N.J. Admin. Code § 10:73-3.1

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

Section 10:73-3.1 - Purpose and scope

(a) This subchapter sets forth the manner in which care management organization (CMO) services shall be provided to eligible Medicaid/NJ FamilyCare beneficiaries and children, youth and young adults receiving services under the Children's System of Care (CSOC), and shall apply to all CMO services provided under Title XIX and Title XXI of the Social Security Act, 42 U.S.C. §§ 1396 and 1397, or State-funded only programs.

(b) Care management organization services are administered under the auspices of the Department of Human Services (DHS) and its Division of Medical Assistance and Health Services (DMAHS) and the Department of Children and Families' Children's System of Care.

(c) All services shall be provided and administered in accordance with all DHS, DCF, CSOC, and DMAHS rules and contract obligations and all other applicable State and Federal laws, rules, and regulations including, but not limited to, N.J.A.C. 10:3 and 10:49 and this chapter.

(d) If a conflict arises between contract requirements and any existing provider rules, the terms set forth in the DHS or DCF contract shall prevail.

N.J. Admin. Code § 10:73-3.1

Amended by R.2006 d.421, effective 5/21/2007.
See: 38 N.J.R. 2585(a), 39 N.J.R. 2096(a).
Rewrote (a); in (b), substituted "Division" for "Divisions", deleted "Mental Health Services (DMHS), Youth and Family Services (DYFS and" preceding "Medical", and inserted "and the Department of Children and Families' Division of Child Behavioral Health Services"; rewrote (c); and in (d), inserted "or DCF".

Amended by 53 N.J.R. 1492(a), effective 9/7/2021