New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 49 - ADMINISTRATION MANUAL
Subchapter 12 - PROVIDER REINSTATEMENT
Section 10:49-12.6 - Criteria for reinstatement
Universal Citation: NJ Admin Code 10:49-12.6
Current through Register Vol. 56, No. 18, September 16, 2024
(a) Reinstatement will not be granted unless it is reasonably certain that the causes which led to the debarment, disqualification or suspension shall not be repeated. In determining a person's fitness for reinstatement, the Committee and the Director may consider, among other factors:
1. Statements from debarred, disqualified or
suspended persons setting forth the reasons why they should be
reinstated;
2. Statements from
private health insurers, indicating whether there have been any questionable
claims submitted during the period of exclusion from Program
participation;
3. Statements from
peer review bodies, probation or parole officers or professional associates,
attesting to their belief, supported by facts, that the causes which led to the
debarment, disqualification or suspension shall not be repeated;
4. The absence of any pending criminal,
licensing, or professional disciplinary proceedings;
5. Full restitution and the payment of any
criminal fines imposed;
6. Full
satisfaction of any civil penalties imposed;
7. Full satisfaction of interest
payments;
8. Compliance with the
terms and conditions of Consent Orders or Court Orders; and
9. Satisfaction of any conditions or
requirements previously imposed by the Medicaid or the NJ FamilyCare
program.
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