N.J. Admin. Code § 11:24C-2.11

Current through Register Vol. 56, No. 24, December 18, 2024

Section 11:24C-2.11 - Cessation of services

(a) When loss of designation results from a situation set forth at N.J.A.C. 11:24C-2.1 0(a)1, 2 or 3, the health care provider shall cease providing home treatment for bleeding episodes associated with hemophilia immediately.

1. The health care provider shall coordinate with the carrier to arrange for another designated health care provider, whether or not in the carrier's network, to provide services to covered persons, prior to withdrawal of any nursing services or supplies from the home of any covered person.

(b) When the loss of designation results from any other reason not specified in N.J.A.C. 11:24C-2.1 0(a)1, 2 or 3, the health care provider shall continue to provide services and supplies to covered persons that have been receiving services and supplies from the health care provider, at the option of the covered person, for four months following the loss of designation, or until the covered person is able to obtain services and supplies from another designated health care provider, whichever occurs first, but shall not provide services to any other covered person for the home treatment of bleeding episodes associated with hemophilia.

1. The health care provider shall coordinate with the carrier to arrange for another designated health care provider, whether or not in the carrier's network at that time, to provide services to covered persons.

(c) A health care provider that continues to provide services for home treatment of bleeding episodes associated with hemophilia following loss of its designation shall continue to abide by all aspects of its agreement with the carrier for the provision of such services, except those that would otherwise cause it to be in violation of this section.

(d) A health care provider shall comply with the requirements of (a) or (b) above, as appropriate to the health care provider's situation, notwithstanding that the health care provider may have requested, and the Department may have granted the request, for a hearing.

N.J. Admin. Code § 11:24C-2.11