reglab/housing_qa huggingface dataset:
NJ Rev Stat § 30:4D-7j (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-7j - Annual cost report to receive reimbursement from Medicaid for personal care assistant services.

30:4D-7j Annual cost report to receive reimbursement from Medicaid for personal care assistant services.  1. As a condition of receiving reimbursement from the State Medicaid program, pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.), for personal care assistant services, as described in N.J.A.C.10:60-3.3, which are provided to Medicaid recipients, a health care service firm, as defined in N.J.A.C.13:45B-13.2, shall file an annual cost report with the Division of Disability Services in the Department of Human Services. The Division of Disability Services shall develop the form of the annual cost report, which shall include information on costs and revenues. The cost report shall be filed on an annual basis, beginning January 1, 2010, in a form and manner specified by the division. L.2009, c.181, s.1.
NJ Rev Stat § 30:4D-7k (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-7k - Definitions relative to reimbursement for family planning services.

30:4D-7k Definitions relative to reimbursement for family planning services.  1. a. The reimbursement rate for an office visit for family planning services billed by a health care facility, which is licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) and receives funding under Title X of the Public Health Service Act (42 U.S.C. s.300 et seq.), to the State Medicaid program shall be an amount that equals at least 90% of the amount of the actual cost of services provided during an office visit, as such rate is in effect on the date of enactment of this act. b. As used in this section: "Family planning services" means comprehensive reproductive health care services, including: contraception; pregnancy detection; options counseling; diagnosis or treatment, or both, of sexually transmitted diseases; routine gynecological and cancer screening services; health promotion activities; and Level I infertility services such as an interview, education, physical examination, laboratory testing, counseling, and appropriate referral. The term does not include termination of pregnancy. Family planning services may also include: prenatal and postpartum care; other gynecological services, including colposcopy and cryotherapy; menopausal services; Level II infertility services, which include semen analysis, assessment of ovulatory function, and post coital testing; and Level III infertility services, which include more sophisticated and complex infertility testing and procedures than Levels I and II. "Medicaid" means the Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.). "Office visit" means a procedure billed under a common procedure terminology code that includes a family planning modifier in the description of the code. L.2009, c.268, s.1.
NJ Rev Stat § 30:4D-7l (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-7l - Department to facilitate implementation of C.30:4D-7k.

30:4D-7l Department to facilitate implementation of C.30:4D-7k.  2. The Department of Health shall adjust the Family Planning Services Grant-in-Aid appropriation and transfer the appropriate amount of State funds to the Division of Medical Assistance and Health Services in the Department of Human Services to facilitate the implementation of section 1 of this act. The Department of Health shall notify the Legislative Budget and Finance Officer as to the amount that is transferred. L.2009, c.268, s.2; amended 2012, c.17, s.362.
NJ Rev Stat § 30:4D-7m (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-7m - Certain HMOs, changes in certain reimbursement rates; procedure.

30:4D-7m Certain HMOs, changes in certain reimbursement rates; procedure.  1. Notwithstanding any law, rule, or regulation to the contrary, a health maintenance organization that contracts with the Division of Medical Assistance and Health Services in the Department of Human Services to provide benefits under a managed care plan to persons who are eligible for Medicaid shall not reduce reimbursement rates for personal care assistant services or home based supportive care services, as those services are defined by regulation or in the contract with the division, under the health maintenance organization's Medicaid managed care plan, unless the health maintenance organization notifies the division, in writing, at least 90 days before the effective date of such changes. Such notice shall be accompanied by written assurance that the reduction will not reduce sufficient provider access or quality of service as required by the contract with the division. L.2015, c.234, s.1.
NJ Rev Stat § 30:4D-7n (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-7n - Hourly reimbursement rate for Medicaid personal care services.

30:4D-7n Hourly reimbursement rate for Medicaid personal care services.  1. The hourly reimbursement rate for personal care services within the Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.), whether the services are provided in the Medicaid fee-for-service delivery system or through a managed care delivery system, shall be no less than the established State Medicaid fee-for-service rate. On July 1, 2019, the reimbursement rate shall be $18 per hour. L.2017, c.239, s.1; amended 2019, c.275, s.2.
NJ Rev Stat § 30:4D-7o (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-7o - Report.

30:4D-7o Report.  2. Every provider that receives reimbursement for personal care services pursuant to a Medicaid managed care contract shall annually provide a report to the Division of Medical Assistance and Health Services in the Department of Human Services regarding the use of funds received as reimbursement for personal care services, including detailed data on any salary increases resulting from section 1 of P.L.2017, c.239 (C.30:4D-7n); including the prior salary, current salary, and other changes to the salary of the workers who directly provide personal care services. L.2017, c.239, s.2; amended 2019, c.275, s.3.
NJ Rev Stat § 30:4D-7p (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-7p - Medicaid reimbursement for certain emergency services.

30:4D-7p Medicaid reimbursement for certain emergency services.  1. a. A hospital licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) providing emergency services to patients enrolled in the State Medicaid fee-for-service program shall accept as final payment an emergency room triage reimbursement fee of $140.00 when the emergency services provided are for low acuity emergency room encounters. The Commissioner of Human Services shall publish a list of diagnostic codes that would be considered low acuity emergency room encounters for the purpose of applying this fee.  b. As used in this section: "Acuity" means the measurement of the intensity of nursing care required by a patient. "Medicaid" means the Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.). L.2018, c.51, s.1.
NJ Rev Stat § 30:4D-7q (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-7q - Rules, regulations.

30:4D-7q Rules, regulations.  3. The Commissioner of Human Services shall adopt rules and regulations pursuant to the "Administrative Procedure Act" P.L.1968, c.410 (C.52:14B-1 et seq.) to effectuate the purposes of this act.  L.2018, c.51, s.3.
NJ Rev Stat § 30:4D-7r (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-7r - Short title.

30:4D-7r Short title.  1. This act shall be known and may be cited as "The County Option Hospital Fee Pilot Program Act." L.2018, c.136, s.1.
NJ Rev Stat § 30:4D-7s (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-7s - Definitions relative to "The County Option Hospital Fee Pilot Program Act."

30:4D-7s Definitions relative to "The County Option Hospital Fee Pilot Program Act."  2. As used in this act:  "Commissioner" means the Commissioner of Human Services.  "Department" means the Department of Human Services.  "Fee" means the local health care-related fee authorized pursuant to this act.  "Hospital" means a hospital that is licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) and is located within the borders of a participating county. "Medicaid program" means the "New Jersey Medical Assistance and Health Services Program" established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.).  "Participating county" means a county with a population greater than 250,000, according to the federal decennial census immediately preceding the effective date of this act; that contains a municipality which: (1) is classified, pursuant to N.J.S.40A:6-4, as a First or Second Class municipality, or a Fourth Class municipality whose population exceeds 20,000, and (2) has a Municipal Revitalization Index score, as last calculated by the New Jersey Department of Community Affairs prior to the effective date of this act, that exceeds 60; and which chooses to participate in the pilot program.  "Pilot program" means "The County Option Hospital Fee Pilot Program" established pursuant to this act.  "Proposed fee and expenditure report" means a written report by a participating county that describes how the fee will be imposed in the participating county; how the funds collected from the fee will be used by the participating county, including the amount and services the participating county plans to provide with the funds; and how the plan satisfies paragraph (1) of subsection b. of section 3 of this act.  L.2018, c.136, s.2.
NJ Rev Stat § 30:4D-7u (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-7u - Transfer of funds to commissioner, uses; fee.

30:4D-7u Transfer of funds to commissioner, uses; fee.  4. a. A participating county may transfer funds collected from the fee imposed pursuant to subsection c. of section 3 of this act to the commissioner. The commissioner shall use funds transferred from a participating county, and any matching amount of federal Medicaid funds or other federal funds generated therefrom, for the following purposes: to increase Medicaid payments to hospitals in the jurisdiction from which the funds are received; for payments to managed care organizations that have contracted with Medicaid serving the jurisdiction from which the funds are received for increased hospital or hospital-related payments; and for direct costs related to administrative purposes to implement the pilot program. The commissioner shall seek to minimize the length of time between the collection of the fee by the participating county and the distribution of payments pursuant to this subsection. Notwithstanding any other law to the contrary, the commissioner and a participating county are authorized to enter into an intergovernmental transfer agreement as may be necessary to transfer funds under this subsection or to otherwise satisfy the requirements of this act.  b. A participating county may retain the funds collected from the imposition of the fee, in which case the participating county shall generate the same level of funding, in addition to the funds collected from the imposition of the fee, that would be generated by the department through any matching amount of federal Medicaid funds or other federal funds, and use the total funding amount to satisfy paragraph (1) of subsection b. of section 3 of this act. c. At least 90 percent of the funds collected from imposition of the fee shall be used by a participating county or the department for the benefit of local hospitals within the participating county's borders to ensure that the hospitals continue to provide necessary services to low-income citizens. The participating counties shall transfer at least one percent of funds collected from the imposition of the fee to the department for administration of the program. L.2018, c.136, s.4.
NJ Rev Stat § 30:4D-7v (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-7v - Imposition of fee.

30:4D-7v Imposition of fee.  5. a. The fee imposed pursuant to subsection c. of section 3 of this act shall be imposed in relation to health care items or services provided only during the effective period of this act, and shall not be collected until the commissioner notifies the appropriate governmental entities that any State plan amendment or waivers submitted pursuant to section 6 of this act have been approved.  b. No hospital subject to the fee shall pass on the cost of the fee to any patient, insurer, self-insured employer program, or other responsible party, nor list it separately on any invoice or statement sent to a patient, insurer, self-insured employer program, or other responsible party.  c. Unless otherwise prohibited by the federal government, no managed care organization operating in the State that has contracted with Medicaid shall retain any funds generated by the fee, other than to offset any increased administrative costs incurred as a result of the pilot program.  d. Funds generated by the fee shall not supplant or offset any current or future State funds allocated to a county participating in the pilot program.  e. Payments distributed to hospitals pursuant to this act shall not supplant or offset any current or future funds paid to hospitals through other State or federal funding mechanisms or pools. L.2018, c.136, s.5.
NJ Rev Stat § 30:4D-7w (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-7w - Application by commissioner, approval prior to collection of fee.

30:4D-7w Application by commissioner, approval prior to collection of fee.  6. The Commissioner of Human Services shall apply for such State plan amendments or waivers as may be necessary to implement the provisions of this act and to secure federal financial participation for State Medicaid expenditures under the federal Medicaid program, and shall receive approval for such State plan amendments or waivers prior to collection of a fee authorized pursuant to subsection c. of section 3 of this act. L.2018, c.136, s.6.
NJ Rev Stat § 30:4D-7x (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-7x - Rules, regulations.

30:4D-7x Rules, regulations.  7. The commissioner shall promulgate, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), rules and regulations necessary for the implementation of this act which shall include appropriate methodologies for the county proposed fee and expenditure report. Participating counties shall not submit the proposed fee and expenditure plan to the department prior to the adoption of rules and regulations. L.2018, c.136, s.7.
NJ Rev Stat § 30:4D-7y (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-7y - Perinatal Risk Assessment form for certain pregnant women.

30:4D-7y Perinatal Risk Assessment form for certain pregnant women.  1. An obstetrical provider, nurse midwife, or other licensed health care professional, approved as a provider under the Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.), shall complete the Perinatal Risk Assessment form, as used by the Division of Medical Assistance and Health Services in the Department of Human Services, for each pregnant Medicaid recipient and for each individual eligible for Emergency Medical Services for Non-Qualified Aliens who receives prenatal care from the provider. The Perinatal Risk Assessment form shall be the uniform document used by all providers and Medicaid managed care plans. The form shall be completed by the provider during the first prenatal visit with the pregnant Medicaid recipient or other eligible individual and updated by the provider in the third trimester of the recipient or other eligible individual. L.2019, c.88, s.1.
NJ Rev Stat § 30:4D-7z (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-7z - Submission of form to division.

30:4D-7z Submission of form to division.  2. The division shall require providers to submit each Perinatal Risk Assessment form completed pursuant to section 1 of this act to the division, or to a nonprofit entity contracted by the division to process, distribute to appropriate Medicaid managed care plans, and maintain the Perinatal Risk Assessment data. A provider shall not receive authorization for reimbursement for prenatal services provided to a pregnant Medicaid recipient until a Perinatal Risk Assessment form is submitted for that recipient. L.2019, c.88, s.2.
NJ Rev Stat § 30:4D-7aa (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-7aa - Analysis of data.

30:4D-7aa Analysis of data.  3. The division, in collaboration with the Department of Health, Medicaid managed care organizations, and any nonprofit entity contracted by the division to process, distribute, and maintain the Perinatal Risk Assessment data, shall analyze the Perinatal Risk Assessment data in order to identify trends in the risk factors associated with Medicaid recipients and individuals eligible for Emergency Medical Services for Non-Qualified Aliens during pregnancy. Commencing no later than 18 months after the effective date of this act, and annually thereafter, the division shall submit a written report to the Governor, and to the Legislature pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), providing a summary of its findings and any proposals for legislative action needed to improve the maternal outcomes of Medicaid recipients and individuals eligible for Emergency Medical Services for Non-Qualified Aliens. L.2019, c.88, s.3.
NJ Rev Stat § 30:4D-7bb (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-7bb - Rules, regulations.

30:4D-7bb Rules, regulations.  4. The Commissioners of Health and Human Services, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt rules and regulations necessary to implement the provisions of this act. L.2019, c.88, s.4.
NJ Rev Stat § 30:4D-7dd (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-7dd - Risk reduction model to prescription drug services, third party contract.

30:4D-7dd Risk reduction model to prescription drug services, third party contract.  1. The Division of Medical Assistance and Health Services in the Department of Human Services shall contract with a third party entity to apply a risk reduction model to prescription drug services provided under the Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.), for the purpose of identifying and reducing simultaneous, multi-drug medication-related risk and adverse drug events, enhancing compliance and quality of care, and improving health-related outcomes while reducing total cost of care in a measurable and reportable manner. In carrying out this purpose, the model, at a minimum, shall leverage Medicaid prescription drug claims data, pharmacokinetic and pharmacodynamic sciences, appropriate technologies, clinical call centers located in New Jersey and staffed by board-certified pharmacists licensed pursuant to P.L.2003, c.280 (C.45:14-40 et seq.), and include coordination of services with a network of local community pharmacies located throughout the State. For the duration of the contract, the division shall share the medical and pharmacy claims data for all Medicaid beneficiaries with the third party administering the model for the purposes of effectuating the model, which claims data shall include historical data. L.2021, c.151.
NJ Rev Stat § 30:4D-7ee (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-7ee - Pharmacy benefits management services, information disclosure

30:4D-7ee Pharmacy benefits management services, information disclosure  1. a. Any contract or other arrangement entered into by a managed care organization, or by the Division of Medical Assistance and Health Services in the Department of Human Services, for the provision of pharmacy benefits management services under the Medicaid program shall require the pharmacy benefits manager to disclose to the department: (1) all sources and amounts of income, payments, and financial benefits received by the pharmacy benefits manager in relation to the provision and administration of pharmacy benefits management services on behalf of the managed care organization, including, but not limited to, any pricing discounts, rebates of any kind, inflationary payments, credits, clawbacks, fees, grants, chargebacks, reimbursements, or other benefits;  (2) all ingredient costs and dispensing fees or similar payments made by the pharmacy benefits manager to any pharmacy in connection with the contract or other arrangement; and (3) the pharmacy benefits manager's payment model for administrative fees. b. Information disclosed by a pharmacy benefits manager to the division pursuant to subsection a. of this section shall be confidential and not be subject to public disclosure under P.L.1963, c.73 (C.47:1A-1 et seq.), or P.L.2001, c.404 (C.47:1A-5 et al.). In addition to any other penalty provided by law, a person who is authorized to access information submitted by a pharmacy benefits manager to the division who knowingly discloses such information to any person or entity who is not authorized to access the information shall be guilty of a crime of the fourth degree and shall be subject to a civil penalty in an amount not to exceed $10,000. A civil penalty imposed under this subsection shall be collected by the director pursuant to the "Penalty Enforcement Law of 1999," P.L.1999, c.274 (C.2A:58-10 et seq.). c. As used in this section: "Pharmacy benefits manager" means a corporation, business, or other entity, or unit within a corporation, business, or other entity, that administers prescription drug benefits on behalf of a managed care organization. "Pharmacy benefits management services" mean the provision of any of the following services on behalf of a managed care organization: the procurement of prescription drugs at a negotiated rate for dispensation within this State; the processing of prescription drug claims; or the administration of payments related to prescription drug claims. L.2021, c.257.
NJ Rev Stat § 30:4D-7gg (2021)
2021 New Jersey Revised Statutes|Title 30 - Institutions and Agencies|Section 30:4D-7gg - Rules, regulations.

30:4D-7gg Rules, regulations.  2. The Commissioner of Human Services shall adopt rules and regulations pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), to effectuate the purposes of this act. L.2021, c.276, s.2.