N.J. Admin. Code § 10:58-1.4

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

Section 10:58-1.4 - Application for provider status; certified nurse midwife

(a) Any nurse midwife may apply to the New Jersey Medicaid/NJ FamilyCare programs for approval as a Medicaid/NJ FamilyCare provider, if he or she:

1. Is a registered professional nurse licensed by the New Jersey State Board of Nursing;

2. Is certified by the American College of Nurse Midwives (ACNM) or the American College of Nurse Midwives Certification Council;

3. Shows evidence of continuing competency, as required by the ACNM; and

4. Is registered as a certified nurse midwife by the New Jersey State Board of Medical Examiners.

(b) See N.J.A.C. 10:49-3for additional requirements for provider participation.

(c) An applicant shall complete a Medicaid Provider Application (FD-20; see N.J.A.C. 10:49, Appendix, Form #8) and a Medicaid Provider Agreement (FD-62; see N.J.A.C. 10:49, Appendix, Form #9). The forms may be obtained from, and shall be submitted to:

Gainwell Technologies

Provider Enrollment

PO Box 4804

Trenton, NJ 08650-4804

(d) The application and agreement shall be accompanied by a photocopy of the applicant's current:

1. License as a registered professional nurse;

2. Registration as a nurse midwife; and

3. Certification from the American College of Nurse Midwives (ACNM) or the American College of Nurse Midwives Council (ACC).

(e) The applicant will receive notification of approval or disapproval from the Medicaid/NJ FamilyCare fiscal agent Gainwell Technologies. If approved, the CNM shall be furnished with a provider manual and assigned a Medicaid/NJ FamilyCare provider identification number. The CNM shall use the assigned provider identification number in all communication with the Medicaid/NJ FamilyCare programs and/or the fiscal agent.

N.J. Admin. Code § 10:58-1.4

Amended by R.2001 d.204, effective 6/18/2001.
See: 33 N.J.R. 1160(a), 33 N.J.R. 2188(a).
In (a) and (e), inserted references to NJ FamilyCare throughout.

Amended by 53 N.J.R. 1843(c), effective 11/1/2021