New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 79 - NJ FAMILYCARE-CHILDREN'S PROGRAM
Subchapter 7 - NJ FAMILYCARE-CHILDREN'S PROGRAM BENEFICIARY FRAUD AND ABUSE POLICIES
Section 10:79-7.1 - Termination of eligibility for good cause for fraud and abuse
Current through Register Vol. 56, No. 18, September 16, 2024
(a) Any violation of (b) below by an applicant, beneficiary, caretaker adult or authorized agent may result in the termination of the applicant's or beneficiary's eligibility from NJ FamilyCare-Children's Program-Plan B, C and D. An individual receiving a Notice of Proposed Termination issued by the Director of the Division may request, within 20 days of the date of the Notice, an administrative law hearing before the Office of Administrative Law. The Notice shall be dated at least 20 days prior to the end of the month in which the termination is effective. Failure to request a hearing within this time limit shall result in automatic termination of benefits. Until such time as a final agency decision is issued by the Director as a result of such a hearing which terminates an individual from NJ FamilyCare-Children's Program-Plan B, C and D, the individual shall remain eligible for such benefits, unless the Director determines and states in the Notice of Proposed Termination that temporary suspension of benefits prior to a hearing is necessary to protect the integrity of the NJ FamilyCare-Children's Program-Plan B, C and D program and/or the health, safety or welfare of other NJ FamilyCare-Children's Program-Plan B, C and D beneficiaries.
(b) The following grounds shall constitute good cause for termination:
(c) The existence of a cause for termination described in (b) above may be established by a judgment of conviction for a crime, disorderly persons offense, or petty disorderly persons offense; a judgment or order of either a court of competent jurisdiction or an administrative agency; or by a preponderance of the evidence.