MedicaidPrior AuthMedium impact
Newsletter Vol. 4, No. 41
New Jersey Medicaid·NJ · General Surgery, Orthopedics, Cardiothoracic Surgery +8 more·Provider Notice
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid has implemented a Second Surgical Opinion Program requiring patients to obtain a second medical opinion before certain surgical procedures. This policy affects surgical billing and may introduce delays in scheduling covered procedures.
Action Required
Immediately: Billing and scheduling teams must identify which surgical procedures require second opinions under the new NJ Medicaid program. Update patient scheduling workflows to account for second opinion requirements before surgery authorization. Contact NJ MMIS for specific procedure list and implementation guidelines.