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Title: 30 - INSTITUTIONS AND AGENCIES

Chapter: 4D -

30:4D-1: Short title

30:4D-2: Declaration of purpose

30:4D-2.1: Findings, declarations

30:4D-3: Definitions.

30:4D-3a: "Invalid coach service" deemed to mean "mobility assistance vehicle service"

30:4D-3b: Establishment of enrollment simplification practices.

30:4D-4: Division of medical assistance and health services

30:4D-5: Medical assistance program

30:4D-6: Basic medical care and services.

30:4D-6a: $35 monthly personal needs allowance

30:4D-6c: Continued Medicaid eligibility

30:4D-6d: Third party, certain; primary payer

30:4D-6e: Uninsured, ineligible persons may purchase health care coverage

30:4D-6f: Eligibility of aliens for medical assistance.

30:4D-6g: Findings, declarations relative to emergency care.

30:4D-6h: Definitions relative to emergency care.

30:4D-6i: Non-participating hospital, payment for emergency treatment for Medicaid recipient.

30:4D-6j: Criteria for Medicaid admission to certain long-term care facilities for HIV/AIDS patients.

30:4D-6k: State Medicaid, NJ FamilyCare programs to provide coverage, payment

30:4D-6l: Enrollment in Medicaid for medical parolee.

30:4D-6.1: Abortions; payment of claims

30:4D-6.2: Definitions

30:4D-6.3: Provider of mobility assistance vehicle services; conditions for approval for reimbursement

30:4D-6.4: Minimum requirements, liability insurance, personnel; rules, regulations.

30:4D-6.5: Inapplicability of act to services by volunteer first aid, rescue and ambulance squads

30:4D-6.6: Rules and regulations; application of Medical Assistance and Health Services Act

30:4D-6.7: Resident of skilled or intermediate care nursing facility discharged to general or psychiatric hospital; coverage by medical assistance program

30:4D-6.8: Period of maintenance of bed for eligible resident; certification for payment

30:4D-6.9: Inability of discharged resident to return within period; priority for next available bed

30:4D-7: Duties of commissioner.

30:4D-7a: County welfare agency to provide adequate employees to determine Medicaid eligibility

30:4D-7b: Preparation of five-year plan for developing Statewide network of managed care providers

30:4D-7c: Submission of plan to enroll Medicaid recipients by health maintenance organizations

30:4D-7d: Report by commissioner

30:4D-7e: Rules, regulations

30:4D-7f: Access fees charged by fiscal agent; establishment; use

30:4D-7g: Findings, declarations relative to pediatric rehabilitation hospitals.

30:4D-7h: Reimbursement by State Medicaid program, rates; other costs.

30:4D-7i: Exemption from close proximity requirements, notification as to off-site location.

30:4D-7j: Annual cost report to receive reimbursement from Medicaid for personal care assistant services.

30:4D-7k: Definitions relative to reimbursement for family planning services.

30:4D-7l: Department to facilitate implementation of C.30:4D-7k.

30:4D-7m: Certain HMOs, changes in certain reimbursement rates; procedure.

30:4D-7n: Hourly reimbursement rate for Medicaid personal care services

30:4D-7o: Report

30:4D-7.1: Attorney General to enforce rights against third party for recovery of medical assistance payments

30:4D-7.2: Lien against recovery sought from estate of recipient, "estate" defined

30:4D-7.2a: Encumbrances, recovery limited against certain estates.

30:4D-7.3: Form; liens and certificates of debt

30:4D-7.4: Filing liens; attachment to property

30:4D-7.5: Property held in trust; attachment of lien

30:4D-7.6: County clerk; register of deeds; recording liens and certificates of debt

30:4D-7.7: Compromise, settlement or waiver of lien; discharge of lien

30:4D-7.8: Action to determine validity of lien; deposit and bond; discharge prior to adjudication

30:4D-7.9: Payment to pharmacy for certain forged, fraudulent prescriptions under State Medicaid program.

30:4D-8: Claim payment method.

30:4D-8.1: Findings, declarations relative to a Medicaid Accountable Care Organization Demonstration Project.

30:4D-8.10: Application for State plan amendments, waivers.

30:4D-8.11: Construction of act.

30:4D-8.12: Continuation of payments for certain services.

30:4D-8.13: Certain licensure requirements waived.

30:4D-8.14: Report to Governor, Legislature.

30:4D-8.15: Rules, regulations.

30:4D-8.2: Definitions relative to a Medicaid ACO.

30:4D-8.3: Establishment of three-year Medicaid ACO Demonstration Project.

30:4D-8.4: Applications for certification as a Medicaid ACO.

30:4D-8.5: Eligibility to receive, distribute gainsharing payments.

30:4D-8.6: Remission of payment to ACO.

30:4D-8.7: Voluntary participation in demonstration project.

30:4D-8.8: Duties of the department; authorization to seek grants.

30:4D-8.9: Annual evaluation.

30:4D-9: Required contents of solicited bids and contracts

30:4D-9.1: Medicaid contract providers to provide coverage regardless of gender identity, expression.

30:4D-10: Review of sealed bids; report and recommendation; considerations

30:4D-11: Approval or disapproval of lowest responsible bid; direction of payment

30:4D-12: Unnecessary use of care and services; methods and procedures; maintenance of records required for reimbursement

30:4D-13: Enrollment fees or premium charges

30:4D-14: Preparation of comprehensive medical plan

30:4D-15: Eligibility determination

30:4D-16: Provision of funds by state

30:4D-17: Penalty.

30:4D-17a: Additional action by Attorney General.

30:4D-17b: Construction of act.

30:4D-17.1: Suspension or disqualification of providers, termination of benefits to recipients; rules and regulations

30:4D-17.10: Findings, declarations

30:4D-17.11: Definitions

30:4D-17.12: Nursing Home Preadmission Screening Program

30:4D-17.13: Responsibility for preadmission screening

30:4D-17.14: Procedures for preadmission screening

30:4D-17.15: Rules, regulations

30:4D-17.16: Definitions.

30:4D-17.17a: Drug Utilization Review Board.

30:4D-17.18: Responsibilities of department.

30:4D-17.18a: Rules, regulations.

30:4D-17.19: HMOs, certain, to contract for services provided at certain Newark schools

30:4D-17.2: Enforcement of commissioner's decisions; orders by civil action

30:4D-17.20: Written informed parental consent

30:4D-17.21: Approval as provider of psychological services

30:4D-17.22: Compliance with licensure, Medicaid requirements; authorization

30:4D-17.23: Short title.

30:4D-17.24: Findings, declarations relative to long-term care for Medicaid recipients.

30:4D-17.25: Definitions relative to long-term care for Medicaid recipients.

30:4D-17.26: Process to rebalance allocation of funding for expansion of long-term care services; pilot program, use Statewide.

30:4D-17.27: Duties of commissioner relative to report on budget, management plan.

30:4D-17.28: Duties of commissioner relative to funding parity, coordination, assessment instrument.

30:4D-17.29: Medicaid Long-Term Care Funding Advisory Council.

30:4D-17.3: Criminal, civil violations

30:4D-17.30: Waiver of federal requirements.

30:4D-17.31: Tracking of expenditures.

30:4D-17.32: Inclusion of budget line for Medicaid long-term care expenditures.

30:4D-17.33: Medicaid medical home demonstration project; terms defined.

30:4D-17.34: Annual evaluation.

30:4D-17.35: Application for plan amendments, waivers.

30:4D-17.36: Annual report.

30:4D-17.37: Rules, regulations.

30:4D-17.38: Monitoring of long-term care services.

30:4D-17.39: Medicaid home visitation demonstration project.

30:4D-17.4: Reimbursement for retroactive eligibility

30:4D-17.40: Application for amendments, waivers.

30:4D-17.41: Rules, regulations.

30:4D-17.5: Adjusted reimbursement rates

30:4D-17.6: Withdrawal as Medicaid provider

30:4D-17.7: $13 million contingency account

30:4D-17.8: Posting, distribution of law

30:4D-17.9: Annual report

30:4D-18: Reporting and oversight

30:4D-19: Severability clause

30:4D-19.1: "New Jersey Medical Assistance and Health Services Program" administrators, duties

30:4D-19.2: Findings, declarations relative to intergovernmental transfer program under Medicaid

30:4D-19.3: Definitions relative to intergovernmental transfer program under Medicaid.

30:4D-19.4: Intergovernmental transfer program established.

30:4D-19.5: Appropriations for supplemental payments under intergovernmental transfer program; costs.

30:4D-20: Program; establishment

30:4D-21: Pharmaceutical assistance eligibility

30:4D-21.2: Reparations to Japanese Americans not counted as income for PAAD eligibility

30:4D-21.3: Holocaust reparations, restitution not considered income for determination of PAAD eligibility

30:4D-21.4: PAAD recipients, notification as to error in estimated annual income.

30:4D-21.5: Automatic enrollment in certain pharmaceutical assistance programs.

30:4D-22: Copayment; restrictions; definitions

30:4D-22.1: Pharmacy payment condition

30:4D-22.2: "Prescription drugs," syringes, needles included; certain

30:4D-22.3: Payment to pharmacy for certain forged, fraudulent prescriptions, program's responsibilities.

30:4D-23: Prescription drug costs; payment under other plan or insurance; effect on eligibility

30:4D-24: Regulations

30:4D-25: Legislative findings and declarations

30:4D-26: Prescription; inclusion of name and address or identification number

30:4D-27: Notice of penalties on identification cards

30:4D-28: Report to Governor and legislature

30:4D-29: List of maximum quantity of drug to be dispensed per prescription

30:4D-30: Maximum allowable cost per prescription drug; procedure to set and review on continuing basis

30:4D-31: List of maximum quantities and procedures for setting maximum allowable cost; effective date

30:4D-32: Annual report

30:4D-33: Violations; penalties

30:4D-34: Reimbursement for costs of prescription drugs; application and proof of expenditure

30:4D-35: Notice of availability and application forms; supplying to eligible persons

30:4D-35.1: Short title

30:4D-35.2: Coverage limited to manufacturers providing rebates

30:4D-35.3: "Pharmaceutical Assistance to the Aged and Disabled Rebate Fund" established

30:4D-35.4: Rules, regulations

30:4D-36: Hearing aid assistance

30:4D-37: $100 maximum

30:4D-38: Pharmaceutical assistance recipients eligible

30:4D-38.1: "Hearing Aid Assistance to the Aged and Disabled," notification as to error in estimated annual income.

30:4D-39: Other programs

30:4D-40: Payment system; eligibility determination

30:4D-41: Rules, regulations

30:4D-42: Casino revenue funding

30:4D-43: Short title

30:4D-44: Definitions regarding the "Senior Gold Prescription Discount Act."

30:4D-45: "Senior Gold Prescription Discount Program."

30:4D-45.1: "Senior Gold Prescription Discount Program," notification as to error in estimated annual income.

30:4D-45.2: Payment to pharmacy for certain forged, fraudulent prescriptions under State Medicaid program.

30:4D-46: Report to Governor, Legislature

30:4D-47: Violations of act; program identification cards

30:4D-48: New Jersey EASE program, provide information on prescription program

30:4D-48.1: Senior Gold prescription program information displayed on tax return instructions.

30:4D-49: Funding of Senior Gold Prescription Discount Program

30:4D-50: Rules, regulations.

30:4D-51: Conditions on expending funds.

30:4D-52: Rebates to DHS for program.

30:4D-53: Short title.

30:4D-54: Findings, declarations relative to the Office of Medicaid Inspector General.

30:4D-55: Definitions relative to the Office of the Medicaid Inspector General.

30:4D-57: Functions, duties, powers, responsibilities of Medicaid Inspector General.

30:4D-58: Additional authority of the Medicaid Inspector General.

30:4D-59: Transfer of certain functions, powers, employees.

30:4D-60: Reports, recommendations.

30:4D-61: Confidentiality of information.

30:4D-62: "Medicaid Fraud Control Fund"; use.

30:4D-63: Rules, regulations.

30:4D-64: Annual appropriation, minimum required.

30:4D-65: Findings, declarations relative to the "iPHD Project."

30:4D-66: Definitions relative to the "iPHD Project."

30:4D-67: iPHD project governing board.

30:4D-68: Establishment of operation iPHD project.

30:4D-69: Oversight of the iPHD project.

30:4D-70: Annual report.

30:4D-71: Department to facilitate implementation of C.30:4D-7k.

30:4D-72: Access to data, agreement.