N.J. Admin. Code § 8:57A-1.12

Current through Register Vol. 56, No. 21, November 4, 2024

Section 8:57A-1.12 - Audit, Letter, and notice of violations and enforcement actions

(a) A health care facility, physician's, dentist's, other health care provider's office, and clinical laboratory shall be subject to audit at the discretion of the Commissioner by authorized representatives of the Department.

(b) The Department, or its designee, shall evaluate completeness and timeliness of reporting as specified by this subchapter by reviewing documents, such as medical records, diagnostic indices of radiation, laboratory, cytology and/or pathology reports, and discharge records.

(c) Authorized representatives of the Department shall conduct the audit during normal operating hours.

(d) The Department's authorized representatives may cite a deficiency upon a determination that the health care facility, physician's, dentist's, other health care provider's office, and clinical laboratory does not comply with the reporting requirements established in this subchapter.

(e) At the conclusion of the audit or within 10 business days thereafter, the Department or its designee shall provide the health care facility, physician's, dentist's, other health care provider's office or independent clinical laboratory with a written Letter of Potential Violation and Potential Assessment (Letter) summarizing any factual findings used as a basis to determine that reporting has not been complete or timely.

1. The Department or its designee shall set forth in the Letter the proposed assessment of civil monetary penalties, and as applicable, the specific reasons for the action.

2. The Department or its designee shall serve the Letter on a facility, physician, dentist, other health care provider or independent clinical laboratory or its, his or her registered agent in person or by certified mail.

(f) A health care facility, physician, dentist, other health care provider, and clinical laboratory shall have 30 business days after receipt of the Letter by certified mail or personal service in which to correct all deficiencies in its reporting that were discovered during the audit and cited in the Letter.

1.If a health care facility, physician, dentist, other health care provider, and clinical laboratory fails to correct deficiencies in its reporting that were discovered during the audit and cited in the Letter within 30 days, the Department, or its designee, will act as registrar and shall charge the facility, physician, dentist, other health care provider, and clinical laboratory for all costs related to these services, such as the retrieval of case information and the cost of the audit.

i. This fee shall be based upon the fair market value of such services.

ii. All checks for fees for the Department's services shall be made payable to "Treasurer, State of New Jersey" or its designee, as provided in the Letter and forwarded to:

Office of Cancer Epidemiology

New Jersey State Cancer Registry

New Jersey Department of Health

PO Box 369

Trenton, New Jersey 08625-0369

2. If a health care facility, physician, dentist or other health care provider fails to correct deficiencies in its reporting that were discovered during the audit and cited in the Letter within 30 days, the Department or its designee shall serve the entity or provider with a written Notice of Violation and Penalty Assessment.

3. If a health care facility licensed by the Department pursuant to N.J.S.A. 26:2H-1et seq., fails to correct deficiencies in its reporting that were discovered during the audit and cited in the Letter within 30 days, the Department, or its designee, shall report the facility to the Division of Health Facilities Evaluation and Licensing for non-compliance with these rules.

4. If a physician, dentist, and other health care provider fails to correct deficiencies in its reporting that were discovered during the audit and cited in the Letter within 30 days, the Department, or its designee, shall report the provider to the appropriate New Jersey licensing board for non-compliance with this chapter.

5. If a clinical laboratory fails to correct deficiencies in its reporting that were discovered during the audit and cited in the Letter within 30 days, the Department, or its designee, shall report the clinical laboratory to the Clinical Laboratory Improvement Service in the Division of Public Health and Environmental Laboratories for non-compliance with this chapter.

N.J. Admin. Code § 8:57A-1.12

Amended by 50 N.J.R. 1893(a), effective 8/20/2018