N.J. Rev. Stat. § 30:4D-8.15. Rules and regulations: Medical Assistance and Health Services Act – New Jersey
Status: Enacted Year Enacted: 2011
States that the Commissioner of Human Services shall adopt rules and regulations establishing the standards for gainsharing plans submitted by Medicaid ACOs, as well as for the ongoing oversight and monitoring of the quality of …
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N.J. Rev. Stat. § 30:4D-8.2. Definitions: Medical Assistance and Health Services Act – New Jersey
Status: Enacted Year Enacted: 2011
Defines ACO, Medicaid ACO Demonstration Project, Primary care provider, among other terms. Note: This statute is effective Oct. 17, 2011 and Expires three years after adoption of regulations.
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N.J. Rev. Stat. § 30:4D-8.3. Medicaid ACO Demonstration Project; establishment; project duration; applicant qualifications: Medical Assistance and Health Services Act – New Jersey
Status: Enacted Year Enacted: 2011
States that the Department of Human Services shall establish a 3-year Medicaid ACO Demonstration Project in which nonprofit corporations may apply. Note: This statute is effective Oct. 17, 2011 and Expires three years after adoption …
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N.J. Rev. Stat. § 30:4D-8.4. Applicants for certification; time to apply; limitation upon number; additional qualification requirements: Medical Assistance and Health Services Act – New Jersey
Status: Enacted Year Enacted: 2011
States that the department will accept applications to serve as a Medicaid ACO for participation in the demonstration if the applicant meets certain requirements and shall deny applicants that do not meet the requirements, including: …
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N.J. Rev. Stat. § 30:4D-8.5. Receipt and distribution of gainsharing payments; eligibility requirements; determination of benchmark period; distribution of savings; use of savings for expansion of services: Medical Assistance and Health Services Act – New Jersey
Status: Enacted Year Enacted: 2011
Requires a Medicaid ACO to receive approval from the department in order to receive and distribute gainsharing payments. Approval from the department is contingent on whether the gainsharing plans promote: improvements in health outcomes and …
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N.J. Rev. Stat. § 30:4D-8.6. Remittance of savings to participating Medicaid ACOs: Medical Assistance and Health Services Act – New Jersey
Status: Enacted Year Enacted: 2011
States that the department shall remit payment of cost savings to a participating Medicaid ACO following approval by the department of the ACO’s gainsharing plan and identification of cost savings and agreement from the federal …
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N.J. Rev. Stat. § 30:4D-8.7. Voluntary participation in the demonstration project; withdrawal from participation: Medical Assistance and Health Services Act – New Jersey
Status: Enacted Year Enacted: 2011
States that a managed care organization that has contracted with the department may voluntarily seek participation in demonstration project by notifying the Medicaid ACO of its desire to participate and shall submit a separate gainsharing …
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N.J. Rev. Stat. § 30:4D-8.8. Department responsibilities; request for grants: Medical Assistance and Health Services Act – New Jersey
Status: Enacted Year Enacted: 2011
States that the department, in consultation with the Department of Health, shall design and implement the application process for approval of participating ACOs in the demonstration project, collect data from participants, and approve a methodology …
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N.J. Rev. Stat. § 30:4D-8.9. Annual project assessment: Medical Assistance and Health Services Act – New Jersey
Status: Enacted Year Enacted: 2011
States that the Department of Health shall evaluate the demonstration project annually to assess whether costs savings, including savings in administrative costs and due to improved health outcomes, are achieved, in addition to improvement rates …
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N.J. Rev. Stat. § 45:9-22.4. Definitions: Practice of Medicine and Surgery in General – New Jersey
Status: Enacted Year Enacted: 1989
Defines alternative payment entity, alternative payment model, alternative payment model standards, approved quality measure, health care service, hospital and physician incentive plan, among other terms.
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N.J. Rev. Stat. § 45:9-22.5c. Alternative payment model; application: Practice of Medicine and Surgery in General – New Jersey
Status: Enacted Year Enacted: 2017
States that a participant desiring to establish an alternative payment model must submit an application to the Department of Health. The Department of Health shall review the application and notify if the model is approved.
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N.J. Rev. Stat. § 45:9-22.5d. Review of registered alternative payment models by Department of Health; revocation of registration: Practice of Medicine and Surgery in General – New Jersey
Status: Enacted Year Enacted: 2017
States that the Department of Health shall review alternative payment models to determine whether the participants in the alternative payment model have complied with the act and other laws and regulations, and whether the alternative …
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Neb. Rev. Stat. § 44-5225. Definitions, where found: Small Employer Health Insurance Availability Act – Nebraska
Status: Enacted Year Enacted: 1994
Definitions for the Small Employer Health Insurance Availability Act.
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Neb. Rev. Stat. §§ 44-6901 through 44-6918: Group Health Plans – Nebraska
Status: Enacted Year Enacted: 1997
Provisions governing group health plans.
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Okla. Stat. tit. 63, § 5025. Reimbursement methodology: Oklahoma Health Care Authority Act – Oklahoma
Status: Enacted Year Enacted: 2001
The Oklahoma Health Care Authority may establish, with available funds, a reimbursement methodology that will enhance the reimbursement for services provided to Medicaid beneficiaries in emergency hospitals in rural areas of the state.
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Okla. Stat. tit. 63, § 5027. Health care district: Oklahoma Health Care Authority Act – Oklahoma
Status: Enacted Year Enacted: 2007
As used in this section “health care district” means a subordinate health care entity that better promotes efficient administration of health care service delivery for counties with a population of one hundred thousand (100,000) or …
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