N.J. Admin. Code § 10:142-5.3 - Service standards

Current through Register Vol. 54, No. 7, April 4, 2022

(a) For the purposes of this program, the following service standards shall be met:
1. An individual approved for participant-directed services may use traditional provider agency services only when indicated as a private purchase arrangement under an approved cash management plan (CMP);
2. Program funds shall not be used for the performance or arrangement of skilled professional medical services;
3. Services under the program shall be suspended during a period of stay in a medical facility and resumed automatically upon discharge to the participant's residence, if the stay is not more than 30 days, otherwise, authorization from the MCO is required.
(b) Participants may be afforded program services while on a vacation, or at an out-of-State stay at an alternate residence in- or out-of-State, up to 30 days, subject to the following conditions and procedures:
1. Participants must inform their consultant, a minimum of 15 days prior to leaving New Jersey, and must indicate dates of departure and return, and emergency contact information. Participants must also ensure that the vacation or stay will not conflict with required reassessments or consultant visits pursuant to N.J.A.C. 10:142-2.1(a)13 and 6.2.
2. Participants must be accompanied by their current employees while out-of-State, who may continue to receive payment for services performed, in accordance with the CMP.
3. Failure to provide contact information, return when indicated, and/or comply with consultant visits reassessment requirements described in (b)1 above, may result in disenrollment.

Notes

N.J. Admin. Code § 10:142-5.3
Adopted by 49 N.J.R. 3993(a), effective 12/18/2017

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