N.J.S.A. 30:4D-8.2 — Definitions relative to a Medicaid ACO.

30:4D-8.2 Definitions relative to a Medicaid ACO. 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.

This is the verbatim text of N.J.S.A. 30:4D-8.2, retrieved from the New Jersey Legislature's public statute corpus. Statutes are amended periodically — for the most current version, check the external source link above. Kyzer is not a law firm and this page is not legal advice.