MedicaidReimbursementMedium impact
Newsletter Vol. 18, No. 01
New Jersey Medicaid·NJ · Geriatrics, Psychiatry·Provider Notice
Effective date
Jan 1, 2008
We identified it
Jun 20, 2026
Summary
This policy notifies long-term care facilities of a 2.3% Social Security Cost of Living (COLA) increase effective January 1, 2008. Facilities must review COLA UPDATE REPORTS and reconcile patient payment amounts on Turnaround Documents (MCNH-117, Block #35) with recalculated net income figures. If discrepancies of $1.00 or more exist, facilities must update billing records and notify appropriate welfare agencies to request new PR-1 income statements.
Action Required
By end of March 2008: Long-term care facilities must (1) review the enclosed COLA UPDATE REPORT for each beneficiary, comparing NET INC BEFORE and NET INC AFTER columns; (2) identify any discrepancies of $1.00 or more between NET INC AFTER and the current PATIENT PAYMENT amount on the Long Term Care Turnaround Document (MCNH-117, Block #35); (3) for discrepancies ≥$1.00, update Block #35 with the correct NET INC AFTER amount and submit to Unisys (P.O. Box 4807, Trenton, N.J. 08650-4807) or via EDI HI-Value Information segment, then notify the County Welfare Agency (CWA) or Institutional Services Section (ISS) area office to request a new PR-1; (4) for discrepancies <$1.00, update Block #35 but do NOT notify CWA/ISS; (5) for any PR-1 records showing 'MM07 EFF DTE NC' comment with effective dates after January 2008, request a change PR-1 effective January 2008 from ISS or CWA if COLA increase was not applied. Billing staff must verify all patient liability amounts reflect the recalculated post-COLA income. Failure to reconcile will result in incorrect patient payment amounts and potential billing disputes.