Find & Ask › New Jersey › this rule
N.J.A.C. 10:60-1.7 - Relationship of the home care provider with the Medical Assistance Customer Center (MACC) and the NJ FamilyCare Managed Care Organization or DHS-designated entity
New JerseyregulationNJ Dept. of Human Services, Division of Medical Assistance and Health Services (DMAHS)· effective 2022-09-06
What this rule requires your agency to do
- 1Prior authorization is required for all Medicaid/NJ FamilyCare-eligible and non-eligible individuals applying for nursing facility (NF) services.(N.J.A.C. 10:60-1.7 - Relationship of the home care provider with the Medical Assistance Customer Center (MACC) and the NJ FamilyCare Managed Care Organization or DHS-designated entity)
- 2MLTSS services provided under the 1115 New Jersey Comprehensive Medicaid Waiver may require determination of clinical eligibility through the pre-admission screening (PAS) process.(N.J.A.C. 10:60-1.7 - Relationship of the home care provider with the Medical Assistance Customer Center (MACC) and the NJ FamilyCare Managed Care Organization or DHS-designated entity)
Applies to: personal care
Describes prior authorization and clinical eligibility screening for nursing facility and MLTSS services, including the pre-admission screening (PAS) process conducted by Division of Aging Services staff.
Regulatory information, not legal advice — always confirm against the cited official source. Verification reduces error; it does not certify compliance.