30:4D-8.2 Definitions relative to a Medicaid ACO.
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/nj/title-30/chapter-4d/30-4d-8-2A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
2. As used in this act:
"ACO" means an accountable care organization.
"Behavioral health care provider" means a provider licensed or approved by the Department of Human Services to render services to New Jersey residents.
"Department" means the Department of Human Services.
"Designated area" means a municipality or defined geographic area in which no fewer than 5,000 Medicaid recipients reside.
"Disproportionate share hospital" means a hospital designated by the Commissioner of Human Services pursuant to Pub.L.89-87 (42 U.S.C. s.1396a et seq.) and Pub.L.102-234.
"Medicaid" means the Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.).
"Medicaid ACO Demonstration Project" or "demonstration project" means the demonstration project established pursuant to this act.
"Primary care provider" includes the following licensed individuals: physicians, physician assistants, advanced practice nurses, and nurse midwives whose professional practice involves the provision of primary care, including internal medicine, family medicine, geriatric care, pediatric care, or obstetrical/gynecological care.
"Qualified behavioral health care provider" means a behavioral health care provider who participates in the Medicaid program and renders clinic-based and home-based services to individuals residing in the designated area served by the Medicaid ACO.
"Qualified primary care provider" means a primary care provider who participates in the Medicaid program and who spends at least 25% of his professional time or 10 hours per seven-day week, whichever is less, rendering clinical or clinical supervision services at an office or clinic setting located within the designated area served by a Medicaid ACO.
L.2011, c.114, s.2.