N.J. Admin. Code § 10:79A-1.2

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

Section 10:79A-1.2 - Statement of purpose and goals

(a) This chapter implements P.L. 2011, c. 114, by establishing, and thereby allowing the Department to implement, rules for such a demonstration project in a manner that addresses issues including, but not limited to, project standards, antitrust laws (including the active supervision prong of the State Action Immunity Doctrine ( California Retail Liquor Dealers Association v. Midcal Aluminum, Inc., 445 US 97 (1980))), and the Departments exercise of independent judgment and control in its oversight and regulation of the conduct of the Medicaid ACOs in the Demonstration Project.

(b) The Demonstration Project encourages additional appropriate care, not reduced care, for the most vulnerable beneficiaries; and the Demonstration Project does not contain mechanisms to control access, such as pre-certification activities or processes for denying care.

(c) The Department, in consultation with the Office of the Attorney General, will exercise ongoing oversight and regulation of the conduct of the Medicaid ACOs in the Demonstration Project to safeguard against violations of Federal laws.

N.J. Admin. Code § 10:79A-1.2

Amended by 46 N.J.R. 791(a), effective 5/5/2014.