MedicaidAdministrativeHigh impact
Newsletter Vol. 7, No. 04
New Jersey Medicaid·NJ·Provider Notice
Effective date
Feb 1, 1997
We identified it
Jun 20, 2026
Summary
Effective February 1, 1997, Garden State Health Plan (GSHP) operations in Bergen, Middlesex, and Monmouth Counties, NJ are being sold to Managed HealthCare Systems (MHS). All GSHP enrollees in these three counties will transfer to MHS; claims submitted after February 1, 1997 for former GSHP members in these counties will be denied unless they involve ongoing hospitalizations from before the transition date.
Action Required
By January 31, 1997: Billing team must immediately stop processing claims for GSHP enrollees in Bergen, Middlesex, and Monmouth Counties with service dates on or after February 1, 1997. Update billing system to redirect these claims to Managed HealthCare Systems (MHS) at 1-888-362-3368. For any GSHP patients currently hospitalized as of February 1, 1997, continue GSHP billing for inpatient and associated physician services until separate instructions are provided. All staff must verify member HMO enrollment status via Medicaid eligibility card or online eligibility systems before processing claims. Billing staff should expect continued GSHP claims from the remaining 10 NJ counties (Atlantic, Burlington, Cumberland, Gloucester, Mercer, Morris, Salem, Somerset, Sussex, Warren) using existing GSHP instructions. Failure to redirect claims will result in denials and payment delays.