N.J. Admin. Code § 10:52-4.6

Current through Register Vol. 56, No. 21, November 4, 2024

Section 10:52-4.6 - Reimbursement for claims for which there is third-party liability

(a) For beneficiaries for whom any third-party liability exists, claims for hospital services provided that are not the responsibility of a Medicaid/NJ FamilyCare managed care organization shall be reimbursed in accordance with 10:49-7.3 and the provisions of this chapter.

(b) For beneficiaries eligible for Medicare and Medicaid (dual eligibles), claims covered under 10:52-4.7 shall be reimbursed in accordance with the provisions of that section.

Amended by R.2000 d.29, effective 1/18/2000.
See: 31 N.J.R. 3151(a), 32 N.J.R. 276(a).
Rewrote the section.
Amended by R.2005 d.214, effective 7/5/2005.
See: 37 N.J.R. 436(a), 37 N.J.R. 2506(a).
Substituted "FamilyCare" for "KidCare" throughout.
Recodified from N.J.A.C. 10:52-4.5 by R.2009 d.249, effective 8/3/2009.
See: 41 N.J.R. 1351(a), 41 N.J.R. 2895(a).
Former N.J.A.C. 10:52-4.6, Medicare/Medicaid or Medicare/NJ FamilyCare claims, recodified to N.J.A.C. 10:52-4.7.
Repeal and New Rule, R.2014 d.030, effective 2/3/2014.
See: 45 N.J.R. 103(a), 46 N.J.R. 295(a).
Section was "Reimbursement for third-party claims".