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Newsletter Vol. 4, No. 05
Act
immediately
Effective date
Not stated in the notice
Identified
Jun 20, 2026
Summary
Veterans' Improved Pension benefits for surviving spouses without children in nursing facilities are being reduced effective immediately, with the reduced amount becoming their Personal Needs Allowance (PNA) rather than offsetting care costs. Billing teams must monitor for updated PAL forms from County Welfare Agencies and adjust previously paid claims that listed incorrect patient payment amounts.
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What to do
immediately · 4 steps
01Monitor for PAL forms from County Welfare Agencies for veterans and surviving spouses receiving Improved Pension benefits in nursing facilities.
02For claims already paid with incorrect patient payment amounts, complete MMIS Claim Adjustment Request Form (FD) to adjust patient payment to reflect reduced PAL amounts.
03Contact County Welfare Agency if you have veterans/spouses meeting criteria but haven't received updated PAL forms.
04Claims with blank patient payment amounts on original TAD will be adjusted automatically once new PAL is entered in system.
Original notice
Newsletter Vol. 4, No. 05
njmmis.com · Always check the source before changing claims.
Related changes
See all New Jersey Medicaid changes →Newsletter Vol. 4, No. 01MediumEffective Jul 1, 2024 · Provider NoticeNewsletter Vol. 4, No. 03LowNo effective date · CodingNewsletter Vol. 4, No. 04HighEffective Jan 1, 2025 · Provider NoticeNewsletter Vol. 4, No. 06MediumNo effective date · CodingBrowse every New Jersey Medicaid change in the policy list