N.J. Admin. Code § 10:141-1.12

Current through Register Vol. 56, No. 21, November 4, 2024

Section 10:141-1.12 - Ineligible supports and services

(a) The following list represents ineligible goods, services, and other items that will not be considered for assistance from the Fund:

1. Acute medical care or emergency medical treatment;

2. Motor vehicles or automobiles;

3. Recreational drugs, alcohol, or any illegal substances;

4. Costs associated with vacations or other entertainment or recreation expenses;

5. Any item or service that is unrelated to the diagnosis or the treatment of brain injury;

6. Entertainment equipment, such as TVs, VCRs, and gaming systems;

7. Food and meals, except on an emergent basis;

8. Services provided by relatives, except as provided for under N.J.A.C. 10:141-1.11;

9. Services provided by individuals or agencies without appropriate licensure or certification;

10. Furniture or home furnishings, except as provided for under N.J.A.C. 10:141-1.11;

11. Child care services furnished outside the applicant/beneficiary's home;

12. Legal services other than those provided for under N.J.A.C. 10:141-1.11;

13. Any service or support available to the general public through a governmental program or agency, and for which there is no charge;

14. Items to be used as gifts, including cash;

15. Payment for normal expenses related to the operation or maintenance of a vehicle;

16. Payment for cable television and internet services;

17. Payment for services needed by a beneficiary's family;

18. Payment for insurance coverage other than medical or pharmaceutical insurance;

19. Veterinary care, except for credentialed service animals;

20. Consumable supplies associated with the use of a computer;

21. Co-pays and deductibles associated with insurance coverage;

22. Services requested to supplement other government or public programs;

23. Routine costs associated with moving or relocation;

24. Gym and health club memberships;

25. Services requested because a provider does not accept insurance, including Medicare, Medicaid, and/or other government health programs for which the applicant is otherwise entitled or eligible;

26. Hospice services or palliative care;

27. Massage therapy;

28. Therapies and treatments, other than those set forth in N.J.A.C. 10:141-1.11;

29. Treatments and services that are deemed to be experimental and/or have not been approved by the United States Food and Drug Administration or other recognized regulatory body;

30. Personal care services that are determined to be custodial in nature;

31. Payment to providers outside the State of New Jersey;

32. Payment of health insurance premiums; and

33. Payment for desktop and laptop computers in circumstances other than defined in N.J.A.C. 10:141-1.11(a)30.

N.J. Admin. Code § 10:141-1.12

Adopted by 49 N.J.R. 1683(a), effective 6/19/2017