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November 21, 2016 Regulatory Developments

November 22, 2016 | No Comments
Posted by admin

Here are the most recent health care related regulatory developments as published in the New Jersey Register on November 21, 2016:

  • On November 21, 2016 at 48 N.J.R. 2439, the Department of Human Services published notice of its adoption of amendments to its rules governing family support services for family members of individuals suffering from mental illness.

November 7, 2016 Regulatory Developments

November 10, 2016 | No Comments
Posted by admin

Here are the most recent health care related regulatory developments as published in the New Jersey Register on November 7, 2016:

  • On November 7, 2016 at 48 NJR 2211, the Department of Health published notice of its proposal of new rules implementing the Human Trafficking Prevention, Protection and Treatment Act.  Under the Act, the Department of Health is required to develop or approve for use a one-time training course on handling and response procedures in connection with suspected human trafficking activities for employees of licensed health care facilities. The Act requires the Department of Health to establish standards identifying the health care facility employees who will be required, as a condition of their employment, to receive the training. It also makes facility compliance with employee training a condition of facility licensure.
  • On November 7, 2016 at 48 NJR 2336, the Department of Health published notice of its readoption with amendments to its rules governing the standards for licensure for pediatric community transitional homes.
  • On November 7, 2016 at 48 NJR 2354, the Department of Health published notice of its readoption of its rules regarding the standards for licensure of pediatric medical day care facilities.
  •  On November 7, 2016 at 48 NJR 2360, the Department of Health published notice of its adoption of amendments to its rules governing the Small Employer Health Benefits Program.
  • On November 7, 2016 at 48 NJR 2374, the Division of Consumer Affairs published notice of its adoption of new rules governing the Prescription Monitoring Program.
  • On November 7, 2016 at 48 NJR 2400, the Department of Human Services published notice of its action on a petition for rule making. The petitioner asked the Department to require any managed care organization providing health care services to Medicaid and New Jersey FamilyCare beneficiaries to approve medically necessary investigational or experimental services to those beneficiaries. The Department has referred the matter for further deliberation.

 

 

 

 

October 17, 2016 Regulatory Developments

October 31, 2016 | No Comments
Posted by admin

Here are the most recent health care related regulatory developments as published in the New Jersey Register on October 17, 2016:

  • On October 17, 2016, at 48 N.J.R. 2102 the Board of Marriage and Family Therapy Examiners published notice of its proposed amendments to its rules and the proposal of new rules governing professional practice and licensure.  Among other things, the proposal implements a new mechanism for licensees whose licenses are inactive or were administratively suspended to apply for reinstatement.  The proposed rules will also require licensees to include a detailed note regarding termination of services in a client’s treatment record.
  • On October 17, 2016 at 48 N.J.R. 2118, the Alcohol and Drug Counselor Committee published notice of its proposed amendments to its rules and the proposal of new rules governing professional practice and licensure.  Among other things, the proposal implements a new mechanism for licensees whose licenses are inactive or were administratively suspended to apply for reinstatement.
  • On October 17, 2016 at 48 N.J.R. 2144, the Department of Banking & Insurance published notice of its adoption of amendments to its rules governing the internal appeals process used under the Personal Injury Protection (PIP) benefit program.
  • On October 17, 2016 at 48 N.J.R. 2144, the Department of Banking & Insurance published notice of its adoption of amendments to its rules governing the out-of-network payment benefit and calculation methodology for Individual Health Insurance plans which offer out of network benefits.

 

 

 

 

October 3, 2016 Regulatory Developments

October 10, 2016 | No Comments
Posted by Beth Christian

Here are the most recent health care related regulatory developments as published in the New Jersey Register on October 3, 2016:

  • On October 3, 2016 at 48 NJR 2005, the Department of Human Services published notice of its proposed readoption with amendments to its rules governing the Pharmaceutical Assistance to the Aged and Disabled Program.
  • On October 3, 2016 at 48 NJR 2059, the Department of Health published notice of its readoption with amendments to its rule and the adoption of a new rule governing the reporting of occupational and environmental diseases, injuries and poisonings.
  • On October 3, 2016 at 48 NJR 2074, the Department of Law & Public Safety published notice of its readoption of the rules governing the Office of the Insurance Fraud Prosecutor.
  • On October 3, 2016 at 48 NJR 2077, the Department of Health published a notice rescinding the invitation for Certificate of Need applications to establish a new mobile intensive care service.
  • On October 3, 2016 at 48 NJR 2078, the Department of Human Services published notice of its receipt of a petition for rulemaking from Curtis Edmonds, Esq. The petition seeks to have the Department amend its rules applicable to Medicaid and NJ FamilyCare beneficiaries to provide that a managed care organization providing health care services to Medicaid and New Jersey FamilyCare beneficiaries may not deny or refuse to provide medically necessary services to those beneficiaries on the grounds that such services are investigational or experimental in nature.

 

September 19, 2016 Regulatory Developments

October 6, 2016 | No Comments
Posted by Beth Christian

Here are the most recent health care related regulatory developments as published in the New Jersey Register on September 19, 2016:

  • On September 19, 2016 at 48 NJR 1902, the Department of Banking & Insurance published notice of its proposed readoption of the rules governing the Small Employer Health Benefits Program.
  • On September 19, 2016 at 48 NJR 1972, the Department of Health published notice of its cancellation of its Certificate of Need call for new general long-term care beds and services.

July 18, 2016 Regulatory Developments

July 22, 2016 | Comments Off on July 18, 2016 Regulatory Developments
Posted by Beth Christian

Here are the most recent health care related regulatory developments as published in the New Jersey Register on July 18, 2016:

  • On July 18, 2016 at 48 NJR 1412, the Department of Human Services published notice of its proposal of amendments to its rules governing the Pharmaceutical Services Manual, which regulates the provision of pharmaceutical services under New Jersey Medicaid and the New Jersey FamilyCare fee-for-service program.
  • On July 18, 2016 at 48 NJR 1421, the Department of Human Services published notice of its proposal of amendments to its rules governing psychiatric residential treatment facility services for individuals under age 21.
  • On July 18, 2016 at 42 NJR 1428, the State Board of Nursing published notice of proposed amendments to its rules governing the recognition of certain additional entities as meeting the Board requirements for advanced practice nursing certification bodies.
  • On July 18, 2016 at 48 NJR 1445, the Department of Health published notice of its readoption with amendments to its rules governing the licensure of home health agencies. Among other things, the amendments extend the period for notification of the Department of Health of an anticipated change in ownership of a home health agency from the current 30 day time period to a 90 day notification time period. In addition, the amendments revise employee health requirements, require the governing body of the home health agency to develop and implement a written conflict of interest policy, and revise the description of the roles and the responsibilities of the agency director of nursing.
  • On July 18, 2016 at 48 NJR 1462, the Board of Dentistry published notice of its adoption of amendments to its rules as well as the adoption of new rules governing the scope of practice for dental hygienists. The amendments also require each dental office, facility, dental clinic or institution at which there is patient contact to have a written protocol for managing medical and dental emergencies; have equipment to maintain adult and pediatric airways; maintain an ambu bag on site and ensure that all staff are trained upon hire and, at least annually thereafter, to implement the emergency protocol.
  • On July 18, 2016 at 48 NJR 1468, the Department of Health published notice of its rescheduling of a certificate of need call for applications for mobile intensive care units.

July 5, 2016 Regulatory Developments

July 22, 2016 | Comments Off on July 5, 2016 Regulatory Developments
Posted by Beth Christian

Here are the most recent health care related regulatory developments as published in the New Jersey Register on July 5, 2016:

  • On July 5, 2016 at 48 NJR 1350, the Department of Human Services published notice of its proposed readoption of its rules governing the licensure of outpatient substance treatment facilities.
  • On July 5, 2016 at 48 NJR 1352, the Board of Medical Examiners published notice of its proposal of amendments to its rules and the proposal of new rules governing continuing education requirements for the renewal of an athletic trainer license.
  • On July 5, 2016 at 48 NJR 1354, the State Board of Respiratory Care published notice of its proposed amendments to its rules as well as the proposal of new rules governing license reinstatement and reactivation requirements for professional licenses. The amendments would also update the language of the regulations to correct certain of the terminology used and codify current standards of practice and licensure, including, but not limited to, continuing education requirements.
  • On July 5, 2016 at 48 NJR 1366, the Department of Human Services published notice of its readoption with amendments to its rules governing the Pharmaceutical Assistance to the Aged and Disabled eligibility manual.
  • On July 5, 2016 at 48 NJR 1371, the Department of Banking and Insurance published notice of its readoption of its rules governing organized delivery systems.
  • On July 5, 2016 at 48 NJR 1371, the Board of Marriage and Family Therapy Examiners and the Professional Counsellor Examiners Committee jointly proposed amendments to their rules governing educational requirements and licensure by endorsement.

U.S. Supreme Court Issues Important Decision Regarding False Claims Act Liability

July 22, 2016 | Comments Off on U.S. Supreme Court Issues Important Decision Regarding False Claims Act Liability
Posted by Beth Christian

On June 16, 2016, the United States Supreme Court issued a unanimous decision which held that an implied false certification made for the purpose of claiming payment from the government can serve as a basis for False Claims Act liability. The court held that when an individual or entity submits a claim to the government making specific representations about goods or services provided, but fails to disclose noncompliance with material statutory, regulatory or contractual requirements that result in those representations being misleading, that individual or entity may be subject to liability under the False Claims Act.

The case involved claims for payment for mental health services provided to a teenage beneficiary of the Massachusetts Medicaid program. The patient received counseling services from Arbour Counseling Services, a mental health facility owned and operated by a subsidiary of Universal Health Services, Inc. (“Universal”). The patient had an adverse reaction to a medication that an Arbour employee had prescribed. The patient’s condition worsened and she eventually died of a seizure. Read more

June 20, 2016 Regulatory Developments

July 22, 2016 | Comments Off on June 20, 2016 Regulatory Developments
Posted by Beth Christian

Here are the most recent health care related regulatory developments as published in the New Jersey Register on June 20, 2016:

  • On June 20, 2016 at 48 NJR 1049, the Department of Banking and Insurance published notice of its proposed readoption with amendments to its rules governing New Jersey Workers Compensation managed care organizations.
  • On June 20, 2016 at 48 NJR 1059, the Board of Nursing published notice of its proposal of amendments to its rules governing the dispensing of pharmaceutical samples to patients by advanced practice nurses. The proposed amendment would require advance practice nurses who dispense pharmaceutical samples to label the samples with the complete name of the medication dispensed, the strength, and quantity of the medication dispensed, instructions as to the frequency of use, special precautions if appropriate and the expiration date of the medication.

Read more

June 6, 2016 Regulatory Developments

June 7, 2016 | Comments Off on June 6, 2016 Regulatory Developments
Posted by Beth Christian

Here are the most recent health care related regulatory developments as published in the New Jersey Register on June 6, 2016:

  • On June 6, 2016 at 48 NJR 878, the Department of Health published notice of its proposed readoption with amendments to the standards for licensure of pediatric community transitional homes.
  • On June 6, 2016 at 48 NJR 911, the Department of Human Services published notice of its proposed readoption with amendments to its rules governing family support services offered through the Division of Mental Health and Addiction Services.
  • On June 6, 2016 at 48 NJR 945, the Board of Nursing published notice of its proposal of amendments to its rules governing license renewal and the educational requirements for certification of advanced practice nurses.
  • On June 6, 2016 at 48 NJR 946, the Board of Nursing published notice of its proposed repeal of a regulation which allowed advanced practice nurses who have submitted applications for advanced practice nurse certification, but who have not yet passed the certification examination, to apply to the Board for a work permit letter. The Board indicted that the regulation is no longer necessary because certification examinations are available at almost any time via computer, and applicants no longer have to wait an extended period before they can take the certification exam.
  • On June 6, 2016 at 48 NJR 947, the Board of Nursing published notice of its proposed amendments to its rules governing the course content for forensic nurse-certified sexual assault education programs.
  • On June 6, 2016 at 48 NJR 962, the Department of Human Services published notice of its adoption of amendments to its rules governing hospital services, physician services, advanced practice nurse services, independent clinic services, and special Medicaid programs to implement the use of the ICD-10 classification system for disease categories.

 

 

 

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