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New Jersey MedicaidMedicaid · Reimbursement · Provider Notice · NJ · Geriatrics, PsychiatryMedium impact

Newsletter Vol. 5, No. 21

Act
immediately
Effective date
Jan 1, 2024
Identified
Jun 20, 2026

Summary

This policy updates Social Security Cost of Living Adjustment (COLA) calculations for nursing facilities, intermediate care facilities, and psychiatric hospitals effective immediately as of January. Unisys has automatically recalculated Social Security income on Patient Assistance Ledger (PAL) records, and billing teams must review the COLA UPDATE REPORT to identify discrepancies between computed NET INC AFTER amounts and current TAD patient payment amounts, then update records accordingly.

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What to do

immediately · 11 steps
01Billing team must obtain and review the COLA UPDATE REPORT for all facility residents.
02Compare the NET INC AFTER column (newly computed patient payment after COLA adjustment) against the current PATIENT PAYMENT AMOUNT in the Turn Around Document (TAD) Block for each recipient.
03If the difference is $1 or more.
04Update the PATIENT PAYMENT AMOUNT on the TAD Block to reflect the actual patient liability.
05Submit the corrected TAD to Unisys (PO Box, Trenton NJ).
06Inform the County Welfare Agency or Institutional Services Section (ISS) area office that a new PAL must be completed.
07If the difference is less than $1.
08Update the PATIENT PAYMENT AMOUNT on the TAD Block in the billing system.
09Submit to Unisys, but.
10DO NOT notify County Welfare Agency or ISS.
11Note any recipients with comment codes 'SSAZERO COLA APPLIED NET INCOME SET TO ZERO' or 'SSI ZERO COLA NOT APPLIED NET INCOME ZERO' and verify zero net income calculations are correct.
If missed: Failure to update records will result in incorrect patient billing amounts and potential compliance issues with PAL documentation.

Original notice

Newsletter Vol. 5, No. 21
njmmis.com · Always check the source before changing claims.
View original ↗

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New Jersey Medicaid policiesNJ policy changesGeriatricsPsychiatry

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