N.J. Admin. Code § 8:85-1.6

Current through Register Vol. 56, No. 9, May 6, 2024

Section 8:85-1.6 - Termination of a Medicaid NF provider agreement

(a) The Department shall terminate a NF's Medicaid provider agreement if:

1. The Long-Term Care Licensing and Certification Program of the Department or the Centers for Medicare & Medicaid Services (CMS) determines that the NF is no longer certified to provide NF services. In that case:

i. The Medicaid provider agreement shall be terminated 23 days from the survey date if the Long Term Care Licensing and Certification Program of the Department or the CMS finds that deficiencies pose immediate jeopardy to residents' health and safety.

ii. If the deficiencies do not pose immediate jeopardy to the resident's health and safety, the Medicaid provider agreement shall be terminated 180 days from the survey date.

iii. The termination of provider agreement shall be rescinded if, prior to the effective date of termination, the Long Term Care Licensing and Certification Program of the Department or the CMS determines that the deficiencies have been satisfactorily corrected and the NF is certified to provide NF services; and

2. The Department determines that other good cause for such termination exists as cited at 10:49-11.1 or as a result of a pattern of aberrancies reported in a clinical audit as defined at 8:85-1.12.

N.J. Admin. Code § 8:85-1.6

Recodified from N.J.A.C. 10:63-1.6 and amended by R.2005 d.389, effective 1/17/2006.
See: 36 New Jersey Register 4700(a), 37 New Jersey Register 1185(a), 38 New Jersey Register 674(a).
Section was "Termination of a NF provider agreement"; rewrote (a).