N.J. Admin. Code § 10:60C-8.1

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

Section 10:60C-8.1 - Voluntary disenrollment

(a) Voluntary disenrollment of service involves situations in which eligible individuals request and/or agree to the cessation of participant-directed services.

(b) Participants that voluntarily discontinue services and request disenrollment from the program may return to traditional PCA services through an approved Medicaid/NJ FamilyCare home care provider agency at any time, in accordance with N.J.A.C. 10:60C-1.3(a)6.

(c) In the event of a request for a voluntary disenrollment of service by the participant, the following procedures shall be followed:

1. The Division shall inform the MCO of the disenrollment, for individuals enrolled in managed care, to enable transition to traditional PCA services, as requested by the participant.

2. Upon agreeing on a disenrollment date with the MCO as described in (c)1 above, the Division shall instruct the VF/EA to deactivate the participant-directed services account accordingly to avoid duplication of services, upon selection of a provider agency and the effective date of the transition.

3. The Division shall provide assistance for individuals enrolled in Medicaid/ NJ FamilyCare fee-for-service with the transition to traditional services through an approved home care provider, at the request of the participant.

N.J. Admin. Code § 10:60C-8.1

Amended and recodified from 10:142-8.1 by 56 N.J.R. 2294(a), effective 12/2/2024