30:4D-3c Information technology platform relative to eligibility determination for Medicaid, NJ FamilyCare.
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/nj/title-30/chapter-4d/30-4d-3cA research copy — for the controlling text, always check the official state or federal source. Not legal advice.
1. a. The Commissioner of Human Services shall develop an information technology platform for use by the State, county welfare agencies, and State contractors for the purpose of intake, processing, and tracking of applications for benefits under the Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.) and the NJ FamilyCare program established pursuant to P.L.2005, c.156 (C.30:4J-8 et al.). The goals of the system shall be: to simplify the applications and eligibility determination processes for both applicants and eligibility determination staff; to standardize the application of eligibility policy across the various agencies responsible for eligibility determination; to allow for real-time tracking of the status of applications; to allow the rapid exchange of data relevant to applications among various State and county agencies and contractors; and to provide a platform to expand the system to encompass other social service program applications and eligibility determinations as the technology permits.
b. The Commissioner of Human Services shall establish a system to evaluate the performance of all entities responsible for intake and processing of applications for the Medicaid and NJ FamilyCare programs, including all county welfare agencies and the State's contracted health benefits coordinator. The system shall allow for the measurement of a set of relevant common metrics, including but not limited to: the number of complete and incomplete applications of each type received; the time between receipt of completed applications and the completion of the eligibility determination; the time between receipt of an application and the request for supporting documentation sent to the applicant; the number of applicants granted extensions; and the accuracy of eligibility determinations.
Nothing in this section shall be construed to permit a county welfare agency to deny an application for which an applicant requires additional time to provide information or documentation to a county welfare agency, and a county welfare agency shall grant extensions, as appropriate,when needed.
The Commissioner shall annually publish on the Department of Human Services website, the results, including those for each of the common metrics and by individual entity, of the performance evaluation system to be established pursuant to this section.
c. The Commissioner of Human Services shall establish a system of rewards and penalties for all entities responsible for intake, processing of applications, and processing of redetermination applications that provides incentives for performance on the metrics established pursuant to subsection b. of this section. This system shall include incentives for county welfare agencies to streamline their processes and utilize the information technology platform required by subsection a. of this section.
d. The Commissioner of Human Services shall designate a customer service liaison team, which shall be composed of employees of the Department of Human Services, to receive complaints that result from the eligibility application process. The customer service liaison team shall have authority to review all records of the cases about which complaints are submitted; to interview individuals who submit complaints, the individuals who have assisted with their applications, and the State and county staff who have worked on their cases; and to recommend corrective actions to State and county agencies to address specific complaints and reduce future complaints.
L.2019, c.246, s.1.