Title 30, Title 30: INSTITUTIONS AND AGENCIES

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 …

30:4D-7cc Legislative approval of reimbursement rate increases. 3. a. The Commissioner of Human Services shall submit recommendations to the Legislature, pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), for legislative approval of any reimbursement rate increases as may b…

30:4D-7d. Report by commissioner Within six months of the effective date of P.L.1991, c.187 (C.26:2H-18.24 et al.), the Commissioner of Human Services shall report to the Governor and the Chairmen of the Senate Institutions, Health and Welfare and General Assembly Health and Huma…

30:4D-7dd Risk reduction model to prescription drug services, third party contract. 1. The Division of Medical Assistance and Health Services in the Department of Human Services shall contract with a third party entity to apply a risk reduction model to prescription drug services…

30:4D-7e. Rules, regulations 38. The Commissioner of Human Services shall, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) adopt rules and regulations necessary to implement the provisions of sections 9, 11 and 12 of this act as they relate to…

30:4D-7ee Pharmacy benefits management services, information disclosure 1. a. Any contract or other arrangement entered into by a managed care organization, or by the Division of Medical Assistance and Health Services in the Department of Human Services, for the provision of phar…

30:4D-7f. Access fees charged by fiscal agent; establishment; use 1. Notwithstanding the provisions of the "New Jersey Medical Assistance and Health Services Act," P.L.1968, c.413 (C.30:4D-1 et seq.) or any other law to the contrary, an intermediary vendor under contract with the…

30:4D-7ff Amendment of the Medicaid managed care organization contract provisions. 1. a. At the next regular opportunity, the Division of Medical Assistance and Health Services in the Department of Human Services shall amend the Medicaid managed care organization contract provisi…

30:4D-7g. Findings, declarations relative to pediatric rehabilitation hospitals. 1. The Legislature finds and declares that: a. Currently, there are two pediatric rehabilitation hospitals in the State that provide pediatric inpatient and ambulatory rehabilitation and pediatric lo…

30:4D-7gg Rules, regulations. 2. 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. L.2021, c.276, s.2.

30:4D-7h Reimbursement by State Medicaid program, rates; other costs. 2. a. A pediatric rehabilitation hospital licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) with 30 or fewer beds shall be reimbursed 100% of its Medicaid allowable reimbursable costs as defined by Medic…

30:4D-7hh Per diem reimbursement rate compared to established State Medicaid fee-for-service rate. 1. a. Notwithstanding the provisions of any law or regulation to the contrary, the per diem reimbursement rate for providers of adult medical day care services within the Medicaid p…

30:4D-7i Exemption from close proximity requirements, notification as to off-site location. 3. A pediatric rehabilitation hospital licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) shall not be subject to the close proximity requirements established pursuant to N.J.A.C.10:…

30:4D-7ii Restricting modification, termination of existing provider network contract. 2. A managed care organization contracted with the Division of Medical Assistance and Health Services within the Department of Human Services to provide benefits under the Medicaid program, est…

30:4D-7j Annual cost report to receive reimbursement from Medicaid for personal care assistant services. 1. As a condition of receiving reimbursement from the State Medicaid program, pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.), for personal care assistant services, as describ…

30:4D-7jj Findings, declarations. 1. The Legislature funds and declares: a. An acquired brain injury is an injury caused by an event, either internal or external to the injured individual, and does not include congenital or degenerative disorders, or those injuries induced by bir…

30:4D-7k Definitions relative to reimbursement for family planning services. 1. a. The reimbursement rate for an office visit for family planning services billed by a health care facility, which is licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) and receives funding unde…

30:4D-7kk Medicaid per diem, encounter reimbursement rates, eligible brain injury services, minimum requirements. 2. a. Notwithstanding the provisions of any law or regulation to the contrary, the Medicaid per diem or encounter reimbursement rates for eligible brain injury servic…

30:4D-7l Department to facilitate implementation of C.30:4D-7k. 2. The Department of Health shall adjust the Family Planning Services Grant-in-Aid appropriation and transfer the appropriate amount of State funds to the Division of Medical Assistance and Health Services in the Dep…

30:4D-7ll State plan amendments, waivers, brain injury services, application; implementation of provisions. 3. The Commissioner of Human Services shall apply for such State plan amendments or waivers specific to brain injury services, that currently exist or may arise in the futu…

30:4D-7ll.1 Definitions. 1. As used in this act: "Division" mean the Division of Medical Assistance and Health Services in the Department of Human Services. "NJ FamilyCare" means the program established pursuant to P.L.2005, c.156 (C.30:4J-8 et al.), which includes the State's Me…

30:4D-7ll.2 Special care nursing facility, reimbursement, traumatic brain injury, NJ FamilyCare beneficiary. 2. The division shall reimburse a special care nursing facility for services provided to a NJ FamilyCare beneficiary residing in a traumatic brain injury unit at a base pe…

30:4D-7ll.3 Nursing facility, reimbursement, traumatic brain injury, NJ FamilyCare beneficiary, single-occupancy room. 3. a. The division shall reimburse a nursing facility for services provided to a NJ FamilyCare beneficiary residing in a single-occupancy room at an enhanced per…

30:4D-7ll.4 State plan amendments, waivers. 5. 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 State expenditures under the fed…

30:4D-7m Certain HMOs, changes in certain reimbursement rates; procedure. 1. Notwithstanding any law, rule, or regulation to the contrary, a health maintenance organization that contracts with the Division of Medical Assistance and Health Services in the Department of Human Servi…

30:4D-7mm Assisted living residences, comprehensive personal care homes, assisted living programs, reimbursement, Medicaid beneficiaries, minimum per diem rates; definitions. 1. a. Notwithstanding the provisions of any other law or regulation to the contrary, commencing upon the …

30:4D-7n Hourly reimbursement rate for Medicaid personal care services. 1. The hourly reimbursement rate for personal care services within the Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.), whether the services are provided in the Medicaid fee-for-s…

30:4D-7nn State plan amendments, waivers, provisions, implementation. 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 financial participation for State Me…

30:4D-7o Report. 2. Every provider that receives reimbursement for personal care services pursuant to a Medicaid managed care contract shall annually provide a report to the Division of Medical Assistance and Health Services in the Department of Human Services regarding the use o…

30:4D-7oo Per diem reimbursement rate, pediatric medical day care services, on-site. 1. a. Notwithstanding any other provision of law or regulation to the contrary, the per diem reimbursement rate for pediatric medical day care services delivered by a pediatric medical day care p…

30:4D-7p Medicaid reimbursement for certain emergency services. 1. a. A hospital licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) providing emergency services to patients enrolled in the State Medicaid fee-for-service program shall accept as final payment an emergency roo…

30:4D-7pp State plan amendments, waivers, provisions, implementation. 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 financial participation for State Me…

30:4D-7q 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. L.2018, c.51, s.3.

30:4D-7qq Homemaker-home health aide certification program, family member; definition; report to Governor, Legislature. 1. a. As used in this section, "family member" means a child, parent, parent-in-law, sibling, grandparent, grandchild, spouse, domestic partner, or one partner …

30:4D-7r Short title. 1. This act shall be known and may be cited as "The County Option Hospital Fee Program Act." L.2018, c.136, s.1; amended 2022, c.61, s.1.

30:4D-7rr State plan amendments, waivers, apply, Commissioner, Human Services. 3. 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 financial participation for…

30:4D-7s Definitions relative to "The County Option Hospital Fee Pilot Program Act." 2. As used in this act: "Commissioner" means the Commissioner of Human Services. "Department" means the Department of Human Services. "Fee" means the local healthcare-related fee authorized pursu…