MedicaidAdministrativeMedium impact
New Jersey Medicaid: Billing our members for covered services is not permitted
UnitedHealthcare·NJ·State news
We identified it
Apr 1, 2026
Summary
New Jersey Medicaid has issued a reminder that providers are prohibited from billing members directly for any covered services. This reinforces existing balance billing restrictions for NJ Medicaid members.
Action Required
Immediately: Billing team must verify all NJ Medicaid claims are submitted to the plan and never billed directly to patients for covered services. Review current billing practices to ensure no balance billing occurs for NJ Medicaid members. Update staff training on Medicaid billing restrictions to prevent compliance violations.