Title 30, Title 30: INSTITUTIONS AND AGENCIES

30:4D-6bb Contracts purchased by the Division of Medical Assistance and Health Services, managed care organization, behavioral health, children. 4. a. Notwithstanding any law, rule, or regulation to the contrary, the Division of Medical Assistance and Health Services within the D…

30:4D-6c. Continued Medicaid eligibility 2. A dependent child or the parent or caretaker relative of a dependent child who would lose eligibility for the aid to families with dependent children program under the State Plan for Title IV-A of the federal Social Security Act in effe…

30:4D-6d. Third party, certain; primary payer 3. If a person who is eligible for continued Medicaid benefits pursuant to section 2 of this act obtains employment which provides health insurance coverage through a third party as defined in section 3 of P.L.1968, c.413 (C.30:4D-3),…

30:4D-6e. Uninsured, ineligible persons may purchase health care coverage a. Any person who is not eligible for medical assistance pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.) who is employed full-time or part-time and does not have health insurance coverage provided by his em…

30:4D-6f Eligibility of aliens for medical assistance. 2. An eligible alien as defined in section 3 of P.L.1968, c.413 (C.30:4D-1 et seq.) who otherwise meets all eligibility criteria therefor is entitled to medical assistance provided pursuant to section 6 of P.L.1968, c.413 (C.…

30:4D-6g Findings, declarations relative to emergency care. 1. The Legislature finds and declares that: a. In accordance with the "Health Care Reform Act," P.L.1992, c.160 (C.26:2H-18.51 et al.), it has been and continues to be of paramount public interest for the State to take a…

30:4D-6h Definitions relative to emergency care. 2. As used in this act: "Contractor" means a health maintenance organization authorized to operate in this State which contracts with the Department of Human Services for the provision of health care services to recipients of Medic…

30:4D-6i Non-participating hospital, payment for emergency treatment for Medicaid recipient. 3. A non-participating hospital that provides emergency health care services to a Medicaid recipient enrolled in a managed care plan shall accept, as payment in full, the amount that the …

30:4D-6j Criteria for Medicaid admission to certain long-term care facilities for HIV/AIDS patients. 1. a. Subject to federal financial participation under Title XIX of the federal Social Security Act (42 U.S.C. s.1396 et seq.), the Commissioner of Health shall establish special …

30:4D-6k State Medicaid, NJ FamilyCare programs to provide coverage, payment 7. a. The State Medicaid and NJ FamilyCare programs shall provide coverage and payment for health care services delivered to a benefits recipient through telemedicine or telehealth, on the same basis as,…

30:4D-6l Enrollment in Medicaid for medical parolee. 3. Any inmate who is an applicant for medical parole pursuant to the provisions of section 1 of P.L.1997, c.214 (C.30:4-123.51c) shall not be denied enrollment into the Medicaid program on the sole basis that the applicant is a…

30:4D-6m Provision of benefits for certain treatments for substance use disorder. 1. a. Notwithstanding any State law or regulation to the contrary, the Department of Human Services shall ensure that the provision of benefits for methadone, buprenorphine, naltrexone, combination …

30:4D-6n Rules, regulations. 3. The Commissioner of Human Services, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt rules and regulations necessary to implement the provisions of this act. L.2019, c.163, s.3.

30:4D-6o Provision of breastfeeding support through Medicaid. 11. a. Notwithstanding any State law or regulation to the contrary, the Department of Human Services shall, contingent on maintaining or receiving necessary federal approvals, ensure that benefits for comprehensive lac…

30:4D-6p Coverage of certain prescription refills by Medicaid, NJ FamilyCare during state of emergency. 1. a. Subject to subsection b. of this section and to the extent consistent with clinical guidelines, the State Medicaid and NJ FamilyCare programs shall provide coverage of pr…

30:4D-6q Medicaid, NJ FamilyCare, opioid antidote coverage. 2. a. The Division of Medical Assistance and Health Services in the Department of Human Services shall provide coverage for an opioid antidote under the Medicaid program and the NJ FamilyCare program without the impositi…

30:4D-6r Medicaid to cover newborn home nurse visitation. 13. a. Notwithstanding any State law or regulation to the contrary, the Department of Human Services shall, contingent on maintaining or receiving necessary federal approvals, ensure that expenses incurred for services pro…

30:4D-6s State Medicaid program, coverage for family planning services. 11. Coverage for family planning services under the State Medicaid program shall include prescriptions for dispensing contraceptives for up to a 12-month period at one time. The Commissioner of Human Services…

30:4D-6t Remote participation in certain meetings, eligible Medicaid recipients, authorization. 1. The Division of Medical Assistance and Health Services in the Department of Human Services, to the extent permitted under federal law, shall authorize a recipient of Medicaid benefi…

30:4D-6u Commissioner of Human Services, waivers, implementation, provisions, secure federal financial participation. 2. The Commissioner of Human Services shall apply for such State plan amendments or waivers as may be necessary to implement the provisions of this act and to sec…

30:4D-6v Rules, regulations. 3. The Commissioner of Human Services shall adopt rules and regulations pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) to effectuate the purposes of this act including guidance on the medical conditions and progno…

30:4D-6w Division of Medical Assistance and Health Services, managed care organization, NJ FamilyCare beneficiaries, reimbursement, claims, conditions. 1. a. Notwithstanding any law, rule, or regulation to the contrary, the Division of Medical Assistance and Health Services withi…

30:4D-6x Commissioner of Human Services, State plan amendments, waivers, apply as may be necessary. 2. The Commissioner of Human Services shall apply for such State plan amendments or waivers as may be necessary to implement the provisions of this act and to secure federal financ…

30:4D-6y Biomarker precision medical testing, Medicaid recipients, no cost-sharing. 11. a. Notwithstanding any State law or regulation to the contrary, the Department of Human Services shall ensure that expenses incurred for biomarker precision medical testing shall be provided w…

30:4D-6z Department of Human Services, HIV preexposure prophylaxis, HIV postexposure prophylaxis. 11. a. (1) Notwithstanding any State law or regulation to the contrary, and except as provided in paragraph (2) of this subsection, the Department of Human Services shall ensure that…

30:4D-7 Duties of commissioner. 7. Duties of commissioner. The commissioner is authorized and empowered to issue, or to cause to be issued through the Division of Medical Assistance and Health Services, all necessary rules and regulations and administrative orders, and to do or c…

30:4D-7.1. Attorney General to enforce rights against third party for recovery of medical assistance payments a. The commissioner may request the Attorney General to enforce any rights against any third party, institute legal proceedings against any third party, or intervene in a…

30:4D-7.2 Lien against recovery sought from estate of recipient, "estate" defined. 7. a. (1) A lien may be filed against and recovery sought from the estate of a deceased recipient for assistance correctly paid or to be paid on his behalf for all services received when he was 65 …

30:4D-7.2a Encumbrances, recovery limited against certain estates. 1. No encumbrance or recovery shall be imposed against or sought from the estate of a deceased recipient for assistance correctly paid under: a. The "New Jersey Medical Assistance and Health Services Act," P.L.196…

30:4D-7.3. Form; liens and certificates of debt All liens and certificates of debt under section 7 of this amendatory and supplementary act shall be in a form to be prescribed by the commissioner, and shall be signed by the commissioner or director, or by such person designated b…

30:4D-7.4. Filing liens; attachment to property All liens or certificates of debt under section 7 of this amendatory and supplementary act shall be filed with the clerk or register of deeds and mortgages of the county wherein the affected property is located, or with the clerk of…

30:4D-7.5. Property held in trust; attachment of lien If it is found that any party chargeable under any lien or certificate of debt filed pursuant to this act is possessed of any goods, rights, credits, chattels, moneys or effects which are held by any person, firm, or corporati…

30:4D-7.6. County clerk; register of deeds; recording liens and certificates of debt The clerk of the county or register of deeds and mortgages, or clerk of the superior court, as the case may be, shall provide suitable books in which he shall enter the liens and certificates of …

30:4D-7.7. Compromise, settlement or waiver of lien; discharge of lien The commissioner or director or such person designated by the commissioner or director is hereby authorized to compromise, settle or waive in whole or in part any lien or certificate of debt filed under the pr…

30:4D-7.8. Action to determine validity of lien; deposit and bond; discharge prior to adjudication Any person affected in any manner, whether directly or indirectly, by any lien filed under this act, or any certificate of debt filed prior to a final agency adjudication in accorda…

30:4D-7.9 Payment to pharmacy for certain forged, fraudulent prescriptions under State Medicaid program. 1. a. A pharmacy shall receive full payment and shall not be penalized for dispensing a forged or fraudulent prescription that has been approved by the State Medicaid program …

30:4D-70 Annual report. 6. No later than 12 months following the receipt of data by the iPHD Project pursuant to this act, and on an annual basis thereafter, the Rutgers Center for State Health Policy, in consultation with the Governing Board, shall publish a report that is made …

30:4D-71 Application for, receipt of funding. 7. The iPHD Project Governing Board and the Rutgers Center for State Health Policy may apply for and receive funding in relation to the iPHD Project from the following sources: a. Grants from research or other private entities; b. Fee…

30:4D-72 Access to data, agreement. 8. Any department or agency that creates, receives, or maintains publicly supported programs data or health data shall, only after execution of an enforceable data use, data sharing, or other similar agreement that is acceptable to the departme…

30:4D-7a. County welfare agency to provide adequate employees to determine Medicaid eligibility The Commissioner of Human Services shall require that a county welfare agency provide adequate employees to determine Medicaid eligibility to any hospital in the county that has been d…

30:4D-7aa Analysis of data. 3. The division, in collaboration with the Department of Health, Medicaid managed care organizations, and any nonprofit entity contracted by the division to process, distribute, and maintain the Perinatal Risk Assessment data, shall analyze the Perinat…

30:4D-7aaa NJ FamilyCare reimbursement rates for certain special care nursing facilities. 1. a. Beginning January 1, 2024, the division shall reimburse a special care nursing facility, issued a certificate of need by the Department of Health as of July 1, 2023 to operate a neurol…

30:4D-7b. Preparation of five-year plan for developing Statewide network of managed care providers The Commissioner of Human Services shall prepare a five-year plan to develop a Statewide network of managed care providers for Medicaid recipients pursuant to P.L.1968, c.413 (C.30:…

30:4D-7bb Rules, regulations. 4. The Commissioners of Health and Human Services, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt rules and regulations necessary to implement the provisions of this act. L.2019, c.88, s.4.

30:4D-7bbb Application for State plan amendments, waivers as necessary. 3. The Commissioner of Human Services shall apply for such State plan amendments or waivers as shall be necessary to implement the provisions of this act and to ensure federal financial participation for Stat…

30:4D-7c. Submission of plan to enroll Medicaid recipients by health maintenance organizations Within one year of the effective date of P.L.1991, c.187 (C.26:2H-18.24 et al.), every State approved or federally qualified health maintenance organization in the State shall submit a …