N.J. Admin. Code § 10:58A-3.4

Current through Register Vol. 57, No. 1, January 6, 2025

Section 10:58A-3.4 - HealthStart provider participation criteria

(a) The following Medicaid-enrolled or NJ FamilyCare fee-for-service enrolled provider types are eligible to participate as HealthStart providers: independent clinics, hospital outpatient departments, local health departments meeting the New Jersey State Department of Health Improved Pregnancy Outcome criteria and/or approved as Child Health Conferences, physicians and physician groups, certified nurse midwives, and APNs.

(b) In addition to New Jersey Medicaid/NJ FamilyCare fee-for-service program rules applicable to provider participation, HealthStart APN providers shall:

1. Sign an Addendum to the New Jersey Medicaid and NJ FamilyCare fee-for-service programs' Provider Agreement;

2. Have a valid HealthStart Provider Certificate; and

3. Provide maternity health support services and/or pediatric services in accordance with this subchapter.

(c) In addition to (a) and (b) above, a HealthStart APN pediatric care provider shall participate in program evaluation and training activities including, but not limited to, documentation of outreach and follow-up activities in the patient's record.

(d) A site review may be required to ascertain an applicant's ability to meet the standards for a HealthStart Provider Certificate and to provide services in accordance with the New Jersey State Department of Health Guidelines for HealthStart Providers in the appropriate area.

(e) A HealthStart Provider Certificate will be reviewed by the New Jersey State Department of Health at least every 18 months from the date of issuance.

(f) An application for a HealthStart Provider Certificate can be downloaded free of charge from the New Jersey State Department of Health website at http://web.doh.state.nj.us/apps2/forms/subforms.aspx?pro=fhs#healthstart. Persons who do not have access to the internet please contact the address below to request a copy of the application:

HealthStart Program

New Jersey State Department of Health

50 East State Street

PO Box 364

Trenton, NJ 08625-0364

(g) Guidelines for HealthStart services, when rendered by an APN employed by a clinic, physician or hospital, can be found at Independent Clinic Services, N.J.A.C. 10:66; Physician Services, N.J.A.C. 10:54; or Hospital Services, N.J.A.C. 10:52; respectively, and the guidelines for qualifications of HealthStart providers can be found at N.J.A.C. 10:66, Independent Clinic Services.

N.J. Admin. Code § 10:58A-3.4

Amended by R.2000 d.265, effective 7/3/2000.
See: 32 N.J.R. 1127(a), 32 N.J.R. 2483(a).
In (a) and (b), inserted references to NJ KidCare fee-for-service throughout.
Amended by R.2004 d.334, effective 9/7/2004.
See: 36 N.J.R. 312(a), 36 N.J.R. 4136(a).
Amended by R.2004 d.409, effective 11/1/2004.
See: 35 N.J.R. 4977(a), 36 N.J.R. 4968(a).
Amended by R.2011 d.119, effective 4/18/2011.
See: 42 N.J.R. 2890(a), 43 N.J.R. 1015(a).
Rewrote the introductory paragraph of (f).

Amended by 56 N.J.R. 2191(a), effective 11/4/2024