MedicaidCoverageHigh impact
Newsletter Vol. 12, No. 59
New Jersey Medicaid·NJ·Provider Notice
Effective date
Jun 15, 2002
We identified it
Jun 20, 2026
Summary
New Jersey is transitioning WFNJ/GA and other NJ FamilyCare adults without children from managed care to the New Jersey Hospital Care Payment Assistance Program (charity care) for hospital services. Effective immediately for June 15-30, 2002, and fully effective July 1, 2002, billing teams must process these patients through charity care using minimal documentation requirements (patient name, address, valid NJ FamilyCare card, and one form of ID) instead of standard managed care billing.
Action Required
By June 15, 2002: (1) Billing team must update hospital billing system to identify patients with '70' in positions 3-4 of June NJ FamilyCare eligibility card and route ALL hospital services to charity care processing instead of managed care claims. (2) Update registration/intake workflows to collect minimal documentation: patient name, address (or 'homeless' if applicable), one form of acceptable ID, and patient signature. (3) Instruct front desk/registration staff to photocopy both the June 2002 NJ FamilyCare card and HMO card (if applicable) and file in patient chart for audit. (4) Verify patient name matches on all three documents (ID, HMO card, and FamilyCare card) before processing. By July 1, 2002: (5) Update system to recognize 'Plan G' on July 2002 FamilyCare cards as indicating full conversion from managed care—process ALL hospital services through charity care (no HMO card will exist). (6) Recognize 'Plan H' on July 2002 cards as indicating physical health through HMO but behavioral health services only through charity care; photocopy both HMO and FamilyCare cards for these patients. (7) Train billing staff on new card identification codes (Plan G = all services to charity care; Plan H = behavioral health only to charity care). Failure to process through charity care will result in improper claims submissions and audit failures.