reglab/housing_qa huggingface dataset:
NJ Rev Stat § 30:4D-6p (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-6p - Coverage of certain prescription refills by Medicaid, NJ FamilyCare during state of emergency.

30:4D-6p Coverage of certain prescription refills by Medicaid, NJ FamilyCare during state of emergency.  1. a. Subject to subsection b. of this section and to the extent consistent with clinical guidelines, the State Medicaid and NJ FamilyCare programs shall provide coverage of prescription drug refills even when the covered person has not yet reached the scheduled refill date, provided that the prescription itself would remain valid beyond the refill date, in a manner calculated to ensure an enrollee's ability to maintain at least a 30-day supply, or a 90-day supply of a maintenance medication supply at home but not to exceed a 120-day supply on-hand at any given time. The coverage shall be provided based on the authorization for the most recently filled prescription and additional authorization for the refill shall not be required. b. The provisions of this section shall be in effect if:  (1) a state of emergency or public health emergency is declared by the State or federal government, or an emergency supply of a drug is recommended by the Centers for Disease Control and Prevention; and (2) the Commissioner of Human Services determines that an emergency supply of prescription drugs is necessary.  c. The coverage shall be provided on an in-network basis to the same extent as for any other refills of prescription drugs, except that: (1) in the event of a drug shortage or access issue, formulary flexibility shall be provided for a covered alternative; and (2) no fees shall be imposed for home delivery of the drugs.  d. The Commissioner of Human Services shall apply for such State plan amendments or waivers as may be necessary to implement the provisions of this section and to secure federal financial participation for State Medicaid expenditures under the federal Medicaid program. e. The Division of Consumer Affairs, in consultation with the Commissioner of Human Services, may develop restrictions on the filling or refilling of prescriptions by pharmacists to address shortage concerns, provided those restrictions shall exclude restricting use for existing conditions to the maximum extent practicable. L.2020, c.30, s.1.
NJ Rev Stat § 30:4D-6q (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-6q - Medicaid, NJ FamilyCare, opioid antidote coverage.

30:4D-6q Medicaid, NJ FamilyCare, opioid antidote coverage.  2. a. The Division of Medical Assistance and Health Services in the Department of Human Services shall provide coverage for an opioid antidote under the Medicaid program and the NJ FamilyCare program without the imposition of any prior authorization or other utilization management requirements, provided that the drug is: (1) prescribed or administered to an enrollee by a licensed medical practitioner who is authorized to prescribe or administer that treatment pursuant to State and federal law; or  (2) dispensed to an enrollee by a licensed pharmacist under a standing order to dispense an opioid antidote pursuant to section 1 of P.L.2017, c.88 (C.45:14-67.2). b. The provisions of this section shall not be construed to limit the coverage of an opioid antidote only when administered by a medical practitioner. c. The division shall require each managed care organization contracted with the division to provide pharmacy benefits to Medicaid and NJ FamilyCare enrollees to comply with the provisions of this section.  d. The Commissioner of Human Services shall apply for such State plan amendments or waivers as may be necessary to implement the provisions of this section and to secure federal financial participation for State Medicaid expenditures under the federal Medicaid program. e. As used in this section:  "Medicaid program" means the program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.).  "Opioid antidote" means naloxone hydrochloride, or any other similarly acting drug approved by the United States Food and Drug Administration for self-administration for the treatment of an opioid overdose. "NJ FamilyCare program" means the program established pursuant to P.L.2005, c.156 (C.30:4J-8 et al.). L.2021, c.157, s.2.
NJ Rev Stat § 30:4D-6r (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-6r - Medicaid to cover newborn home nurse visitation.

30:4D-6r Medicaid to cover newborn home nurse visitation.  13. a. Notwithstanding any State law or regulation to the contrary, the Department of Human Services shall, contingent on maintaining or receiving necessary federal approvals, ensure that expenses incurred for services provided under the newborn home nurse visitation program established pursuant to section 2 of P.L.2021, c.187 (C.26:2H-159) shall be provided with no cost-sharing to eligible persons under the Medicaid program, established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.). The coverage provided under this section shall: (1) provide coverage for the services provided by the newborn home nurse visitation program established pursuant to section 2 of P.L.2021, c.187 (C.26:2H-159);  (2) notify a covered person of the services provided by the newborn home nurse visitation program, upon application by the covered person for coverage of a newborn infant;  (3) ensure that the plan does not contain any provision that requires a covered person to receive the services provided by the newborn home nurse visitation program as a condition of coverage, or that denies or limits benefits to the covered person if that person declines the services provided under the program; and (4) have the discretion to determine how best to reimburse for the expenses incurred for services provided under the newborn home nurse visitation program, including, but not limited to, utilizing: (a) a value-based payment methodology; (b) an invoice claim process; (c) a capitated payment arrangement;  (d) a payment methodology that takes into account the need for an agency or organization providing services under the program to expand its capacity to provide services and address health disparities; or (e) any other payment arrangement agreed to by the carrier and an agency or organization providing services under the program. b. Any copayment, coinsurance, or deductible that may be required pursuant to the contract for services covered pursuant to subsection a. of this section shall be waived. c. The Assistant Commissioner of Human Services shall submit to the Department of Children and Families, in a form and manner prescribed by the department, a report on the claims submitted for services provided under the newborn home nurse visitation program. The information contained in the report shall be used by the department to assess the newborn home nurse visitation program pursuant to subsection a. of section 4 of P.L.2021, c.187 (C.26:2H-161). d. The benefits shall be provided to the same extent as for any other medical condition under the contract. L.2021, c.187, s.13.
NJ Rev Stat § 30:4D-6.1 (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-6.1 - Abortions; payment of claims

30:4D-6.1. Abortions; payment of claims  No payments for medical assistance shall be made under the act hereby supplemented for the termination of a woman's pregnancy for any reason except where it is medically indicated to be necessary to preserve the woman's life. In any case where a pregnancy is so terminated, the act shall be performed in a hospital and the physician performing the act shall submit in writing a report to the division stating in detail his reasons for finding it necessary to terminate the pregnancy. L.1975, c. 261, s. 1, eff. Dec. 18, 1975.
NJ Rev Stat § 30:4D-6.2 (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-6.2 - Definitions.

30:4D-6.2 Definitions.  1. For the purposes of this act: a. "Certified trained personnel" means one or more individuals directly providing mobility assistance vehicle services possessing and carrying upon their persons a current certificate of completion of an advanced medical training course, as determined by the Commissioner of Health. b. "Division" means the Division of Medical Assistance and Health Services in the Department of Human Services. c. "Mobility assistance vehicle service" means the provision of nonemergency health care transportation, supervised by certified trained personnel, for Medicaid recipients who are sick, have an infirmity, or have a disability, and who are under the care and supervision of a physician and whose medical condition is not of sufficient magnitude or gravity to require transportation by ambulance, but does require transportation from place to place for medical care and whose use of an alternate form of transportation, such as taxicab, bus, other public conveyance or private vehicle might create a serious risk to life and health. d. "Medicaid recipient" means any person who is determined to be eligible to receive mobility assistance vehicle services as provided under P.L.1981, c.134 (C.30:4D-6.2 et seq.) and meets the eligibility requirements pursuant to the "New Jersey Medical Assistance and Health Services Act," P.L.1968, c. 413. e. "Provider" means any person, public or private institution, agency or business concern lawfully providing mobility assistance vehicle services authorized under P.L.1981, c.134 (C.30:4D-6.2). L.1981, c.134, s.1; amended 1997, c.102, s.1; 2017, c.131, s.118.
NJ Rev Stat § 30:4D-6.3 (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-6.3 - Provider of mobility assistance vehicle services; conditions for approval for reimbursement

30:4D-6.3. Provider of mobility assistance vehicle services; conditions for approval for reimbursement  2. No provider of mobility assistance vehicle services shall be approved for reimbursement by the Division of Medical Assistance and Health Services for services rendered to Medicaid recipients unless such provider meets all the standards and requirements issued pursuant to section 3 and section 5 of this act. L.1981,c.134,s.2; amended 1997, c.102, s.2.
NJ Rev Stat § 30:4D-6.4 (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-6.4 - Minimum requirements, liability insurance, personnel; rules, regulations.

30:4D-6.4 Minimum requirements, liability insurance, personnel; rules, regulations.  3. After consulting with the Commissioner of Human Services, the Commissioner of Health is authorized and empowered to issue and enforce, or cause to be issued and enforced through the division, all necessary rules, regulations, and administrative orders with respect to: a. The development of minimum requirements concerning the equipment, supplies, and vehicles of providers of mobility assistance vehicle services; b. The establishment of standards for the amount of liability insurance each provider must maintain in order to be eligible to provide mobility assistance vehicle services. Evidence of such insurance, including the name of the insurer and the policy number, shall be filed at the time of application for approval by the division and from time to time as the division shall deem necessary; and c. The establishment of standards for certified trained personnel employed by providers of mobility assistance vehicle services. L.1981, c.134, s.3; amended 1997, c.102, s.3; 2012, c.17, s.360.
NJ Rev Stat § 30:4D-6.5 (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-6.5 - Inapplicability of act to services by volunteer first aid, rescue and ambulance squads

30:4D-6.5. Inapplicability of act to services by volunteer first aid, rescue and ambulance squads  The provisions of this act shall not apply to services provided by volunteer first aid, rescue and ambulance squads as defined in the "New Jersey Highway Safety Act of 1971," P.L.1971, c. 351 (C. 27:5F-1 et seq.). L.1981, c. 134, s. 4.
NJ Rev Stat § 30:4D-6.6 (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-6.6 - Rules and regulations; application of Medical Assistance and Health Services Act

30:4D-6.6. Rules and regulations; application of Medical Assistance and Health Services Act  a. After consulting with the Commissioner of Human Services, the Commissioner of Health is authorized and empowered to adopt such rules and regulations as are necessary to carry out his functions and duties under this act and to effectuate its purposes. b. The provisions of the "New Jersey Medical Assistance and Health Services Act" and all rules, regulations and administrative orders issued thereunder shall apply, where applicable. L.1981, c. 134, s. 5.
NJ Rev Stat § 30:4D-6.7 (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-6.7 - Resident of skilled or intermediate care nursing facility discharged to general or psychiatric hospital; coverage by medical assistance program

30:4D-6.7. Resident of skilled or intermediate care nursing facility discharged to general or psychiatric hospital; coverage by medical assistance program  A resident of a skilled or intermediate care nursing facility who is a recipient of medical assistance payments under P.L.1968, c. 413 (C. 30:4D-1 et seq.), and who is discharged to a general or a psychiatric hospital, shall be covered by the medical assistance program for the number of days the nursing facility maintains the resident's bed. L.1984, c. 139, s. 1, eff. Sept. 5, 1984.
NJ Rev Stat § 30:4D-6.8 (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-6.8 - Period of maintenance of bed for eligible resident; certification for payment

30:4D-6.8. Period of maintenance of bed for eligible resident; certification for payment  Every skilled or intermediate care nursing facility in this State shall maintain a bed for an eligible resident for a period not to exceed 10 days. The facility shall notify the Division of Medical Assistance and Health Services in the Department of Human Services upon the discharge of an eligible resident to a general or a psychiatric hospital. The division shall confirm the need to maintain a bed for the discharged resident and shall certify the facility's eligibility to receive payment. L.1984, c. 139, s. 2, eff. Sept. 5, 1984.
NJ Rev Stat § 30:4D-6.9 (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-6.9 - Inability of discharged resident to return within period; priority for next available bed

30:4D-6.9. Inability of discharged resident to return within period; priority for next available bed  If the discharged resident is unable to return to the nursing facility before the end of the 10 day period, the discharged resident shall have priority for the next available bed in the facility. L.1984, c. 139, s. 3, eff. Sept. 5, 1984.
NJ Rev Stat § 30:4D-6.10 (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-6.10 - Conditions for reimbursement to providers; educational materials; terms defined.

30:4D-6.10 Conditions for reimbursement to providers; educational materials; terms defined.  2. a. No provider shall be approved for reimbursement by the Division of Medical Assistance and Health Services in the Department of Human Services under Medicaid for a non-medically indicated early elective delivery performed at a hospital on a pregnant woman earlier than the 39th week of gestation on or after the ten-month period following the effective date of this section. During the ten-month period following the effective date of this section, the Division of Medical Assistance and Health Services in the Department of Human Services shall provide accessible educational materials to inform pregnant women, their support networks, and Medicaid providers about the risks of non-medically indicated early elective delivery. b. As used in this section: "Medicaid" means the Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.). "Non-medically indicated early elective delivery" means the artificial start of the birth process through medical interventions or other methods, also known as labor induction, or the surgical delivery of a baby via a cesarean section for purposes or reasons that are not fully consistent with established standards of clinical care as provided by the American College of Obstetricians and Gynecologists. L.2019, c.87, s.2.
NJ Rev Stat § 30:4D-7a (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-7a - County welfare agency to provide adequate employees to determine Medicaid eligibility

30:4D-7a. County welfare agency to provide adequate employees to determine Medicaid eligibility  The Commissioner of Human Services shall require that a county welfare agency provide adequate employees to determine Medicaid eligibility to any hospital in the county that has been designated by the Commissioner of Health pursuant to section 9 of P.L.1991, c.187 (C.26:2H-18.32).  The Commissioner of Human Services shall bill the designated hospital quarterly for the nonfederal share of costs associated with a county welfare agency employee stationed at the hospital, and reimburse the county welfare agency upon receipt of payment from the hospital.  L.1991,c.187,s.10.
NJ Rev Stat § 30:4D-7b (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-7b - Preparation of five-year plan for developing Statewide network of managed care providers

30:4D-7b. Preparation of five-year plan for developing Statewide network of managed care providers  The Commissioner of Human Services shall prepare a five-year plan to develop a Statewide network of managed care providers for Medicaid recipients pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.). A managed care plan may include, but is not limited to, the Garden State Health Plan, or its successor, any other State approved or federally qualified health maintenance organization, or any other cost effective health plan, prepaid or otherwise, that is under contract with the Division of Medical Assistance and Health Services in the Department of Human Services to provide managed care services to Medicaid recipients.  The commissioner shall prepare the plan within one year of the effective date of P.L.1991, c.187 (C.26:2H-18.24 et al.) and submit the plan to the Governor and the Chairmen of the Senate Institutions, Health and Welfare and General Assembly Health and Human Services Committees.  L.1991,c.187,s.42.
NJ Rev Stat § 30:4D-7c (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-7c - Submission of plan to enroll Medicaid recipients by health maintenance organizations

30:4D-7c. Submission of plan to enroll Medicaid recipients by health maintenance organizations  Within one year of the effective date of P.L.1991, c.187 (C.26:2H-18.24 et al.), every State approved or federally qualified health maintenance organization in the State shall submit a plan to the Commissioner of Human Services to enroll Medicaid recipients pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.). The plan shall include the terms and conditions for enrolling Medicaid recipients, including the number of recipients that can reasonably be enrolled, the health care services that will be offered, and an estimate of the per capita cost for enrollment of these persons.  The commissioner shall provide a health maintenance organization, upon written request, with any nonidentifying information about Medicaid recipients that is necessary to assist the health maintenance organization in preparing its plan.  L.1991,c.187,s.43.
NJ Rev Stat § 30:4D-7d (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-7d - Report by commissioner

30:4D-7d. Report by commissioner  Within six months of the effective date of P.L.1991, c.187 (C.26:2H-18.24 et al.), the Commissioner of Human Services shall report to the Governor and the Chairmen of the Senate Institutions, Health and Welfare and General Assembly Health and Human Services Committees on ways: to increase the number of providers in the Medicaid program pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.); to improve Medicaid provider relations with the Medicaid program; to reduce administrative burdens encountered by Medicaid providers; and to streamline Statewide administration of the Medicaid program.  L.1991,c.187,s.44.
NJ Rev Stat § 30:4D-7e (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-7e - Rules, regulations

30:4D-7e. Rules, regulations  38. The Commissioner of Human Services shall, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) adopt rules and regulations necessary to implement the provisions of sections 9, 11 and 12 of this act as they relate to payments from the Health Care Subsidy Fund to disproportionate share hospitals.  L.1992,c.160,s.38.
NJ Rev Stat § 30:4D-7f (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-7f - Access fees charged by fiscal agent; establishment; use

30:4D-7f. Access fees charged by fiscal agent; establishment; use  1. Notwithstanding the provisions of the "New Jersey Medical Assistance and Health Services Act," P.L.1968, c.413 (C.30:4D-1 et seq.) or any other law to the contrary, an intermediary vendor under contract with the Division of Medical Assistance and Health Services' fiscal agent, which vendor has direct access to the Medical Assistance Eligibility System, shall be charged an access fee by the fiscal agent. The Commissioner of Human Services shall, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) adopt regulations establishing the access fee.  Receipts from access fees in excess of development and operational costs incurred by the division's fiscal agent shall be appropriated annually to the division.  L.1994,c.60,s.1.
NJ Rev Stat § 30:4D-7g (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-7g - Findings, declarations relative to pediatric rehabilitation hospitals.

30:4D-7g. Findings, declarations relative to pediatric rehabilitation hospitals.  1. The Legislature finds and declares that: a. Currently, there are two pediatric rehabilitation hospitals in the State that provide pediatric inpatient and ambulatory rehabilitation and pediatric long-term care services to children throughout the State. These hospitals offer a variety of medical, developmental and educational services to children with severe disabilities and chronic illnesses; and b. There is a tremendous need in the State for the unique services provided by these facilities, and few providers within the health care community have the capability and expertise to properly treat the special needs of these children. L.2001,c.393,s.1.
NJ Rev Stat § 30:4D-7i (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-7i - Exemption from close proximity requirements, notification as to off-site location.

30:4D-7i Exemption from close proximity requirements, notification as to off-site location.  3. A pediatric rehabilitation hospital licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) shall not be subject to the close proximity requirements established pursuant to N.J.A.C.10:52-1.3(b)(1) for the purposes of receiving Medicaid fee-for-service reimbursement for outpatient hospital services. A pediatric rehabilitation hospital which establishes an off-site location to provide outpatient services shall notify the Division of Medical Assistance and Health Services in the Department of Human Services in accordance with the requirements of N.J.A.C.10:52-1.3. L.2001,c.393,s.3.