MedicaidAdministrativeMedium impact
Newsletter Vol. 12, No. 56
New Jersey Medicaid·NJ · Psychiatry·Provider Notice
Effective date
Jul 1, 2002
We identified it
Jun 20, 2026
Summary
This policy establishes mandatory serious occurrence reporting procedures for Psychiatric Residential Treatment Centers (PRTCs) in New Jersey, requiring immediate notification to state agencies, protection and advocacy organizations, parents/guardians of minors, and CMS when deaths occur. Billing teams must ensure their facilities comply with these incident documentation and reporting requirements to maintain Medicaid eligibility.
Action Required
Immediately: Billing and compliance teams at PRTCs must verify facility compliance with serious occurrence reporting procedures. Confirm that incident documentation logs capture: (1) name of reporting individual, (2) name of receiving individual, (3) time and date of all notifications. For NJ-based PRTCs under DYFS/DMHS contract: ensure reports are sent to NJ Protection and Advocacy (210 South Broad Street, 3rd floor, Trenton, NJ 08608) within 24 hours of incident. For NJ-based PRTCs NOT under DYFS/DMHS contract: establish protocol to report via phone (609-588-2749) and fax (609-588-3889) to DMAHS within 24 hours, followed by formal FD-400 form submission and 45-day comprehensive incident report. For deaths: notify CMS regional office (Lois Suntzenich, New York Regional Office). Failure to comply with reporting requirements may result in loss of Medicaid contract and billing authorization. Update facility policies and staff training to reflect these requirements.