New Jersey Statutes Title 30. Institutions and Agencies 30 § 4D-8.2

As used in this act:  1

“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.