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Managed Care Bulletins

Prior to September 2005, the Department of Health and Senior Services had oversight of and enforcement authority with respect to laws codified at N.J.S.A. 26:2J-1 et seq., and N.J.S.A. 26:2S-1 et seq., as well as N.J.S.A. 17:48H-2 through 10. Bulletins addressing these laws and rules promulgated pursuant thereto by the Department of Health and Senior Services from 2000 to September 2005 can be accessed below.

Subsequent bulletins regarding these statutes and relevant rules issued by the Department of Banking and Insurance will be posted on the Department of Banking and Insurance's web pages listing activity in the same manner as other bulletins are posted.

2000 Bulletins
Bulletin Subject Date
OMC 2000-01 Hospital Contract Terminations
06-01-00
OMC 2000-02 Fraud Plan
07-20-00
OMC 2000-03 Administrative and UM Denials
08-15-00
OMC 2000-04 Complaints and UM Appeals 08-15-00

2001 Bulletins
Bulletin Subject Date
OMC 2001-01 Supplement to OMC 2000-03 and -04 02-05-01
OMC 2001-02 Binding IHCAP Decisions 02-28-01
OMC 2001-03 Managed Health Care Consumer Assistance Program Disclosure 08-03-01
OMC 2001-04 Hemophilia Home Care Standards, Interim Compliance 08-03-01

2002 Bulletins
Bulletin Subject Date
OMC 2002-01 UM Appeals - Stage 1 and 29 C.F.R. 2560.503-1
06-20-02
OMC 2002-02 IHCAP Fees and Forms 06-25-02

2003 Bulletins
Bulletin Subject Date
OMC 2003-01 Regulatory Notice of Hospital Termination 04-01-03
OMC 2003-02 Notice of Changes in Key Personnel 05-28-03
OMC 2003-03 Managed Health Care Consumer Assistance Program Status 10-01-03
OMC 2003-04 Medical Screening Examinations 10-22-03

2004 Bulletins
Bulletin Subject Date
OMC 2004-01 Review of Provider Agreements > Checklist 4-20-04
OMC 2004-02 Side Agreements 08-11-04
OMC 2004-03 Carrier Consent Forms for Appeals 09-24-04

2005 Bulletins
Bulletin Subject Date
OMC 2005-01 Hemophilia Home Care Standards, Interim Compliance 02-02-05
OMC 2005-02 Hemophilia Home Care Designations 06-30-05
OMC 2005-03 Bariatric Surgery 06-30-05
OMC 2005-04 Physician Credentialing 08-02-05
OMC 2005-05 IHCAP Contractor and Fee Changes 08-19-05
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New Jersey Department of Banking and Insurance