N.J. Admin. Code § 10:60-1.3
Current through Register Vol. 56, No. 11, June 3, 2024
Section 10:60-1.3 - Providers eligible to participate(a) A home care agency or organization, as described at (a)1 through 4 below, is eligible to participate as a New Jersey Medicaid/NJ FamilyCare provider of specified home care services in accordance with N.J.A.C. 10:49-3.2: 1. A home health agency. i. Out-of-State home health agencies providing services to Medicaid/NJ FamilyCare beneficiaries out of State, must meet the requirements of that state, including licensure, if applicable, and must meet all applicable Federal requirements;2. A health care service firm;3. A private duty nursing agency; and(b) In order to be approved as a Medicaid/NJ FamilyCare-participating provider, the applicant shall have a valid National Provider Identifier (NPI) obtained from the National Plan and Provider Enumeration System (NPPES) and a valid taxonomy code obtained from the NPPES.(c) Once approved as a Medicaid/NJ FamilyCare provider, the provider shall remain a provider in good standing by successfully completing provider revalidation when requested by DMAHS.(d) Health care service firms shall be accredited, initially and on an ongoing basis, by an accreditation organization approved by the Department.(e) Entities seeking to become accreditation organizations approved by the Department shall petition the Division of Disability Services (DDS) in writing to become a Medicaid/NJ FamilyCare-approved accrediting entity. DDS will oversee the process, review credentials, and, within 90 days of the date of the initial request for consideration, make a recommendation to the DMAHS Director for final decision. DDS may, at its discretion, request documentation from the party to support the request. In such case, the 90-day timeframe shall be tolled pending responsive submission of all such necessary documentation.N.J. Admin. Code § 10:60-1.3
Amended by 50 N.J.R. 1992(b), effective 9/17/2018Amended by 54 N.J.R. 1721(a), effective 9/6/2022