N.J. Admin. Code § 10:64-2.2

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

Section 10:64-2.2 - Dispensing of a hearing aid to a Medicaid/NJ FamilyCare beneficiary residing in a nursing facility

(a) Coverage of hearing aid devices in a nursing facility shall be based on the requirements of hearing aid candidacy described under N.J.A.C. 10:64-2.1(b) and 2.5.

(b) A medical examination of a beneficiary's ear may be performed by an otologist or beneficiary's attending physician or other type of physician practicing in a nursing facility.

(c) Hearing aids dispensed in nursing facilities shall be subject to a prepayment review by the Medicaid program following the date the aid was provided to assess the appropriateness of the aid and the overall response of the beneficiary to the aid's availability.

(d) Completed documentation (see Fiscal Agent Billing Supplement, incorporated herein by reference as the chapter Appendix) required for coverage of these services by the Medicaid/NJ FamilyCare program shall include, but shall not be limited to, the following:

1. The Nursing Facility Hearing Aid Screening form (FD-257);

2. The Audiologic and Hearing Aid Examinations form (FD-36); and

3. The Follow-up to Hearing Aid Examination form (FD-244).

(e) Follow-up will be performed by Medicaid/NJ FamilyCare staff, who will sign the form FD-244, indicate on the form whether the aid is approved for purchase, and return the form to the provider.

(f) If the hearing aid is denied, a notification letter shall be sent to the provider and beneficiary.

(g) In lieu of an otologic report, the resident's attending physician may sign the bottom of the form FD-257, indicating that the beneficiary has been given the appropriate examination and is medically cleared for a hearing aid.

N.J. Admin. Code § 10:64-2.2

Amended by R.2001 d.71, effective 3/5/2001.
See: 32 New Jersey Register 3965(a), 33 New Jersey Register 793(a).
Substituted references to beneficiaries for references to recipients throughout.
Amended by R.2006 d.289, effective 8/21/2006.
See: 38 New Jersey Register 1385(a), 38 New Jersey Register 3304(a).
Rewrote (a); in (c), substituted "shall be" for "are", and "aid's" for "aids'"; in (d), substituted "shall include" for "includes", and "shall not be" for "is not"; recodified former (d)i through (d)iii as current (d)1 through (d)3; and in (e), substituted "aid" for "aids", and "provider" for "dispenser".

Amended by 53 N.J.R. 2222(a), effective 12/20/2021