MedicaidAdministrativeMedium impact
Newsletter Vol. 7, No. 63
New Jersey Medicaid·NJ·Provider Notice
Effective date
Dec 1, 1997
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid announces the Health Connections program, a high-cost case management and utilization review initiative effective immediately. Providers serving Medicaid fee-for-service beneficiaries may be contacted by the Peer Review Organization (PRO) of New Jersey to provide service information and coordinate appropriate care.
Action Required
Immediately: All providers (except long-term care and HMOs) serving New Jersey Medicaid fee-for-service beneficiaries must be prepared to cooperate with the Peer Review Organization of New Jersey. When contacted by PRO of N.J., billing and clinical staff must promptly provide requested service information and documentation for Medicaid beneficiaries undergoing case management review. Establish internal protocols to respond to PRO requests within the timeframe specified by the PRO. Maintain records of all PRO communications. For questions, contact Barbara Zarzeczny at (609) 588-7283. Failure to cooperate with PRO requests may result in reduced reimbursement or program sanctions.