MedicaidReimbursementMedium impact
Newsletter Vol. 11, No. 47
New Jersey Medicaid·NJ·Reimbursement
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid and NJ FamilyCare Plan A beneficiaries enrolled in Medicare or commercial managed care plans will now have their cost-sharing copayment charges paid by the state program. This affects billing for dual-eligible patients where secondary coverage will handle copayments.
Action Required
Immediately: Billing team must update procedures for NJ Medicaid and FamilyCare Plan A beneficiaries who also have Medicare or commercial coverage. Verify secondary coverage handling of copayments and adjust patient billing to reflect that state program will pay cost-sharing amounts. Update billing software rules to prevent charging copayments to these dual-eligible patients.