New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 6 - MOBILE RESPONSE AND STABILIZATION MANAGEMENT SERVICES › Section 10:77-6.3 - Provider participation requirements

Current through Register Vol. 56, No. 14, July 15, 2024
(a) In order to
				participate as a Medicaid/NJ FamilyCare/Children's System of Care provider of
				children's mobile response and stabilization management services, a provider
				must apply to, and be approved by, the New Jersey Medicaid/NJ FamilyCare
				fee-for-service program as a mobile response agency, in accordance with the
				provisions of this subchapter. Providers who are enrolled as other provider
				types in the Medicaid/NJ FamilyCare program shall complete a separate
				application to enroll as a mobile response agency.
(b) Children's mobile response and
				stabilization management services providers shall be approved by the Children's
				System of Care and under contract with the Department of Children and Families
				as a mobile response agency. Such contract shall be in full effect and not
				suspended or terminated.
(c) All
				applicants shall complete and submit a provider application to:
Department of Children and Families
PO Box 717
Trenton, NJ 08625-0717
Attn: CSOC Provider Enrollment Unit
(d) The applicant shall receive notification
				of approval or disapproval of provider status as determined by CSOC. If
				approved, the applicant shall be enrolled as a Medicaid/NJ FamilyCare provider
				and shall be assigned a unique provider number for seeking reimbursement for
				the provision of mobile response and stabilization management services. All
				approved and enrolled providers shall receive a copy of the provider manual and
				the fiscal agent billing supplement.
(e) Providers of children's mobile response
				and stabilization management services shall, at all times, maintain compliance
				with all applicable State and Federal laws, rules and regulations, including
				N.J.A.C. 10:49, this subchapter and any applicable Department of Children and
				Families rules.
(f) If a provider
				receives notification that the provider is no longer approved by CSOC, or if
				the provider receives notice that its contract with the Department of Children
				and Families is in default status or has been suspended or terminated for any
				reason, the provider shall notify the Division of Medical Assistance and Health
				Services at the address below within 10 business days.
Division of Medical Assistance and Health Services
Office of Provider Enrollment
PO Box 712
Trenton, NJ 08625-0712
(g) If the provider's contract with the
				Department of Children and Families is in default status or has been suspended
				or terminated for any reason, or if the provider is no longer approved by the
				Children's System of Care, the provider shall be immediately disenrolled as a
				Medicaid/NJ FamilyCare mobile response and stabilization management services
				provider until such time as the Department of Children and Families contract is
				renewed or reinstated and the Division of Medical Assistance and Health
				Services has been notified by the Director of the Children's System of Care
				that the provider should be reinstated as a Medicaid/NJ FamilyCare mobile
				response and stabilization management services provider.
(h) In order to participate in the New Jersey
				Medicaid/NJ FamilyCare Program, a provider shall:
1. Have a valid National Provider Identifier
				(NPI) number obtained from the National Plan and Provider Enumeration System
				(NPPES);
2. Have a valid taxonomy
				code obtained from the NPPES; and
3. Remain a provider in good standing by
				successfully completing provider revalidation, when requested by
				DMAHS.