New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 49 - ADMINISTRATION MANUAL › Subchapter 1 - GENERAL PROVISIONS › Section 10:49-1.4 - Overview of provider manuals

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The Medicaid
				Fiscal Agent and the Division of Medical Assistance and Health Services
				maintain New Jersey Medicaid and NJ FamilyCare provider manuals. Each is
				designed for use by a specific type of provider that provides services to
				Medicaid and/or NJ FamilyCare beneficiaries. Each manual is written in
				accordance with Federal and State laws, rules, and regulations, with the intent
				to ensure that such laws, rules, and regulations are uniformly
				applied.
(b) Each provider manual
				consists of two chapters, broken down into subchapters. The first chapter is
				referred to as N.J.A.C. 10:49, Administration Manual, and outlines the general
				administrative policies of the New Jersey Medicaid program and other special
				programs including NJ FamilyCare. The second chapter of each manual specifies
				the rules and regulations relevant to the specific provider-type and the
				services provided. Following the second chapter of the manuals is the Fiscal
				Agent Billing Supplement.
(c)
				Codification of manual material follows that of the New Jersey Administrative
				Code (N.J.A.C.). The citation for a particular section of the provider manual
				reflects the same material under the same citation in the N.J.A.C. The
				following is an example of a citation in the N.J.A.C. or a provider manual:
Data in
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(d) There
				is an individual Program provider manual for each of the following services.
				These services are listed in the New Jersey Administrative Code (N.J.A.C.)
				under Title 10 (Department of Human Services) Chapters 10:50 through 10:79 as
				follows:
1.
10:50--Transportation Services Manual
2.
10:51--Pharmacy Services Manual
3.
10:52--Hospital Services Manual
4.
10:53--(Reserved)
5.
10:53A--Hospice Services Manual
6.
10:54--Physician Services Manual
7.
10:55--Prosthetic and Orthotic Services
						Manual
8.
10:56--Dental Services Manual
9.
10:57--Podiatry Services Manual
10.
10:58--Nurse-Midwifery Services Manual
11.
10:58A--Advanced Practice Nurse;
12.
10:59--Medical Supplier Services Manual
13.
10:60--Home Care Services Manual
14.
10:61--Independent Clinical Laboratory
						Services Manual
15.
10:62--Vision Care Services Manual
16.
10:63--Long Term Care Services Manual
17.
10:64--Hearing Aid Services Manual
18.
10:65--Medical Day Care Services Manual
19.
10:66--Independent Clinic Services
						Manual
20.
10:67--Psychological Services Manual
21.
10:68--Chiropractic Services Manual
22.
10:69 AFDC-Related Medicaid
23.
10:70 Medically Needy Manual
24.
10:71 Medicaid Only Manual
25.
10:72 New Jersey Care ... Special Medicaid
						Programs Manual
26.
10:73--Case Management Services Manual
27.
10:74--Managed Health Care Services for
						Medicaid and NJ
FamilyCare Beneficiaries
28.
10:75--Psychiatric Residential Treatment
						Facility Services
for Individuals Under Age 21
29.
10:76--Programs for Assertive Community
						Treatment (PACT)
Services
30.
10:77 Rehabilitation Services Manual
31.
10:78 NJ FamilyCare Manual
32.
10:79--NJ FamilyCare Children's Program
(e) Manual
				updates, revised pages or additions to the provider manual are issued, as
				required, for new policy, policy clarification, and/or revisions to the New
				Jersey Medicaid or NJ FamilyCare program. A newsletter system is utilized to
				distribute new or revised manual material and to provide any other pertinent
				information regarding manual updates. Newsletters should be filed at the back
				of the manual and replacement pages should be added to the manual in accordance
				with instructions provided. Substantive manual revisions shall be made through
				the rulemaking process, in accordance with the Administrative Procedure Act,
				N.J.S.A.
				52:14B-1 et seq.
(f) This manual and all subsequent updates
				are distributed as a guide to assist providers in their participation in the
				New Jersey Medicaid or NJ FamilyCare program. The provider is ultimately
				responsible for knowing and abiding by current Federal and State laws and
				regulations pertaining to this program.