MedicaidCoverageMedium impact
Newsletter Vol. 12, No. 10
New Jersey Medicaid·NJ·Provider Notice
Effective date
Feb 1, 2002
We identified it
Jun 20, 2026
Summary
New Jersey FamilyCare Presumptive Eligibility Program continues for eligible children (family income up to 200% federal poverty level) and pregnant women, but has been discontinued for adults and certain legal immigrant children (entry date on or after August 22, 1996). Billing teams at acute care hospitals and Federally Qualified Health Centers must continue to determine and process presumptive eligibility for remaining eligible populations.
Action Required
Immediately: Admissions and billing teams must update presumptive eligibility screening procedures to reflect discontinued coverage for adults and legal immigrant children entering the US on or after August 22, 1996. Continue processing presumptive eligibility determinations ONLY for: (1) children with family incomes up to 200% federal poverty level, including legal immigrant children with US entry prior to August 22, 1996, and (2) eligible pregnant women. Update intake forms and eligibility determination workflows to include date-of-entry verification for immigrant children. Train front desk and admissions staff on the eligibility criteria changes. Retain this newsletter in the policy file for reference. Direct any questions to the NJ Department of Human Services Presumptive Eligibility Unit at (609) 588-2911.