Current through Register Vol. 54, No. 7, April 4, 2022
(a) DMAHS shall
conduct quality assurance reviews of all hospital-based mental health programs
annually or more frequently, as required by DMAHS if deficiencies in the
program are identified by DMAHS staff.
(b) DMAHS shall notify a program of any
noncompliance findings revealed during the quality assurance review within 20
days of the review having been completed.
(c) A program shall respond in writing to any
notification of findings within 30 days of notice.
(d) The program response shall include a
corrective action plan to address and prevent all incidences of
action plan shall include, but may not be limited to:
1. A timeline detailing remediation of
2. A detailed
description of those steps determined necessary by the provider to ensure
compliance with the corrective plan; and
3. Individuals and titles responsible for
ensuring compliance with that plan.
(f) DMAHS shall review the corrective action
plan submitted by the program. If the corrective action plan does not
adequately address the deficiencies identified in a quality assurance review,
DMAHS shall return the plan to the program for revision. Any program
deficiencies identified by DMAHS shall be rectified by the program within 30
days of receipt.
(g) DMAHS has the
authority to restrict and/or terminate program admissions of NJ
FamilyCare/Medicaid or Work First New Jersey (WFNJ)/General Assistance (GA)
beneficiaries because of provider noncompliance with Medicaid standards, such
as, but not limited to, actions taken by DMHS, quality assurance reviews
conducted by DMAHS and immediate health and safety concerns.
(h) Programs may be subject to follow-up
visits by DMAHS staff based on the outcome of quality assurance reviews
conducted by DMAHS.