The New Jersey Department of Human Services (“DHS”) has announced that its Federal Section 1135 Waiver Request has been approved by the U.S. Department of Health & Human Services Centers for Medicare & Medicaid Services (“CMS”).

On March 20, 2020, the New Jersey DHS had outlined federal Medicaid requirements that “pose issues or challenges for the health care delivery system” in light of COVID-19, and requested a waiver or modification of those requirements.

In a March 23, 2020 notice, CMS advised the New Jersey DHS that its Medicaid waiver request was approved. It includes the following:

  • Temporarily suspending Medicaid fee-for-service prior authorization requirements;
  • Extending pre-existing authorizations for which a beneficiary has previously received prior authorization;
  • Suspending Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days;
  • Extending fair hearing requests and appeal deadlines;
  • Expanding provider enrollment; and
  • Allowing nursing and other facilities to provide services in alternative settings.

The approved waivers are effective March 1, 2020, and will terminate upon the termination of the COVID-19 public health emergency.

A full text of the CMS Section 1135 Waiver Request approval and response can be found here: https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/?entry=54033

For additional information concerning Medicaid and public benefits planning, visit:

NJ Medicaid and Public Benefits Planning

For additional information concerning Medicaid applications and appeals, visit:

NJ Medicaid Applications

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