MedicaidCoverageHigh impact
Newsletter Vol. 2, No. 49
New Jersey Medicaid·NJ · Palliative Care·Provider Notice
Effective date
Sep 1, 1993
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid is establishing a new hospice services program with specific eligibility requirements, covered services, and billing procedures. Hospice agencies must obtain prior approval from the interdisciplinary team for all Medicaid services (except physician services) before providing care, and billing must follow the enclosed Fiscal Agent Billing Supplement. A limited MEI card will be issued to hospice-eligible recipients restricting coverage to hospice and physician services.
Action Required
By September 1993: (1) Hospice agencies must discard the draft Fiscal Agent Supplement provided at July training and implement the revised Fiscal Agent Billing Supplement enclosed in this newsletter. (2) Billing team must update internal processes to require interdisciplinary team approval BEFORE providing any Medicaid-covered hospice services (except physician services) to ensure proper plan of care documentation; failure to obtain approval will result in payment denial. (3) Obtain and stock revised forms by projecting three-month supply needs and ordering through Division of Medical Assistance and Health Services (address provided). (4) Train billing staff on new recipient eligibility verification procedures, including recognition of the limited MEI card with hospice-only restrictions. (5) For HMO members (GSHP or other plans providing hospice authorization), billing team must obtain and record authorization numbers from HMO physician case managers BEFORE billing for services.