MedicaidAdministrativeMedium impact
Newsletter Vol. 9, No. 55
New Jersey Medicaid·NJ·Provider Notice
Effective date
Sep 7, 1999
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid and NJ KidCare can now withhold payments from providers when there is reliable evidence of fraud or willful misrepresentation. Providers can request a fair hearing if they disagree with the withholding decision.
Action Required
Immediately: Review billing practices to ensure compliance with Medicaid fraud prevention requirements. Billing team should familiarize themselves with fair hearing process outlined in N.J.A.C. 10:49-9.10(d) in case of payment withholding. Contact Bruce Fritzges at (609) 588-3001 with questions. Update provider manual with revised pages 10:49-9-1 through 10:49-9-17.