N.J. Admin. Code § 11:24B-3.4

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

Section 11:24B-3.4 - ODS: performance of health care services

(a) In order to qualify for certification to provide or arrange for the provision of the performance of health care services only, an ODS shall:

1. Submit a statement certifying that the ODS shall not engage in the performance of any of the other functions set forth in this chapter for which certification is required;

2. Demonstrate that its contracted health care providers are credentialed, providing a description of the credentialing standards and procedures that the ODS uses;

3. Submit a statement specifying whether all contracted health care providers are required to become participating providers with all carriers with which the ODS contracts, for all products, or whether a health care provider may limit participation; and

4. Submit a statement that the ODS shall provide written notice to the Department no later than 10 business days following the date that the ODS alters the types of health care services the performance of which the ODS provides or arranges to provide under contract with one or more carriers.

(b) In order to qualify for certification to provide or arrange for the provision of the performance of health care services and one or more other categories of services, as set forth at N.J.A.C. 11:24B-2.4(a), the ODS shall comply with (a)2 through 4 above, in addition to the standards applicable to the other categories of services to be provided.

N.J. Admin. Code § 11:24B-3.4