New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 58 - NURSE MIDWIFERY SERVICES
Subchapter 1 - GENERAL PROVISIONS
Section 10:58-1.4 - Application for provider status; certified nurse midwife

Universal Citation: NJ Admin Code 10:58-1.4

Current through Register Vol. 56, No. 18, September 16, 2024

(a) Any nurse midwife may apply to the New Jersey Medicaid/NJ FamilyCare programs for approval as a Medicaid/NJ FamilyCare provider, if he or she:

1. Is a registered professional nurse licensed by the New Jersey State Board of Nursing;

2. Is certified by the American College of Nurse Midwives (ACNM) or the American College of Nurse Midwives Certification Council;

3. Shows evidence of continuing competency, as required by the ACNM; and

4. Is registered as a certified nurse midwife by the New Jersey State Board of Medical Examiners.

(b) See N.J.A.C. 10:49-3for additional requirements for provider participation.

(c) An applicant shall complete a Medicaid Provider Application (FD-20; see N.J.A.C. 10:49, Appendix, Form #8) and a Medicaid Provider Agreement (FD-62; see N.J.A.C. 10:49, Appendix, Form #9). The forms may be obtained from, and shall be submitted to:

Gainwell Technologies

Provider Enrollment

PO Box 4804

Trenton, NJ 08650-4804

(d) The application and agreement shall be accompanied by a photocopy of the applicant's current:

1. License as a registered professional nurse;

2. Registration as a nurse midwife; and

3. Certification from the American College of Nurse Midwives (ACNM) or the American College of Nurse Midwives Council (ACC).

(e) The applicant will receive notification of approval or disapproval from the Medicaid/NJ FamilyCare fiscal agent Gainwell Technologies. If approved, the CNM shall be furnished with a provider manual and assigned a Medicaid/NJ FamilyCare provider identification number. The CNM shall use the assigned provider identification number in all communication with the Medicaid/NJ FamilyCare programs and/or the fiscal agent.

Disclaimer: These regulations may not be the most recent version. New Jersey may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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