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August 18, 2014 Regulatory Developments

Here are the most recent health care related regulatory developments as published in the New Jersey Register on August 18, 2014: On August 18, 2014 at 46 N.J.R. 1816, the Department of Health published notice of its readoption of its rules governing certificate of need and licensure requirements for regionalized perinatal services and maternal and […]

OIG Issues Unfavorable Advisory Opinion to Specialty Pharmacy For Support Service Payments

On August 15, 2014, the OIG issued an unfavorable Advisory Opinion to a specialty pharmacy in connection with the pharmacy’s proposal to pay local retail pharmacies for support services that they provide in connection with patient referrals to the specialty pharmacy.  The specialty pharmacy dispensed specialty pharmaceuticals that are often unavailable to retail pharmacies.  Under […]

Medicare Joins New Jersey Medicaid In Mandating Pre-Authorization for Non-Emergency Ambulance Transports

CMS has announced that it will be transitioning to us of a prior authorization requirement for repetitive non-emergency ambulance transports.  New Jersey Medicaid already has a pre-authorization requirement. Under the prior authorization requirement, ambulance suppliers will need submit a request for provisional affirmation of coverage before a non-emergency, repetitive ambulance transport is rendered to a […]

August 4, 2014 Regulatory Developments

Here are the most recent health care related regulatory developments as published in the New Jersey Register on August 4, 2014: On August 4, 2014 at 46 N.J.R. 1731, the Department of Banking and Insurance published notice of its proposal of amendments to its rules regarding licensure and certification of organized delivery systems.

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