MedicaidPrior AuthMedium impact
Newsletter Vol. 4, No. 49
New Jersey Medicaid·NJ·Prior Authorization
Effective date
Oct 1, 1994
We identified it
Jun 20, 2026
Summary
Garden State Health Plan has updated procedures for completing Prior Authorization form GSHP-7 for Medicaid services. The policy clarifies form completion requirements, extends authorization periods up to one year, and specifies special rules for hospital referrals and mental health services.
Action Required
Immediately: Billing team must update Medicaid prior authorization procedures for Garden State Health Plan members. Ensure GSHP-7 forms include all required recipient and provider information in sections 1-13. Send top copy to Unisys at PO Box 4803, Trenton, NJ 08650-4803. Use GS-17 for inpatient hospital referrals and GS-18 for outpatient hospital services (not both on same form). For mental health services, only authorize first visit per six-month period using GS-18 for hospital settings or GS-08 for clinic settings.