N.J. Stat. tit. 30, ch. 4D
N.J. Stat. tit. 30, ch. 4D
in effectContents
section4D-1. Short titlesection4D-2. Declaration of purposesection4D-2.1. Findings, declarationssection4D-3. Definitions.section4D-3a. "Invalid coach service" deemed to mean "mobility assistance vehicle service"section4D-3b. Establishment of enrollment simplification practices.section4D-3b1. Permanent change of station order, residency requirement, Division of Medical Assistance and Health Services; definitions.section4D-3c. Information technology platform relative to eligibility determination for Medicaid, NJ FamilyCare.section4D-3d. Definitions, Medicaid eligibility redetermination.section4D-3d1. Presumptive eligibility, Medicaid, home, community-based services, long-term services, supports program; definitions.section4D-3e. Rules, regulations.section4D-4. Division of medical assistance and health servicessection4D-4.1. Process for reviewing NJ FamilyCare provider applications.section4D-5. Medical assistance programsection4D-6. Medical assistance for qualified applicants.section4D-6a. $35 monthly personal needs allowancesection4D-6aa. State plan amendments, waivers, HIV preexposure prophylaxis, HIV postexposure prophylaxis, benefits.section4D-6bb. Contracts purchased by the Division of Medical Assistance and Health Services, managed care organization, behavioral health, children.section4D-6c. Continued Medicaid eligibilitysection4D-6d. Third party, certain; primary payersection4D-6e. Uninsured, ineligible persons may purchase health care coveragesection4D-6f. Eligibility of aliens for medical assistance.section4D-6g. Findings, declarations relative to emergency care.section4D-6h. Definitions relative to emergency care.section4D-6i. Non-participating hospital, payment for emergency treatment for Medicaid recipient.section4D-6j. Criteria for Medicaid admission to certain long-term care facilities for HIV/AIDS patients.section4D-6k. State Medicaid, NJ FamilyCare programs to provide coverage, paymentsection4D-6l. Enrollment in Medicaid for medical parolee.section4D-6m. Provision of benefits for certain treatments for substance use disorder.section4D-6n. Rules, regulations.section4D-6o. Provision of breastfeeding support through Medicaid.section4D-6p. Coverage of certain prescription refills by Medicaid, NJ FamilyCare during state of emergency.section4D-6.1. Abortions; payment of claimssection4D-6.2. Definitions.section4D-6.3. Provider of mobility assistance vehicle services; conditions for approval for reimbursementsection4D-6.4. Minimum requirements, liability insurance, personnel; rules, regulations.section4D-6.5. Inapplicability of act to services by volunteer first aid, rescue and ambulance squadssection4D-6.6. Rules and regulations; application of Medical Assistance and Health Services Actsection4D-6.7. Resident of skilled or intermediate care nursing facility discharged to general or psychiatric hospital; coverage by medical assistance programsection4D-6.8. Period of maintenance of bed for eligible resident; certification for paymentsection4D-6.9. Inability of discharged resident to return within period; priority for next available bedsection4D-6.10. Conditions for reimbursement to providers; educational materials; terms defined.section4D-6q. Medicaid, NJ FamilyCare, opioid antidote coverage.section4D-6r. Medicaid to cover newborn home nurse visitation.section4D-6s. State Medicaid program, coverage for family planning services.section4D-6t. Remote participation in certain meetings, eligible Medicaid recipients, authorization.section4D-6u. Commissioner of Human Services, waivers, implementation, provisions, secure federal financial participation.section4D-6v. Rules, regulations.section4D-6w. Division of Medical Assistance and Health Services, managed care organization, NJ FamilyCare beneficiaries, reimbursement, claims, conditions.section4D-6x. Commissioner of Human Services, State plan amendments, waivers, apply as may be necessary.section4D-6y. Biomarker precision medical testing, Medicaid recipients, no cost-sharing.section4D-6z. Department of Human Services, HIV preexposure prophylaxis, HIV postexposure prophylaxis.section4D-7. Duties of commissioner.section4D-7a. County welfare agency to provide adequate employees to determine Medicaid eligibilitysection4D-7aa. Analysis of data.section4D-7aaa. NJ FamilyCare reimbursement rates for certain special care nursing facilities.section4D-7b. Preparation of five-year plan for developing Statewide network of managed care providerssection4D-7bb. Rules, regulations.section4D-7bbb. Application for State plan amendments, waivers as necessary.section4D-7c. Submission of plan to enroll Medicaid recipients by health maintenance organizationssection4D-7cc. Legislative approval of reimbursement rate increases.section4D-7d. Report by commissionersection4D-7dd. Risk reduction model to prescription drug services, third party contract.section4D-7e. Rules, regulationssection4D-7ee. Pharmacy benefits management services, information disclosuresection4D-7f. Access fees charged by fiscal agent; establishment; usesection4D-7ff. Amendment of the Medicaid managed care organization contract provisions.section4D-7g. Findings, declarations relative to pediatric rehabilitation hospitals.section4D-7gg. Rules, regulations.section4D-7h. Reimbursement by State Medicaid program, rates; other costs.section4D-7hh. Per diem reimbursement rate compared to established State Medicaid fee-for-service rate.section4D-7i. Exemption from close proximity requirements, notification as to off-site location.section4D-7ii. Restricting modification, termination of existing provider network contract.section4D-7j. Annual cost report to receive reimbursement from Medicaid for personal care assistant services.section4D-7jj. Findings, declarations.section4D-7k. Definitions relative to reimbursement for family planning services.section4D-7kk. Medicaid per diem, encounter reimbursement rates, eligible brain injury services, minimum requirements.section4D-7l. Department to facilitate implementation of C.30:4D-7k.section4D-7ll. State plan amendments, waivers, brain injury services, application; implementation of provisions.section4D-7ll.1. Definitions.section4D-7ll.2. Special care nursing facility, reimbursement, traumatic brain injury, NJ FamilyCare beneficiary.section4D-7ll.3. Nursing facility, reimbursement, traumatic brain injury, NJ FamilyCare beneficiary, single-occupancy room.section4D-7ll.4. State plan amendments, waivers.section4D-7m. Certain HMOs, changes in certain reimbursement rates; procedure.section4D-7mm. Assisted living residences, comprehensive personal care homes, assisted living programs, reimbursement, Medicaid beneficiaries, minimum per diem rates; definitions.section4D-7n. Hourly reimbursement rate for Medicaid personal care services.section4D-7nn. State plan amendments, waivers, provisions, implementation.section4D-7o. Report.section4D-7oo. Per diem reimbursement rate, pediatric medical day care services, on-site.section4D-7p. Medicaid reimbursement for certain emergency services.section4D-7.1. Attorney General to enforce rights against third party for recovery of medical assistance paymentssection4D-7.2. Lien against recovery sought from estate of recipient, "estate" defined.section4D-7.2a. Encumbrances, recovery limited against certain estates.section4D-7.3. Form; liens and certificates of debtsection4D-7.4. Filing liens; attachment to propertysection4D-7.5. Property held in trust; attachment of liensection4D-7.6. County clerk; register of deeds; recording liens and certificates of debtsection4D-7.7. Compromise, settlement or waiver of lien; discharge of liensection4D-7.8. Action to determine validity of lien; deposit and bond; discharge prior to adjudicationsection4D-7.9. Payment to pharmacy for certain forged, fraudulent prescriptions under State Medicaid program.section4D-7pp. State plan amendments, waivers, provisions, implementation.section4D-7q. Rules, regulations.section4D-7qq. Homemaker-home health aide certification program, family member; definition; report to Governor, Legislature.section4D-7r. Short title.section4D-7rr. State plan amendments, waivers, apply, Commissioner, Human Services.section4D-7s. Definitions relative to "The County Option Hospital Fee Pilot Program Act."section4D-7ss. Definitions.section4D-7t. "County Option Hospital Fee Program."section4D-7tt. State plan amendments, waivers, application, implementation, secure financial participation.section4D-7u. Transfer of funds to commissioner, uses; fee.section4D-7uu. Findings, declarations.section4D-7v. Imposition of fee.section4D-7vv. Definitions.section4D-7w. Application by commissioner, approval prior to collection of fee.section4D-7ww. Clinical review criteria, guidelines, step therapy protocol, Medicaid.section4D-7x. Rules, regulations.section4D-7xx. Prescription drug coverage restriction, step therapy protocol, exception process, managed care organization.section4D-7y. Perinatal Risk Assessment form for certain pregnant women.section4D-7yy. Statistics made available, step therapy exception request approvals, denials, managed care organization.section4D-7z. Submission of form to division.section4D-7zz. State plan amendments, waivers, apply as necessary for implementation, step therapy.section4D-8. Claim payment method.section4D-8.1. Findings, declarations relative to a Medicaid Accountable Care Organization Demonstration Project.section4D-8.2. Definitions relative to a Medicaid ACO.section4D-8.3. Establishment of three-year Medicaid ACO Demonstration Project.section4D-8.4. Applications for certification as a Medicaid ACO.section4D-8.5. Eligibility to receive, distribute gainsharing payments.section4D-8.6. Remission of payment to ACO.section4D-8.7. Voluntary participation in demonstration project.section4D-8.8. Duties of the department; authorization to seek grants.section4D-8.9. Annual evaluation.section4D-8.10. Application for State plan amendments, waivers.section4D-8.11. Construction of act.section4D-8.12. Continuation of payments for certain services.section4D-8.13. Certain licensure requirements waived.section4D-8.14. Report to Governor, Legislature.section4D-8.15. Rules, regulations.section4D-8.16. Findings, declarations relative to the establishment of a Regional Health Hub Program.section4D-8.17. Definitions relative to Regional Health Hubs.section4D-8.18. Regional Health Hub Program.section4D-8.19. Designation, delineation of boundaries.section4D-8.20. Revocation of status.section4D-8.21. Mandatory activities.section4D-8.22. Submission of annual proposal.section4D-8.23. Funding for Regional Health Hub.section4D-8.24. Health information platform.section4D-8.25. Consultations relative to pilot program.section4D-8.26. Application for amendments, waivers.section4D-8.27. Rules, regulations.section4D-9. Required contents of solicited bids and contractssection4D-9.1. Medicaid contract providers to provide coverage regardless of gender identity, expression.section4D-9.2. Medicaid to not provide coverage for certain early elective deliveries.section4D-10. Review of sealed bids; report and recommendation; considerationssection4D-11. Approval or disapproval of lowest responsible bid; direction of paymentsection4D-12. Unnecessary use of care and services; methods and procedures; maintenance of records required for reimbursementsection4D-13. Enrollment fees or premium chargessection4D-14. Preparation of comprehensive medical plansection4D-15. Eligibility determinationsection4D-16. Provision of funds by statesection4D-17. Penalty.section4D-17a. Additional action by Attorney General.section4D-17b. Construction of act.section4D-17.1. Suspension or disqualification of providers, termination of benefits to recipients; rules and regulationssection4D-17.2. Enforcement of commissioner's decisions; orders by civil actionsection4D-17.3. Criminal, civil violationssection4D-17.4. Reimbursement for retroactive eligibilitysection4D-17.5. Adjusted reimbursement ratessection4D-17.6. Withdrawal as Medicaid providersection4D-17.7. $13 million contingency accountsection4D-17.8. Posting, distribution of lawsection4D-17.9. Annual reportsection4D-17.10. Findings, declarationssection4D-17.11. Definitionssection4D-17.12. Nursing Home Preadmission Screening Programsection4D-17.13. Responsibility for preadmission screeningsection4D-17.14. Procedures for preadmission screeningsection4D-17.15. Rules, regulationssection4D-17.16. Definitions.section4D-17.17a. Drug Utilization Review Board.section4D-17.18. Responsibilities of department.section4D-17.18a. Rules, regulations.section4D-17.19. HMOs, certain, to contract for services provided at certain Newark schoolssection4D-17.20. Written informed parental consentsection4D-17.21. Approval as provider of psychological servicessection4D-17.22. Compliance with licensure, Medicaid requirements; authorizationsection4D-17.23. Short title.section4D-17.24. Findings, declarations relative to long-term care for Medicaid recipients.section4D-17.25. Definitions relative to long-term care for Medicaid recipients.section4D-17.26. Process to rebalance allocation of funding for expansion of long-term care services; pilot program, use Statewide.section4D-17.27. Duties of commissioner relative to report on budget, management plan.section4D-17.28. Duties of commissioner relative to funding parity, coordination, assessment instrument.section4D-17.29. Medicaid Long-Term Care Funding Advisory Council.section4D-17.30. Waiver of federal requirements.section4D-17.31. Tracking of expenditures.section4D-17.32. Inclusion of budget line for Medicaid long-term care expenditures.section4D-17.33. Medicaid medical home demonstration project; terms defined.section4D-17.34. Annual evaluation.section4D-17.35. Application for plan amendments, waivers.section4D-17.36. Annual report.section4D-17.37. Rules, regulations.section4D-17.38. Monitoring of long-term care services.section4D-17.39. Medicaid home visitation demonstration project.section4D-17.40. Application for amendments, waivers.section4D-17.41. Rules, regulations.section4D-18. Reporting and oversightsection4D-19. Severability clausesection4D-19.1. "New Jersey Medical Assistance and Health Services Program" administrators, dutiessection4D-19.2. Findings, declarations relative to intergovernmental transfer program under Medicaidsection4D-19.3. Definitions relative to intergovernmental transfer program under Medicaid.section4D-19.4. Intergovernmental transfer program established.section4D-19.5. Appropriations for supplemental payments under intergovernmental transfer program; costs.section4D-20. Program; establishmentsection4D-21. Pharmaceutical assistance eligibility.section4D-21.2. Reparations to Japanese Americans not counted as income for PAAD eligibilitysection4D-21.3. Holocaust reparations, restitution not considered income for determination of PAAD eligibilitysection4D-21.4. PAAD recipients, notification as to error in estimated annual income.section4D-21.5. Automatic enrollment in certain pharmaceutical assistance programs.section4D-22. Copayment; restrictions; definitionssection4D-22.1. Pharmacy payment conditionsection4D-22.2. "Prescription drugs," syringes, needles included; certainsection4D-22.3. Payment to pharmacy for certain forged, fraudulent prescriptions, program's responsibilities.section4D-22.4. Community retail pharmacy practice site, display, Pharmaceutical Assistance to the Aged and Disabled information.section4D-23. Prescription drug costs; payment under other plan or insurance; effect on eligibilitysection4D-24. Regulationssection4D-25. Legislative findings and declarationssection4D-26. Prescription; inclusion of name and address or identification numbersection4D-27. Notice of penalties on identification cardssection4D-28. Report to Governor and legislaturesection4D-29. List of maximum quantity of drug to be dispensed per prescriptionsection4D-30. Maximum allowable cost per prescription drug; procedure to set and review on continuing basissection4D-31. List of maximum quantities and procedures for setting maximum allowable cost; effective datesection4D-32. Annual reportsection4D-33. Violations; penaltiessection4D-34. Reimbursement for costs of prescription drugs; application and proof of expendituresection4D-35. Notice of availability and application forms; supplying to eligible personssection4D-35a. Pharmaceutical Assistance to the Aged and Disabled program, reimbursement, prescription drug costs, remainder.section4D-35.1. Short titlesection4D-35.2. Coverage limited to manufacturers providing rebatessection4D-35.3. "Pharmaceutical Assistance to the Aged and Disabled Rebate Fund" establishedsection4D-35.4. Rules, regulationssection4D-36. Hearing aid assistancesection4D-37. $100 maximumsection4D-38. Pharmaceutical assistance recipients eligiblesection4D-38.1. "Hearing Aid Assistance to the Aged and Disabled," notification as to error in estimated annual income.section4D-39. Other programssection4D-40. Payment system; eligibility determinationsection4D-41. Rules, regulationssection4D-42. Casino revenue fundingsection4D-43. Short titlesection4D-44. Definitions regarding the "Senior Gold Prescription Discount Act."section4D-45. "Senior Gold Prescription Discount Program."section4D-45a. Senior Gold Prescription Discount Program, reimbursement, prescription drug costs, remainder.section4D-45.1. "Senior Gold Prescription Discount Program," notification as to error in estimated annual income.section4D-45.2. Payment to pharmacy for certain forged, fraudulent prescriptions under State Medicaid program.section4D-45.3. Community retail pharmacy practice site, display, Senior Gold Prescription Discount Program information.section4D-46. Report to Governor, Legislaturesection4D-47. Violations of act; program identification cardssection4D-48. New Jersey EASE program, provide information on prescription programsection4D-48.1. Senior Gold prescription program information displayed on tax return instructions.section4D-49. Funding of Senior Gold Prescription Discount Programsection4D-50. Rules, regulations.section4D-51. Conditions on expending funds.section4D-52. Rebates to DHS for program.section4D-53. Short title.section4D-54. Findings, declarations relative to the Office of Medicaid Inspector General.section4D-55. Definitions relative to the Office of the Medicaid Inspector General.section4D-57. Functions, duties, powers, responsibilities of Medicaid Inspector General.section4D-58. Additional authority of the Medicaid Inspector General.section4D-59. Transfer of certain functions, powers, employees.section4D-60. Reports, recommendations.section4D-61. Confidentiality of information.section4D-62. "Medicaid Fraud Control Fund"; use.section4D-63. Rules, regulations.section4D-64. Annual appropriation, minimum required.section4D-65. Findings, declarations relative to the "iPHD Project."section4D-66. Definitions relative to the "iPHD Project."section4D-67. iPHD project governing board.section4D-68. Establishment of operational iPHD project.section4D-69. Oversight of the iPHD project.section4D-70. Annual report.section4D-71. Application for, receipt of funding.section4D-72. Access to data, agreement.
Source: Open US Law by Vaquill AI (CC BY 4.0)URL: https://www.njleg.state.nj.us/legislative-activity/statutesFetched: 10/17/2026