26:2H-166 NJ FamilyCare, Medicaid, coverage, acute hospital care services, same basis as within hospital.
145 words·~1 min read·
/nj/title-26/chapter-2h/26-2h-166·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
4. The NJ FamilyCare and Medicaid programs, and any carrier that offers a health benefits plan in this State, shall provide coverage for acute hospital care services delivered to a covered person through the program established pursuant to section 3 of this act, on the same basis as when services are delivered within the facilities of a hospital. Reimbursement payments under this section shall be established pursuant to the contract between the carrier and the hospital and shall be provided to the hospital, facility, or organization providing the services or the individual practitioner who delivered the reimbursable services, or to the agency, facility, or organization that employs or contracts with the individual practitioner who delivered the reimbursable services, as appropriate.
Carriers shall not utilize more stringent utilization management criteria than apply when those services are provided within the facilities of a hospital.
L.2023, c.163, s.4.