New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 77A - ADULT MENTAL HEALTH REHABILITATION SERVICES PROVIDED IN/BY COMMUNITY RESIDENCE PROGRAMS
Subchapter 1 - GENERAL PROVISIONS
Section 10:77A-1.3 - Provider participation
Current through Register Vol. 56, No. 18, September 16, 2024
(a) In order to participate in the Medicaid/NJ FamilyCare programs, all applicants shall be licensed by and under contract with the Division of Mental Health and Addiction Services (DMHAS) as a community residence for mentally ill adults in accordance with N.J.A.C. 10:37A.
(b) All providers shall complete and submit the following documents, and shall update the documents when the information contained therein changes, for example, when a new license is issued and/or when any information on the FD-20 changes:
(c) Providers shall submit the documents listed in (b) above to:
Division of Medical Assistance and Health Services
Office of Provider Enrollment
PO Box 712, Mail Code #9
Trenton, New Jersey 08625-0712
(d) A separate application shall be submitted for each county in which the provider renders services.
(e) The applicant will receive written notification of approval or disapproval of Medicaid/NJ FamilyCare provider status from the Division of Medical Assistance and Health Services (DMAHS). If approved, the applicant will be assigned a Medicaid/NJ FamilyCare Provider Number and will receive a copy of this chapter as part of the provider manual. Each provider agency shall be assigned a unique provider number for each county in which services are provided.
(f) DMHAS will certify to DMAHS, the level of care and the number of beds and separate sites for each agency.
(g) If an adult mental health rehabilitation services provider loses its license from DMHAS, the provider shall notify the DMAHS Provider Enrollment Unit, at the address in (c) above, within five business days of losing the license.