New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 167B - SENIOR GOLD PRESCRIPTION PROGRAM MANUAL
Subchapter 6 - ELIGIBILITY REQUIREMENTS
Section 10:167B-6.9 - Authorization
Universal Citation: NJ Admin Code 10:167B-6.9
Current through Register Vol. 56, No. 18, September 16, 2024
(a) By signing or marking the certification and authorization statement on a Senior Gold eligibility application or a renewal application form, an applicant or a reapplicant authorizes:
1. The Department to serve as the authorized
representative of the applicant or reapplicant;
2. The Department
to verify any information on the form by contacting the Social Security Administration, the Internal Revenue
Service, the New Jersey Division of Taxation, employers and others as the need arises;
3. Visitation and review by representatives of the Department;
4. Assignment of benefits to the State of New Jersey if he or she or his or
her spouse has any other plan of assistance or insurance that covers, at least in part, the cost of
prescription drugs; and
5. Prescribing practitioners to release
information concerning prescriptions which have been paid by the Senior Gold Program to the Department or any
law enforcement authority of this State charged with the investigation or prosecution of violations of the
civil and criminal provisions of the "Senior Gold Prescription Discount Act" or the criminal laws of this
State.
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