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17B:30-1 |
Declaration of purpose (2013-06-10 16:36:30,14400.000000000) |
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17B:30-2 |
Practices prohibited (2013-06-10 16:36:30,14401.000000000) |
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17B:30-3 |
Misrepresentations and false advertising of policies or annuity contracts (2013-06-10 16:36:30,14402.000000000) |
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17B:30-4 |
False information and advertising (2013-06-10 16:36:30,14403.000000000) |
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17B:30-5 |
False financial statements (2013-06-10 16:36:30,14404.000000000) |
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17B:30-6 |
"Twisting" prohibited (2013-06-10 16:36:30,14405.000000000) |
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17B:30-7 |
Defamation (2013-06-10 16:36:30,14406.000000000) |
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17B:30-8 |
Boycott, coercion and intimidation (2013-06-10 16:36:30,14407.000000000) |
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17B:30-9 |
Stock operations and advisory board contracts (2013-06-10 16:36:30,14408.000000000) |
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17B:30-10 |
Stock acquisition, common management (2013-06-10 16:36:30,14409.000000000) |
|
17B:30-11 |
Interlocking directorate (2013-06-10 16:36:30,14410.000000000) |
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17B:30-12 |
Discrimination prohibited; terms defined. (2021-07-06 15:51:59,14411.000000000) |
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17B:30-13 |
Rebates and special inducements (2013-06-10 16:36:30,14412.000000000) |
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17B:30-13.1 |
Unfair claim settlement practices (2013-06-10 16:36:30,14413.000000000) |
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17B:30-13.2 |
Record of complaints (2013-06-10 16:36:30,14414.000000000) |
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17B:30-14 |
Exceptions to discrimination and rebates (2013-06-10 16:36:30,14415.000000000) |
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17B:30-15 |
Enumeration of acts not exclusive (2013-06-10 16:36:30,14416.000000000) |
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17B:30-16 |
Commissioner's powers of investigation (2013-06-10 16:36:30,14417.000000000) |
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17B:30-17 |
Desist orders for prohibited practices; penalty (2013-06-10 16:36:30,14418.000000000) |
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17B:30-18 |
Procedures as to undefined practices (2013-06-10 16:36:30,14419.000000000) |
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17B:30-19 |
Appeal by intervenor (2013-06-10 16:36:30,14420.000000000) |
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17B:30-20 |
Violation of cease and desist order; penalty (2013-06-10 16:36:30,14421.000000000) |
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17B:30-21 |
Provisions of chapter additional to existing laws (2013-06-10 16:36:30,14422.000000000) |
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17B:30-22 |
Immunity from prosecution (2013-06-10 16:36:30,14423.000000000) |
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17B:30-23 |
Timetable for implementation of electronic receipt, transmission of health care claim information; standard forms. (2013-06-10 16:36:30,14424.000000000) |
|
17B:30-24 |
Regulations. (2013-06-10 16:36:30,14425.000000000) |
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17B:30-25 |
Thomas A. Edison State College to study, monitor effectiveness of electronic data interchange technology, electronic health records. (2013-06-10 16:36:30,14426.000000000) |
|
17B:30-26 |
Definitions relative to payment of health and dental insurance plans. (2013-06-10 16:36:30,14427.000000000) |
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17B:30-27 |
Applicability. (2013-06-10 16:36:30,14428.000000000) |
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17B:30-28 |
Provision of information. (2013-06-10 16:36:30,14429.000000000) |
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17B:30-29 |
Provision of toll-free telephone number. (2013-06-10 16:36:30,14430.000000000) |
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17B:30-30 |
Maintenance of claims records; audit required. (2013-06-10 16:36:30,14431.000000000) |
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17B:30-31 |
Additional record of claims. (2013-06-10 16:36:30,14432.000000000) |
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17B:30-32 |
Overdue capitation payment. (2013-06-10 16:36:30,14433.000000000) |
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17B:30-33 |
Regulations. (2013-06-10 16:36:30,14434.000000000) |
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17B:30-34 |
Inapplicability of act. (2013-06-10 16:36:30,14435.000000000) |
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17B:30-34.1 |
Health care provider, carrier, more than one method of payment, reimbursement; definitions. (2024-04-11 15:11:51,14435.000100000) |
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17B:30-35 |
Definitions relative to standardized pharmacy identification cards (2013-06-10 16:36:30,14436.000000000) |
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17B:30-36 |
Issuance of standardized pharmacy identification information, card to primary insured (2013-06-10 16:36:30,14437.000000000) |
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17B:30-37 |
Exceptions for issuance of card (2013-06-10 16:36:30,14438.000000000) |
|
17B:30-38 |
Provision of new pharmacy identification card (2013-06-10 16:36:30,14439.000000000) |
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17B:30-39 |
Rules, regulations (2013-06-10 16:36:30,14440.000000000) |
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17B:30-40 |
Definitions, construction, regulations on notice of premium increase to employers. (2013-06-10 16:36:30,14441.000000000) |
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17B:30-41 |
Findings, declarations relative to collection of unpaid hospital accounts. (2013-06-10 16:36:30,14442.000000000) |
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17B:30-42 |
Definitions relative to collection of unpaid hospital accounts. (2013-06-10 16:36:30,14443.000000000) |
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17B:30-44 |
"New Jersey Hospital Care Payment Fund." (2013-06-10 16:36:30,14444.000000000) |
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17B:30-45 |
Authority of department. (2013-06-10 16:36:30,14445.000000000) |
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17B:30-46 |
Decisions of department constitute final agency action. (2013-06-10 16:36:30,14446.000000000) |
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17B:30-47 |
Procedures for participating hospitals. (2013-06-10 16:36:30,14447.000000000) |
|
17B:30-48 |
Short title. (2013-06-10 16:36:30,14448.000000000) |
|
17B:30-49 |
Findings, declarations relative to processing health claims. (2013-06-10 16:36:30,14449.000000000) |
|
17B:30-50 |
Definitions relative to processing health claims. (2013-06-10 16:36:30,14450.000000000) |
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17B:30-51 |
Information required from payer. (2013-06-10 16:36:30,14451.000000000) |
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17B:30-52 |
Response by payer to request for authorization of health care services. (2013-06-10 16:36:30,14452.000000000) |
|
17B:30-53 |
Reimbursement for covered services, conditions. (2013-06-10 16:36:30,14453.000000000) |
|
17B:30-54 |
Reimbursement according to provider contract. (2013-06-10 16:36:30,14454.000000000) |
|
17B:30-55 |
Violations, penalties; rules, regulations. (2013-06-10 16:36:30,14455.000000000) |
|
17B:30-55.1 |
Short title. (2024-06-14 13:50:32,14455.000100000) |
|
17B:30-55.2 |
Findings, declarations. (2024-06-14 13:50:35,14455.000200000) |
|
17B:30-55.3 |
Definitions. (2024-06-14 13:50:38,14455.000300000) |
|
17B:30-55.4 |
Payer, information, utilization management, processing, payment of claims. (2024-06-14 13:50:41,14455.000400000) |
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17B:30-55.5 |
Payer, respond, hospital, health care provider request, prior authorization. (2024-06-14 13:50:44,14455.000500000) |
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17B:30-55.6 |
Carrier, respond, prior authorization requests, medication coverage submitted, NCPDP SCRIPT Standard for ePA transactions. (2024-06-14 13:50:47,14455.000600000) |
|
17B:30-55.7 |
Prior authorization, chronic, long-term care condition, validity, exception, timeline. (2024-06-14 13:50:50,14455.000700000) |
|
17B:30-55.8 |
Prior authorization, denial, limitation imposed by payer, physician, scope of actions. (2024-06-14 13:50:53,14455.000800000) |
|
17B:30-55.9 |
Prior authorization, defined number, discrete services, set time frame, validity, exception. (2024-06-14 13:50:56,14455.000900000) |
|
17B:30-55.10 |
Payer to honor prior authorization granted to covered person by previous payer, initial coverage, upon receipt of documentation. (2024-06-14 13:50:59,14455.001000000) |
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17B:30-55.11 |
Denial of prior authorization, communicated via written communication agreed to by payer, hospital, health care provider. (2024-06-14 13:51:03,14455.001100000) |
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17B:30-55.12 |
Adverse determinations, appeal, reviewed by physician. (2024-06-14 13:51:06,14455.001200000) |
|
17B:30-55.13 |
Payer shall not deny reimbursement, hospital, health care provider in compliance, circumstances, (2024-06-14 13:51:09,14455.001300000) |
|
17B:30-55.14 |
Payer, reimbursement according to provider contract, medically necessary emergency, urgent care covered under plan. (2024-06-14 13:51:12,14455.001400000) |
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17B:30-55.15 |
Failure by payer to comply with deadline, health care services subject to review, automatic authorization. (2024-06-14 13:51:15,14455.001500000) |
|
17B:30-55.16 |
Statistics available regarding prior authorization approvals, denials, website. (2024-06-14 13:51:18,14455.001600000) |
|
17B:30-55.17 |
Liberal construction. (2024-06-14 13:51:21,14455.001700000) |
|
17B:30-56 |
Rules, regulations. (2024-06-14 13:51:30,14456.000000000) |
|
17B:30-57 |
Liberal construction. (2013-06-10 16:36:30,14457.000000000) |
|
17B:30-58 |
Definitions relative to reimbursement for certain ambulance services. (2013-06-10 16:36:30,14458.000000000) |
|
17B:30-59 |
Assignment of benefits to service provider of right to receive reimbursement for ambulance service. (2013-06-10 16:36:30,14459.000000000) |
|
17B:30-60 |
Definitions relative to certain dental provider networks. (2019-09-26 13:30:58,14459.000100000) |
|
17B:30-61 |
Third party access. (2019-09-26 13:30:58,14459.000200000) |
|
17B:30-62 |
Inapplicability. (2019-09-26 13:30:58,14459.000300000) |
|
17B:30-63 |
Rules, regulations. (2019-09-26 13:30:58,14459.000400000) |