New Jersey Administrative Code
Title 11 - INSURANCE
Chapter 4 - ACTUARIAL SERVICES
Subchapter 50 - REIMBURSEMENT OF INMATE HEALTH CARE COSTS
Section 11:4-50.6 - Filing of claims for reimbursement
Current through Register Vol. 56, No. 18, September 16, 2024
(a) Where the inmate is an enrollee, he or she shall provide a signed and completed assignment of benefits form in favor of the treasurer of the State or county institution, a claims form and a medical release. These forms shall be obtained from the inmate's plan. The assignment of benefit form shall designate the State or County Treasurer as the assignee for the reimbursement of benefits. Such forms shall be used by the institution to process claims for reimbursement.
(b) Where the inmate is a covered person under a policy or plan of health insurance, the enrollee shall complete the assignment of benefits form designating the State or county treasurer of the institution as the recipient for the reimbursement of benefits. Thereafter, the inmate shall execute all claims and medical release forms.
(c) The forms and claims filing procedures established by the health care plan shall, in so far as practicable, be followed by the institution to facilitate the reimbursement of benefits. All health care plans shall cooperate in the expeditious processing of claims for reimbursement received from institutions rendering medical services, care and products to inmates.
(d) All health care plans shall be obligated, notwithstanding their approved policy terms and procedures, to accept any assignment of benefits executed by or on behalf of an inmate for medical care and services provided to the inmate while institutionalized.
(e) All reimbursement payments for medical care provided to an inmate shall be made payable to the State or county treasurer of the institution designated on the assignment of benefits form.
