All PlansPrior AuthMedium impact
Newsletter Vol. 2, No. 29
New Jersey Medicaid·NJ · Orthopedics, General Surgery, Cardiothoracic Surgery +8 more·Provider Notice
We identified it
Jun 20, 2026
Summary
A Second Surgical Opinion Program has been implemented, likely requiring patients to obtain a second medical opinion before certain surgical procedures can be approved and covered by insurance.
Action Required
Immediately: Review the full policy document at https://www.njmmis.com/documentDownload.aspx?document=2-29.pdf to understand specific requirements. Surgical teams and billing staff must identify which procedures require second opinions and update pre-authorization workflows to include second opinion documentation before scheduling surgeries.