N.J. Admin. Code § 10:69-5.11

Current through Register Vol. 56, No. 17, September 3, 2024

Section 10:69-5.11 - Notice of agency decision

(a) Each applicant shall receive timely and adequate written notice of any change in Medicaid eligibility status in accordance with N.J.A.C. 10:69-6.

(b) If the notice of intention to terminate Medicaid eligibility is related to identification of possible fraud, beneficiaries are entitled to timely notice as defined at N.J.A.C. 10:69-6.1.

1. Seven days notice shall be considered timely when, in the judgment of the CWA director, there is substantiated evidence that the client is receiving Medicaid coverage through willful fraud (see N.J.A.C. 10:69-9.15 through 9.18).

N.J. Admin. Code § 10:69-5.11

Amended by 49 N.J.R. 3729(a), effective 12/4/2017