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April, 2019 Regulatory Developments

April 25, 2019 | No Comments
Posted by Anjali Baxi

Here are the most recent health care related regulatory developments as published in the New Jersey Register in April, 2019:

  • On April 1, 2019, 51 N.J.R. 452(a), the Department of Human Services, Division Of Medical Assistance and Health Services proposed amendments to N.J.A.C. 10:74, Managed Health Care Services for Medicaid and NJ FamilyCare Beneficiaries. The proposed readoption regulates the enrollment of Medicaid and NJ FamilyCare beneficiaries into managed care as a health care delivery system and the provision of services by a managed care organization (MCO) to these beneficiaries. Notably, there are new proposed definitions of “Comprehensive Waiver” and “MLTSS”.
  • On April 1, 2019, 51 N.J.R. 473(a), the Department of Law and Public Safety, Division of Consumer Affairs, State Board of Optometrists adopted amendments to N.J.A.C. 13:38-7.3, requiring optometrists to complete, at a minimum, one credit for educational programs or topics that concern the prescription of hydrocodone, or the prescription of opioid drugs in general, including responsible prescribing practices, the alternatives to the use of opioids for the management and treatment of pain, and the risks and signs of opioid abuse, addiction, and diversion.
  • On April 1, 2019, at 51 N.J.R. 481(a), the Department of Banking and Insurance, Division of Insurance, Office of the Commissioner published a notice regarding the minimum deposit requirements for Health Maintenance Organizations (HMOs) and 3.3% increase in the medical component of the CPI for all urban consumers in the New York-Northern New Jersey-Long Island region and the Philadelphia-Wilmington-Atlantic City region as reported by the United States Department of Labor, Bureau of Labor Statistics Existing HMOs shall make adjustment for their minimum net worth no later than July 1, 2019. The required deposit shall be made no later than July 1, 2019, pursuant to N.J.A.C. 11:24-11.4(e) to include the specific CPI adjustment.
  • On April 1, 2019, at 51 N.J.R. 481(b), the Department of Banking and Insurance, Division of Insurance, Office of the Commissioner published a notice regarding the minimum net worth requirements for Health Maintenance Organizations (HMOs) and 3.3% increase in the medical component of the CPI for all urban consumers in the New York-Northern New Jersey-Long Island region and the Philadelphia-Wilmington-Atlantic City region as reported by the United States Department of Labor, Bureau of Labor Statistics Existing HMOs shall make adjustment for their minimum net worth no later than July 1, 2019. The required deposit shall be made no later than July 1, 2019, pursuant to N.J.A.C. 11:24-11.4(e) to include the specific CPI adjustment.
  • On April 15, 2019, at 51 N.J.R. 501(b), the Department of Banking and Insurance, Division of Insurance, Office of the Commissioner adopted amended rules regarding permissible network deductibles and network coinsurances in contracts issued by HMOs that provide out-of-network benefits for emergency and urgent care. See rule at N.J.A.C 11:22.
  • On April 15, 2019, at 51 N.J.R. 509(a), the Department of Health, Office of the Commissioner published a notice of cancellation of a certificate of need call for new specialized long-term care beds for severe behavior management. The call for CN applications was scheduled for January 2, 2019.The Department has determined there is not a need for new specialized long-term care beds for severe behavior management at this time. On January 2, 2018, the Department had issued a certificate of need call for additional specialized long-term care beds for severe behavior management at 50 N.J.R. 260(b). In response to this call, the Department received applications from several applicants, which are currently under review by the Department. The next scheduled call for new specialized long-term care beds for severe behavior management will be January 2, 2020. The Department will continue to monitor the utilization and availability of specialized long-term care beds for severe behavior management and, should the need arise, issue a future call for these services prior to January 2, 2020.

 

 

 

 

 

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