MedicaidReimbursementHigh impact
Newsletter Vol. 2, No. 44
New Jersey Medicaid·NJ·Provider Notice
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Summary
Designated outstation hospitals must reimburse county welfare agencies for the nonfederal share of Medicaid eligibility determination costs. The Division will implement automated withholding of Medicaid payments at the beginning of each calendar quarter (one-fourth of estimated annual outstation charge), identified by county welfare agency numeric codes on the Remittance Advice.
Action Required
REQUIREMENTS:
- Immediately: Billing team and Chief Financial Officer must identify whether your hospital is designated as an outstation site for Medicaid eligibility determinations by reviewing the attached list of New Jersey County Welfare Agencies.
- Beginning January 2024: Implement monitoring process to track automated Medicaid payment withholdings on the Remittance Advice from fiscal agent Paramax-Unisys. Look for Lien/Levy Transaction Advice codes (two-digit numeric codes) identifying the county welfare agency being reimbursed.
- Each calendar quarter: Reconcile withheld amounts against actual county welfare agency costs on federally-approved cost allocation plans. Flag discrepancies for adjustment in subsequent year estimates.
- Notify: Chief Financial Officer and Accounting Department of expected quarterly payment reductions tied to outstation charges.
- Contact David Lowenthal, Budget and Fiscal Operations Division of Medical Assistance and Health Services with questions regarding outstation charge calculations.
CONSEQUENCES: Failure to account for these withholdings will result in unexpected revenue shortfalls and cash flow impact. Inaccurate reconciliation may result in overpayment or underpayment of county welfare agencies.