N.J. Admin. Code § 11:24-2.7

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

Section 11:24-2.7 - Notice of changes in HMO operations

(a) Following issuance of a certificate of authority, the HMO shall notify the Department, in writing, of any substantial change to items identified at N.J.A.C. 11:24-2.2(c)1 through 24, at least 30 days prior to the date when such change is expected to occur. The Department shall deem such change approved within 30 days from the date of receipt of notice of the change unless the Department notifies the HMO otherwise. Substantial changes include, but are not limited to:

1. Any change or reduction in the provider network that adversely impacts network adequacy requirements identified at N.J.A.C. 11:24-6;

2. The subcontracting of any major functions not specified at N.J.A.C. 11:24-2.6(a) to another entity;

3. The nonrenewal of a hospital provider's contract which shall be reported in accord with N.J.A.C. 11:24-3.5(b); and

4. The establishment of a new group health center in a county or service area that has previously received certificate of authority approval for initiation of group health center services in that area.

N.J. Admin. Code § 11:24-2.7

Amended by R.2000 d.183, effective 5/1/2000.
See: 31 N.J.R. 953(a), 32 N.J.R. 1544(a).
In (a), rewrote the introductory paragraph and 2.