LONG TERM CARE NEW JERSEY MEDICAID PROVIDER APPLICATION
Regarding enrollment as a Long Term Care (LTC) New Jersey Medicaid
The Department of Health contracts Molina Medicaid Solutions as the fiscal agent for the processing of Medicaid applications. To access Medicaid applications and for inquiries regarding Medicaid and Medicaid Provider Enrollment, please click on the following link: http://www.njmmis.com or contact Molina Medicaid Solutions at (609) 588-6036.
To become a provider the following documents will be required by Molina Medicaid Solutions:
Jersey Medicaid Provider Application
and Control Interest Disclosure Statement for the facility;
for Nursing Facility Participation and;
- Pharmacy Notification form.
Term Care (LTC) license
between the LTC agency and the Pharmacy.