MedicaidCoverageMedium impact
Newsletter Vol. 14, No. 54
New Jersey Medicaid·NJ · Family Medicine, Internal Medicine, Geriatrics·Pharmacy
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid has implemented a carve-out policy for prescription drugs and home health services for dual-eligible beneficiaries who are aged, blind, or disabled. This affects how these services are billed and covered for patients with both Medicare and Medicaid.
Action Required
Review current dual-eligible ABD patient roster and identify those receiving prescription drugs or home health services. Contact New Jersey Medicaid to understand new billing procedures and coverage requirements. Update patient eligibility verification processes to account for carve-out provisions.