Chapter 74 - MANAGED HEALTH CARE SERVICES FOR MEDICAID/NJ FAMILYCARE BENEFICIARIES

  1. Subchapter 1 - GENERAL PROVISIONS (§ 10:74-1.1 to 10:74-1.5)
  2. Subchapter 2 - CRITERIA FOR CONTRACTING WITH THE DEPARTMENT (§ 10:74-2.1)
  3. Subchapter 3 - BENEFITS (§ 10:74-3.1 to 10:74-3.15)
  4. Subchapter 4 - MARKETING (§ 10:74-4.1)
  5. Subchapter 5 - INFORMATION PROVIDED TO ENROLLEES (§ 10:74-5.1 to 10:74-5.2)
  6. Subchapter 6 - GENERAL ENROLLMENT (§ 10:74-6.1)
  7. Subchapter 7 - DISENROLLMENT (§ 10:74-7.1 to 10:74-7.3)
  8. Subchapter 8 - ENROLLEES (§ 10:74-8.1 to 10:74-8.7)
  9. Subchapter 9 - EMERGENCY SERVICES (§ 10:74-9.1)
  10. Subchapter 10 - MEDICAL INFORMATION AND QUALITY ASSURANCE (§ 10:74-10.1 to 10:74-10.3)
  11. Subchapter 11 - GRIEVANCE PROCEDURE (§ 10:74-11.1 to 10:74-11.2)
  12. Subchapter 12 - REIMBURSEMENT (§ 10:74-12.1 to 10:74-12.8)
  13. Subchapter 13 - GENERAL REPORTING REQUIREMENTS (§ 10:74-13.1)
  14. Subchapter 14 - CONTRACT SANCTIONS (§ 10:74-14.1)

Notes

CHAPTER SOURCE AND EFFECTIVE DATE:
R.2019 d.088, effective July 23, 2019.
See: 51 N.J.R. 452(a), 51 N.J.R. 1359(a).
CHAPTER HISTORICAL NOTE:
Chapter 74, Managed Health Care Services for Medicaid Eligibles, was adopted as R.1995 d.337, effective June 19, 1995. See: 27 N.J.R. 853(a), 27 N.J.R. 2466(b).
Chapter 74, Managed Health Care Services for Medicaid Eligibles, was renamed Managed Health Care Services for Medicaid Beneficiaries or NJ KidCare Beneficiaries, by special adoption R.1998 d.116, effective January 30, 1998 (operative February 1, 1998; to expire July 31, 1998). See: 30 N.J.R. 713(a). Provisions of R.1998 d.116, adopted without change. See: 30 N.J.R. 3034(a).
Pursuant to Executive Order No. 66(1978), Chapter 74, Managed Health Care Services for Medicaid Beneficiaries or NJ KidCare Beneficiaries, was readopted as R.2000 d.287, effective June 12, 2000. As a part of R.2000 d.287, Chapter 74 was renamed Managed Health Care Services for Medicaid and NJ KidCare Beneficiaries, effective July 3, 2000. See: 32 N.J.R. 1345(a), 32 N.J.R. 2498(a).
Chapter 74, Managed Health Care Services for Medicaid and NJ KidCare Beneficiaries, was readopted as R.2006 d.17, effective December 7, 2005. As a part of R.2006 d.17, Chapter 74 was renamed Managed Health Care Services for Medicaid and NJ FamilyCare Beneficiaries; and Subchapter 15, State-Defined HMOs, was repealed, effective January 3, 2006. See: 37 N.J.R. 2787(a), 38 N.J.R. 294(d).
In accordance with N.J.S.A. 52:14B-5.1b, Chapter 74, Managed Health Care Services for Medicaid and NJ FamilyCare Beneficiaries, was scheduled to expire on June 5, 2013. See: 43 N.J.R. 1203(a).
Chapter 74, Managed Health Care Services for Medicaid and NJ FamilyCare Beneficiaries, was readopted as R.2012 d.041, effective January 24, 2012. As a part of R.2012 d.041, Subchapter 10, Medical Records; Peer Review and Quality Assurance, was renamed Medical Information and Quality Assurance, effective February 21, 2012. See: 43 N.J.R. 257(b), 44 N.J.R. 494(a).
Chapter 74, Managed Health Care Services for Medicaid and NJ FamilyCare Beneficiaries, was readopted as R.2019 d.088, effective July 23, 2019. As a part of R.2019 d.088, Chapter 74 was renamed Managed Health Care Services for Medicaid/NJ FamilyCare Beneficiaries, effective August 19, 2019. See: Source and Effective Date. See, also, section annotations.

CHAPTER AUTHORITY:

N.J.S.A. 30:4D-1 et seq., and 30:4J-8 et seq.