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MedicaidPrior AuthMedium impact

Newsletter Vol. 12, No. 36

New Jersey Medicaid·NJ·Provider Notice
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply
—

Summary

This policy notice announces additions and changes to Prior Determination of Utilization Review (PDUR) standards, which typically affects prior authorization requirements for medical services and procedures.

Action Required

Action needed
Immediately: Review Newsletter Vol. 12, No. 36 from NJ MMIS for specific PDUR standard changes. Billing team should download the full policy document from the provided URL to identify which services now require prior authorization or have modified approval requirements. Update prior authorization workflow and staff training accordingly.

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