraud prevention procedures in employee handbooks. Ensure contractors comply with these policies through contracts. Prepare for annual compliance certification and potential audits by DMAHS.