New Jersey

Tuesday, June 22, 2010

TRENTON, N. J. - Providers here got thrown for a loop when the state announced it would reinstitute a prior authorization (PA) process for incontinence supplies–and gave them only three week's notice.

"It's a large workload that has been brought back to providers," said Wendy Russalesi, executive director of the Jersey Association of Medical Equipment Services (JAMES).

The state has also dropped the monthly cap on incontinence products like diapers, underpads and gloves from 250 units to 180 units. However, with sufficient medical documentation, Medicaid will approve the larger quantities, said Russalesi.

In addition to incontinence supplies, the state now also requires PAs for surgical stockings, and it's rumored to have its eye on "quite a few" other HCPCPS codes.

The JAMES Medicaid committee plans to meet with state officials soon.

"We are watching the budget, and it's very possible further cuts could be coming," said Russalesi. "Like every other state, they are trying to get some control over their expenditures."