Chapter 49 - ADMINISTRATION MANUAL
- Subchapter 1 - GENERAL PROVISIONS (§ 10:49-1.1 to 10:49-1.8)
- Subchapter 2 - NEW JERSEY MEDICAID BENEFICIARIES (§ 10:49-2.1 to 10:49-2.19)
- Subchapter 3 - PROVIDER PARTICIPATION (§ 10:49-3.1 to 10:49-3.5)
- Subchapter 4 - PROVIDERS' ROLE IN A SHARED HEALTH CARE FACILITY (§ 10:49-4.1 to 10:49-4.5)
- Subchapter 5 - SERVICES COVERED BY MEDICAID AND THE NJ FAMILYCARE PROGRAMS (§ 10:49-5.1 to 10:49-5.10)
- Subchapter 6 - AUTHORIZATIONS REQUIRED BY MEDICAID AND THE NJ FAMILYCARE PROGRAMS (§ 10:49-6.1 to 10:49-6.2)
- Subchapter 7 - SUBMITTING CLAIMS FOR PAYMENT POLICIES AND REGULATIONS (§ 10:49-7.1 to 10:49-7.6)
- Subchapter 8 - PAYMENT FOR SERVICES PROVIDED (§ 10:49-8.1 to 10:49-8.5)
- Subchapter 9 - PROVIDER AND BENEFICIARY'S RIGHTS AND RESPONSIBILITIES; ADMINISTRATIVE PROCESS (§ 10:49-9.1 to 10:49-9.15)
- Subchapter 10 - NOTICES, APPEALS AND FAIR HEARINGS (§ 10:49-10.1 to 10:49-10.13)
- Subchapter 11 - EXCLUSION FROM PARTICIPATION IN THE NEW JERSEY MEDICAID AND NJ FAMILYCARE PROGRAMS SUSPENSION, DEBARMENT, AND DISQUALIFICATION (§ 10:49-11.1 to 10:49-11.2)
- Subchapter 12 - PROVIDER REINSTATEMENT (§ 10:49-12.1 to 10:49-12.7)
- Subchapter 13 - PROGRAM CONTROLS (§ 10:49-13.1 to 10:49-13.4)
- Subchapter 14 - RECOVERY OF PAYMENTS AND SANCTIONS (§ 10:49-14.1 to 10:49-14.6)
- Subchapter 15 - AVAILABILITY AND MAINTENANCE OF PROGRAM POLICY ISSUANCES (§ 10:49-15.1 to 10:49-15.3)
- Subchapter 16 - DEMONSTRATION PROJECTS (§ 10:49-16.1 to 10:49-16.5)
- Subchapter 17 - RESERVED
- Subchapter 18 - EARLY AND PERIODIC SCREENING, DIAGNOSIS AND TREATMENT EPSDT (§ 10:49-18.1)
- Subchapter 19 - HEALTHSTART (§ 10:49-19.1)
- Subchapter 20 - RESERVED
- Subchapter 21 - THE MEDICAID/NJ FAMILYCARE MANAGED CARE PROGRAM (§ 10:49-21.1 to 10:49-21.4)
- Subchapter 22 - HOME AND COMMUNITY-BASED SERVICES WAIVER PROGRAMS (§ 10:49-22.1 to 10:49-22.8)
- Subchapter 23 - LIFELINE PROGRAMS (§ 10:49-23.1 to 10:49-23.2)
- Subchapter 24 - WORK FIRST NEW JERSEY/GENERAL ASSISTANCE CLAIMS PROCESSING (§ 10:49-24.1 to 10:49-24.5)
- Appendix - APPENDIX, version 4
Notes
Effective: December 5, 2022.
See: 55 N.J.R. 65(a).
CHAPTER HISTORICAL NOTE:
Chapter 49, Administration, was adopted and became effective prior to September 1, 1969. Subchapters 1 through 6 were amended by R.1977 d.213, effective July 1, 1977. See: 9 N.J.R. 123(b), 9 N.J.R. 342(c).
Pursuant to Executive Order No. 66(1978), Chapter 49, Administration, was readopted as R.1990 d.390. See: 22 N.J.R. 1512(a), 22 N.J.R. 2313(a).
Chapter 49, Administration, was repealed and a new Chapter 49, Administration, was adopted as R.1992 d.317, effective August 17, 1992. See: 24 N.J.R. 1728(b), 24 N.J.R. 2837(a). Subchapter 19, Prepaid Health Care Services:
Pursuant to Executive Order No. 66(1978), Chapter 49, Administration, was readopted as R.1997 d.354, effective August 8, 1997. As a part of R.1997 d.354, effective September 2, 1997, Chapter 49, Administration, was renamed Chapter 49, Administration Manual; Subchapter 2, New Jersey
Subchapter 24, Work First New Jersey/General Assistance Claims Processing, was adopted as R.2000 d.309, effective August 7, 2000. See: 32 N.J.R. 1342(a), 32 N.J.R. 2900(a).
Chapter 49, Administration Manual, was readopted as R.2003 d.81, effective January 22, 2003. See: 34 N.J.R. 2647(a), 35 N.J.R. 1116(a).
Subchapter 20, The Garden State Health Plan (GSHP), was repealed by R.2003 d.82, effective February 18, 2003. See: 34 N.J.R. 2650(a), 35 N.J.R. 1118(a).
Chapter 49, Administration Manual, was readopted as R.2008 d.230, effective July 11, 2008. As a part of R.2008 d.230, Subchapter 21, The
In accordance with N.J.S.A. 52:14B-5.1b, Chapter 49, Administration Manual, was scheduled to expire on July 11, 2015. See: 43 N.J.R. 1203(a).
Chapter 49, Administration Manual, was readopted as R.2016 d.010, effective January 7, 2016. See: 47 N.J.R. 2039(a), 48 N.J.R. 207(a).
Chapter 49, Administration Manual, was readopted, effective December 5, 2022. See: Source and Effective Date.
CHAPTER AUTHORITY:
N.J.S.A. 30:4D-1 et seq. and 30:4J-8 et seq.
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