If Medicaid has not been reinstated 30 days before the termination date shown in iRecord, follow these steps:

Step 1: Submit a Request

The support coordination agency may submit a Voucher Approval Request.docx to the DDD Medicaid Eligibility Helpdesk. Use this subject line in the email: "Voucher Request: DDDID #"

Step 2: Wait for a Decision

The DDD Medicaid Eligibility Helpdesk will review the form and email the support coordination agency with a decision to approve or deny the request.

• If Approved:
  • The Helpdesk will send the agency a Payment Voucher Template.pdf with instructions on how to complete and submit it for payment.
  • All provider agencies listed in the service plan will be copied on the email and asked to submit their own Voucher Approval Request form for tracking purposes.
• If Denied:
  • The Helpdesk will explain the reason for the denial in the email.

Step 3: Notify the Individual or Guardian

• The support coordination agency must inform the individual or their guardian of the decision.

DDD developed the payment voucher process to bridge the payment gap when there is a temporary loss of Medicaid. It enables critical services to continue while the Medicaid issue is resolved. Here's how it works:

Initial 90-Day Approval

• When Medicaid coverage ends, the DDD Medicaid Eligibility Helpdesk will approve the use of payment vouchers for a 90-day period, starting from the date Medicaid was terminated.
• This gives the individual or guardian enough time to work on getting Medicaid reinstated.

After 90 Days

• If Medicaid has not been reinstated after 90 days, additional voucher requests will be reviewed one month at a time.
• An extension of the approval to use payment vouchers will only be approved if the individual or guardian is actively working to get Medicaid back.
• The DDD Medicaid Eligibility Helpdesk will monitor progress and review monthly updates from the support coordination agency.

When Voucher Payments Will Stop

Voucher requests will not be approved if:

• The Medicaid application is denied, or
• The individual or guardian does not take the necessary steps to reinstate Medicaid.

In these cases, the DDD Medicaid Eligibility Helpdesk will recommend that the support coordination agency submit an SOS request to Review to Inactive (RI)/Approve to Inactive (AI) the individual's plan and disenroll them from the waiver program.

Medicaid can take up to 90 days to make an eligibility decision. Because of this, support coordination agencies and providers must wait until the end of the 90-day period before submitting vouchers. In most cases, Medicaid will be reinstated without any gap in coverage.

Voucher Approval Is Temporary: The voucher approval only stays in effect until Medicaid makes a decision. Here's what to do depending on the outcome:

• If Medicaid is Reinstated with No Gap in Coverage: Submit claims as you normally would through Gainwell.
• If No Medicaid Decision Has Been Made After 90 Days: Submit payment vouchers for services provided during the time Medicaid was terminated, to the DDD Medicaid Eligibility Helpdesk at DDD.MediEligHelpdesk@dhs.nj.gov.