N.J. Admin. Code § 10:55-1.1

Current through Register Vol. 57, No. 1, January 6, 2025

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/NJ FamilyCare programs relevant to the provision of prosthetic and orthotic services to Medicaid/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/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/NJ FamilyCare beneficiaries of dentures, artificial eyes, or hearing aids. These services are covered in the New Jersey Medicaid/NJ FamilyCare 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/NJ FamilyCare-Plan A fee-for-service beneficiaries. Prosthetic and orthotic services provided to Medicaid/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).

Amended by 56 N.J.R. 2189(b), effective 11/4/2024