N.J. Admin. Code § 10:50-1.7
Current through Register Vol. 56, No. 12, June 17, 2024
Section 10:50-1.7 - Transportation certification for emergency services(a) The Fiscal Agent Billing Supplement contains a sample transportation certification form and instructions for the form's proper completion. The elements appearing on the sample transportation certification form shall appear on all certification forms furnished and prepared by the independent transportation provider. In addition to the elements appearing on the sample transportation certification form in the Fiscal Agent Billing Supplement, a provider's transportation certification form for emergency ground ambulance service shall contain the following documentation: 1. Beginning and ending mileage amounts for each trip as measured by the vehicle's odometer. Mileage amounts shall accurately reflect the point at which the Medicaid or NJ FamilyCare fee-for-service beneficiary enters the vehicle and the point at which he or she exits the vehicle; and2. The seven-digit Provider Billing Number of the provider at the place of destination.(b) The transportation certification form shall be retained on file at the provider's place of business for a minimum period of five years from the date the service was rendered. The transportation certification form shall be made available for review upon request by staff of the Division of Medical Assistance and Health Services or the Division's fiscal agent during this period of time. If a transportation certification form is not on file for each service, or does not contain all the required elements and signatures as indicated in this section and on the sample transportation certification form in the Fiscal Agent Billing Supplement, Medicaid or NJ FamilyCare reimbursement for the service is subject to recoupment, as indicated in N.J.A.C. 10:49-9.91. Each hard-copy transportation claim form, MC-12, forwarded to the Division's Fiscal Agent shall include, as an attachment, a photocopy of a properly completed, signed, and dated transportation certification form for each corresponding date of service for each beneficiary.(c) The vehicle recognition number (ground ambulance) that corresponds to the vehicle used to provide the respective transportation service shall be entered on the "Transportation Claim" (Form MC-12) in Item 18 (REMARKS) when submitting hard copy claims to the Division's Fiscal Agent for ground ambulance service.N.J. Admin. Code § 10:50-1.7
New Rule, R.1992 d.83, effective 2/18/1992.
See: 23 N.J.R. 3619(a), 24 N.J.R. 610(a).
Prior annotations for this section are as follows:
Amended by R.1972 d.91, effective 5/10/1972.
See: 4 N.J.R. 127(b).
Amended by R.1985 d.427, effective 8/19/1985.
See: 17 N.J.R. 1373(a), 17 N.J.R. 2044(a).
Chart substantially amended.
Amended by R.1985 d.473, effective 9/16/1985.
See: 17 N.J.R. 1637(a), 17 N.J.R. 2271(a).
Chart substantially amended.
Repealed by R.1986 d.52, effective 3/3/1986.
See: 17 N.J.R. 1519(b), 18 N.J.R. 478(a).
This section was "transportation services, maximum allowable fees".
Recodified from 1.6 R.1988 d.262, effective 6/6/1988.
See: 19 N.J.R. 2103(a), 20 N.J.R. 1214(a).
Amended by R.1992 d.447, effective 11/16/1992.
See: 24 N.J.R. 2517(a), 24 N.J.R. 4264(a).
Recodified section as subsections (a)-(c), adding new text at subsections (b) and (c).
Amended by R.1994 d.402, effective 8/1/1994 (operative August 15, 1994).
See: 26 N.J.R. 1425(a), 26 N.J.R. 3211(b).
Amended by R.1999 d.5, effective 1/4/1999.
See: 30 N.J.R. 3625(a), 31 N.J.R. 58(a).
In (b), inserted a reference to NJ KidCare; and in (c), substituted "mobility assistance vehicle" for "invalid coach" throughout.
Amended by R.2000 d.501, effective 1/16/2001.
See: 32 N.J.R. 2397(a), 33 N.J.R. 322(a).
Rewrote (a) and (b).
Amended by R.2002 d.170, effective 6/3/2002.
See: 34 N.J.R. 635(a), 34 N.J.R. 1925(a).
Added (b)1.
Amended by R.2006 d.213, effective 6/19/2006.
See: 37 N.J.R. 4850(a), 38 N.J.R. 2713(a).
Substituted "FamilyCare" for "KidCare" throughout.Amended by 54 N.J.R. 620(b), effective 4/4/2022