MedicaidReimbursementMedium impact
Newsletter Vol. 16, No. 01
New Jersey Medicaid·NJ·Provider Notice
Effective date
Jan 1, 2006
We identified it
Jun 20, 2026
Summary
New Jersey's Division of Medical Assistance & Health Services implemented a 4.1% Social Security Cost of Living (COLA) increase effective January 1, 2006, for beneficiaries in intermediate care facilities, psychiatric hospitals, and long-term care settings. Billing teams must reconcile the updated Social Security Income amounts on COLA UPDATE REPORTS against patient liability figures on Long-Term Care Turnaround Documents (TAD MCNH-117, Block #35) and submit corrections to Unisys or notify County Welfare Agencies/Institutional Services Section when discrepancies of $1.00 or more exist.
Action Required
By February 2006: Billing team must review the enclosed COLA UPDATE REPORT for each facility beneficiary and compare NET INC AFTER column values against current PATIENT PAYMENT amounts in TAD (MCNH-117) Block #35. For discrepancies of $1.00 or more: (1) Update Block #35 on the TAD with the corrected NET INC AFTER amount and submit to Unisys, P.O. Box 4805, Trenton, N.J. 08650-4805 (or submit via EDI HI-Value Information segment if applicable); (2) Notify the County Welfare Agency (CWA) or Institutional Services Section (ISS) area office to request a new PR-1 for the beneficiary. For discrepancies under $1.00: Update Block #35 only—do NOT notify CWA/ISS. If COLA UPDATE REPORT shows 'MM05 EFF DTE NC' comment with month after January 2006, contact ISS/CWA to request a change PR-1 effective January 2006. Verify all PR-1 records with 2006 effective dates already include the 4.1% increase. Contact Provider Services at 1-800-776-6334 with questions.