N.J. Admin. Code § 10:77-6.3 - Provider participation requirements

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

(a) In order to participate as a Medicaid/NJ FamilyCare/Children's System of Care provider of children's mobile response and stabilization management services, a provider must apply to, and be approved by, the New Jersey Medicaid/NJ FamilyCare fee-for-service program as a mobile response agency, in accordance with the provisions of this subchapter. Providers who are enrolled as other provider types in the Medicaid/NJ FamilyCare program shall complete a separate application to enroll as a mobile response agency.
(b) Children's mobile response and stabilization management services providers shall be approved by the Children's System of Care and under contract with the Department of Children and Families as a mobile response agency. Such contract shall be in full effect and not suspended or terminated.
(c) All applicants shall complete and submit a provider application to:

Department of Children and Families

PO Box 717

Trenton, NJ 08625-0717

Attn: CSOC Provider Enrollment Unit

(d) The applicant shall receive notification of approval or disapproval of provider status as determined by CSOC. If approved, the applicant shall be enrolled as a Medicaid/NJ FamilyCare provider and shall be assigned a unique provider number for seeking reimbursement for the provision of mobile response and stabilization management services. All approved and enrolled providers shall receive a copy of the provider manual and the fiscal agent billing supplement.
(e) Providers of children's mobile response and stabilization management services shall, at all times, maintain compliance with all applicable State and Federal laws, rules and regulations, including N.J.A.C. 10:49, this subchapter and any applicable Department of Children and Families rules.
(f) If a provider receives notification that the provider is no longer approved by CSOC, or if the provider receives notice that its contract with the Department of Children and Families is in default status or has been suspended or terminated for any reason, the provider shall notify the Division of Medical Assistance and Health Services at the address below within 10 business days.

Division of Medical Assistance and Health Services

Office of Provider Enrollment

PO Box 712

Trenton, NJ 08625-0712

(g) If the provider's contract with the Department of Children and Families is in default status or has been suspended or terminated for any reason, or if the provider is no longer approved by the Children's System of Care, the provider shall be immediately disenrolled as a Medicaid/NJ FamilyCare mobile response and stabilization management services provider until such time as the Department of Children and Families contract is renewed or reinstated and the Division of Medical Assistance and Health Services has been notified by the Director of the Children's System of Care that the provider should be reinstated as a Medicaid/NJ FamilyCare mobile response and stabilization management services provider.

Notes

N.J. Admin. Code § 10:77-6.3
Amended by 48 N.J.R. 81(a), effective 1/4/2016

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