Current through Register Vol. 54, No. 7, April 4, 2022
presumptive eligibility entity shall be a New Jersey Medicaid provider and:
1. An acute care hospital;
2. A local health department that provides
primary care services; or
Federally Qualified Health Center (FQHC).
(b) An eligible entity shall apply to the
Division of Medical Assistance and Health Services and shall be approved as a
presumptive eligibility determination agency upon training of the entity by the
Division of Medical Assistance and Health Services.
(c) The Division of Medical Assistance and
Health Services shall monitor the presumptive eligibility determinations made
by approved presumptive eligibility determination entities. If the review
discloses a pattern of incorrect presumptive eligibility determinations or
failure to adhere to requirements, the Division shall initiate corrective
action, including, but not limited to, consultation and training. Continued
incorrect presumptive eligibility determinations or failure to adhere to
procedural requirements shall result in the Division revoking approval for that
entity to make presumptive eligibility determinations.
N.J. Admin. Code §
Amended by R.2004 d.42,
See: 35 New Jersey Register 3802(a), 36 New Jersey Register
In (a), inserted "that provides primary care services"
following "department" in 2.