New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 75 - PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY SERVICES FOR INDIVIDUALS UNDER AGE 21
Subchapter 1 - GENERAL PROVISIONS
Section 10:75-1.3 - Program participation criteria
Current through Register Vol. 56, No. 18, September 16, 2024
(a) A psychiatric residential treatment facility (PRTF) that is not licensed as a hospital, but meets the requirements in 42 CFR Part 441 Subpart D and 42 CFR Part 483 Subpart G, shall be eligible for participation in the New Jersey Medicaid/NJ FamilyCare program.
(b) All PRTF providers shall be enrolled in the New Jersey Medicaid/NJ FamilyCare program as a residential treatment center providing services to children under the age of 21. This includes the filing of a Medicaid/NJ FamilyCare Provider Application (FD-20), the signing of a Provider Agreement MCNH-38, and submittal of the CMS-1513, Ownership and Control Interest Disclosure. Provider applications and required forms can be obtained from and should be submitted to: Division of Medical Assistance and Health Services
Office of Provider Enrollment, Mail Code #9
PO Box 712
Trenton, New Jersey 08625-0712
(c) A PRTF located in New Jersey that provides services for New Jersey Medicaid/NJ FamilyCare or DCF/DCSOC beneficiaries under the age of 21 shall, in order to participate in the Medicaid/NJ FamilyCare program:
(d) A PRTF located out of New Jersey that provides services for New Jersey Medicaid, NJ FamilyCare, or DCF/DCSOC beneficiaries under the age of 21 shall, in order to participate in the New Jersey Medicaid/NJ FamilyCare program:
(e) As a condition of enrollment, all PRTF providers shall complete an Attestation of Compliance, indicating that all requirements related to the use of emergency safety interventions in PRTFs as described in 42 C.F.R 483, Subpart G, are met. The form will be included in the enrollment package provided by the Division. If additional copies of this form are needed, they can be obtained from the Office of Provider Enrollment by writing the Division at the address in (b) above.
(f) Upon approval as a Medicaid/NJ FamilyCare PRTF provider, providers shall comply with the provisions of N.J.A.C. 10:49, in addition to this chapter.
(g) All providers, in-State or out-of-State, shall notify the DMAHS Office of Provider Enrollment (Provider Enrollment) at the address in (b) above, if their license or accreditation is terminated, suspended, or not renewed, within five business days of the action taken against their license or accreditation.