45:9-22.5c Application package to operate an alternate payment model.
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/nj/title-45/chapter-9/45-9-22-5c·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
3. a. Participants desiring to establish an alternative payment model shall submit to the Department of Health, in a form and manner established by the Department of Health, an application package to operate an alternative payment model. The application shall include:
(1)a description of the alternative payment model, including the participants in the model and how the model satisfies the definition of an alternative payment model in section 1 of P.L.1989, c.19 (C.45:9-22.4);
(2)a description of the organizational structure of the entity responsible for carrying out the alternative payment model, including information on the organizational role of the participants in the alternative payment model, and information regarding the compliance of any alternative payment entity with applicable provisions of P.L.1999, c.409 (C.17:48H-1 et seq.) and regulations adopted pursuant thereto;
(3)the date on which the alternative payment model is proposed to begin operation;
(4)an explanation of how the alternative payment model satisfies the alternative payment model standards; and
(5)other information reasonably requested by the Department of Health.
b. The Department of Health shall review the application submitted pursuant to subsection a. of this section, and shall notify participants in no more than 60 days if the proposed alternative payment model does not meet the requirement of this act. The Department of Health shall provide the participants with a reasonable opportunity to remedy any deficiencies in the alternative payment model proposal, and may terminate an alternative payment model that continues to fail to meet the requirements of this act.
c. Notwithstanding subsections a. and b. of this section, an alternative payment model shall be deemed approved by the Department of Health without further review, and no participant shall be required under this section to file additional information with the department concerning such an alternative payment model, if the alternative payment model has been authorized and approved under the Medicare Shared Savings Program pursuant to 42 U.S.C. s.1395jjj or under a demonstration operated by the Center for Medicare and Medicaid Innovation described at 42 U.S.C. s.1315a.
L.2017, c.111, s.3.