N.J. Admin. Code § 10:55-1.1

Current through Register Vol. 56, No. 11, June 3, 2024

Section 10:55-1.1 - Introduction

(a) This chapter of the manual N.J.A.C. 10:55 outlines the rules of the New Jersey Medicaid and NJ FamilyCare programs relevant to the provision of prosthetic and orthotic services to Medicaid and NJ FamilyCare fee-for-service beneficiaries. It also lists the specific requirements which must be followed in order to be approved and to participate as a New Jersey Medicaid and NJ FamilyCare provider of prosthetic and orthotic services.

(b) The Prosthetic and Orthotic Services Manual, N.J.A.C. 10:55, does not include rules for the provision to Medicaid and NJ FamilyCare beneficiaries of dentures, artificial eyes, or hearing aids. These services are covered in the New Jersey Medicaid programs' Dental Services Manual, N.J.A.C. 10:56, Vision Care Services Manual, N.J.A.C. 10:62, and the Hearing Aid Services Manual, N.J.A.C. 10:64, respectively.

(c) Unless otherwise stated, the rules of this chapter apply to Medicaid and NJ FamilyCare-Plan A fee-for service beneficiaries. Prosthetic and orthotic services provided to Medicaid and NJ FamilyCare beneficiaries enrolled in a managed care organization (MCO) are governed and administered by that MCO.

1. NJ FamilyCare-Plans B, C, and D beneficiaries are required to be enrolled in managed care organizations. (See N.J.A.C. 10:79.)

N.J. Admin. Code § 10:55-1.1

Amended by R.2000 d.134, effective 4/3/2000.
See: 31 New Jersey Register 3964(a), 32 New Jersey Register 1206(a).
In (a), inserted a reference to NJ KidCare Programs and substituted a reference to Medicaid and NJ KidCare fee-for-service beneficiaries for a reference to Medicaid recipients in the first sentence, and substituted a reference to Medicaid and NJ KidCare providers for a reference to providers in the second sentence; in (b), substituted a reference to Medicaid and NJ KidCare beneficiaries for a reference to Medicaid recipients; and added (c).
Amended by R.2004 d.406, effective 11/1/2004.
See: 35 New Jersey Register 4417(a), 36 New Jersey Register 4963(a).