New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 53A - HOSPICE SERVICES MANUAL
Subchapter 1 - GENERAL PROVISIONS
Section 10:53A-1.1 - Introduction

(a) Reimbursement for hospice services provided by Medicaid was authorized pursuant to § 1905(o) of the Social Security Act, codified as 42 U.S.C. § 1396d(o). N.J.S.A. 30:4D-6b(20) authorizes the New Jersey Division of Medical Assistance and Health Services to develop a program of hospice services. This chapter, N.J.A.C. 10:53A, Hospice Services, sets forth the rules for the provision of hospice services to the terminally ill who are eligible for Medicaid/NJ FamilyCare fee-for-service (FFS) program. Room and board services are also available for those Medicaid /NJ FamilyCare FFS beneficiaries residing in a nursing facility who are also eligible for hospice services. The Home Care Services Manual (N.J.A.C. 10:60), is applicable to hospice care as a waiver service provided under the AIDS Community Care Alternatives Program (ACCAP).

(b) This chapter provides the rules for hospice services for Medicaid/NJ FamilyCare FFS beneficiaries who are not enrolled in, and receiving services through, a health maintenance organization (HMO). Hospice services provided to a beneficiary who is enrolled with an HMO are governed by the policies of the HMO and are not within the purview of these rules.