N.J. Admin. Code Tit. 10, ch. 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

N.J. Admin. Code Tit. 10, ch. 74
CHAPTER SOURCE AND EFFECTIVE DATE:
R.2019 d.088, effective 7/23/2019.
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 6/19/1995. 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 1/30/1998 (operative 2/1/1998; to expire 7/31/1998). 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 6/12/2000. As a part of R.2000 d.287, Chapter 74 was renamed Managed Health Care Services for Medicaid and NJ KidCare Beneficiaries, effective 7/3/2000. 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 12/7/2005. 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Managed Health Care Services for Medicaid and NJ FamilyCare Beneficiaries; and Subchapter 15, State-Defined HMOs, was repealed, effective 1/3/2006. 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 6/5/2013. 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 1/24/2012. 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 2/21/2012. 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 7/23/2019. As a part of R.2019 d.088, Chapter 74 was renamed Managed Health Care Services for Medicaid/NJ FamilyCare Beneficiaries, effective 8/19/2019. See: Source and Effective Date. See, also, section annotations.
Chapter 74, Managed Health Care Services for Medicaid/NJ FamilyCare Beneficiaries, was updated by administrative change, effective 11/4/2024, to change all references to county welfare agencies (CWA) and county welfare boards to county social service agencies (CSSA) and county social services boards, respectively. See: 56 N.J.R. 2299(a).

CHAPTER AUTHORITY:

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

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