MedicaidAdministrativeHigh impact
Medicaid Alert - MA-2004-01
New Jersey Medicaid·NJ·Provider Notice
Effective date
Sep 1, 2004
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid requires providers to check three online databases (Federal Exclusions, State Exclusions, and NJ Professional Licensing) before employing or contracting with individuals to ensure they are not excluded from Medicaid programs or unlicensed. Providers must verify all employees, contractors, and subcontractors before seeking reimbursement for services they provide.
Action Required
Immediately: HR and credentialing staff must check all current and prospective employees, contractors, and subcontractors against three databases: Federal Exclusions (oig.hhs.gov/fraud/exclusions.html), NJ State Exclusions (state.nj.us/treasury/debarred/), and NJ Professional Licensing (state.nj.us/cgi-bin/consumeraffairs/search/searchentry.pl). Establish ongoing verification process before requesting Medicaid reimbursement for any services. Failure to verify could result in compliance violations and claim denials.