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MedicaidPrior AuthMedium impact

Newsletter Vol. 12, No. 16

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

Summary

This policy update introduces additions and changes to PDUR (Prior Determination of Utilization Review) standards. The specific changes are not detailed in the summary provided, but PDUR typically involves prior authorization requirements and utilization review processes for medical services.

Action Required

Action needed
Review the full Newsletter Vol. 12, No. 16 document at https://www.njmmis.com/documentDownload.aspx?document=12-16.pdf to understand specific PDUR standard changes. Billing team should identify any new prior authorization requirements or utilization review processes that may affect claim submissions and update workflows accordingly.