Update Regarding Automatic Extension of Private Duty Nursing Authorizations

Due to the continuing COVID-19 public health emergency, the New Jersey Department of Human Services, Division of Medical Assistance and Health Services (DMAHS) has directed Horizon NJ Health to continue automatically renewing existing authorizations for Private Duty Nursing (PDN) services. This applies to existing PDN authorizations for all Horizon NJ Health members, including MLTSS and Horizon NJ TotalCare (HMO D-SNP).

For existing PDN authorizations, you do not need to request renewal of any existing PDN authorizations, as Horizon NJ Health will continue to renew them automatically for 90 days until we receive further direction form DMAHS.

If you submitted a request to renew an existing PDN authorization through the Utilization Management Request Tool, Horizon NJ Health will void the request and automatically extend the prior authorization. You do not need to take any further action at this time.

For new requests for PDN authorization and changes to existing PDN authorizations, you should continue to submit requests following Horizon NJ Health’s standard process. Also, as we approach a new year, please ensure you contact the member’s primary coverage for requests, and please continue to follow the standard process for members who have Third Party Liability coverage.

We will notify you once DMAHS directs us to stop automatically renewing PDN authorizations, and we also will notify you of any further changes resulting from the COVID-19 public health emergency.

Have Questions?
If you have questions about PDN services and authorization for:

  • Horizon NJ Health, Core Medicaid, Early and Periodic Screening, Diagnostic and Treatment members, call Vivian Keller, Director of Utilization Management at 1-800-682-9094 x45684
  • Horizon NJ TotalCare (HMO D-SNP), Division of Developmental Disabilities Supports Plus PDN and MLTSS (pediatric and adult) members, call Carol Cianfrone, Director, MLTSS at 1-800-682-9094 x53125