Re: Revisions to the Geographic Service Limitations for the Designation of Children's Hospital Home Care as a Hemophilia Home Treatment Providers

State of New Jersey DEPARTMENT OF BANKING AND INSURANCE PO BOX 325 TRENTON, NJ 08625-0325 RICHARD J. CODEY DONALD BRYAN Governor TEL (609) 292-5360 Acting Commissioner Visit us on the Web at www.njdobi.org New Jersey is an Equal Opportunity Employer • Printed on Recycled Paper and Recyclable BULLETIN 06-03 TO: All Carriers Subject to the Health Care Quality Act, P.L. 1997, c. 192 (generally codified as N.J.S.A. 26:2S-1 et seq.) FROM: Donald Bryan, Acting Commissioner RE: Revisions to the Geographic Service Limitations for the Designation of Children’s Hospital Home Care as a Hemophilia Home Treatment Providers In accordance with N.J.S.A. 26:2S-10.1, the Department of Banking and Insurance (Department)1 is required to develop a list of providers determined to be eligible to provide home treatment services for hemophilia (designated hemophilia home treatment providers) with which carriers are permitted to contract for the provision of hemophilia home treatment on an in-network basis when a carrier is offering health benefits plans that are managed care plans. Rules promulgated at N.J.A.C. 8:38C-2, implementing the provisions of N.J.S.A. 26:2S-10.1 through 10.3, establish procedures and standards by which providers may submit applications to become designated hemophilia home treatment providers Children’s Hospital Home Care (Children’s) submitted an application for designation and received final approval on June 13, 2005. Public notice of the designation appeared in the August 1, 2005 New Jersey Register at 2894(b). The notice indicated that Children’s designation was limited to certain zip codes within a 12-county service area developed by the Department of Health and Senior Services based on statements in the application. Children’s subsequently requested that the geographic limitation be removed and, based upon the information provided, the Department of Health and Senior Services determined it was appropriate to revise the service area limitation, but not eliminate it. Shortly thereafter, the Department of Health and Senior Services’ functions and operations related to this activity were transferred to the Department. Accordingly, the Department is issuing this Bulletin as a supplement to OMC Bulletin 2005-02, issued June 30, 2005 by the Department of Health and Senior Services. Effective August 27, 1 As originally enacted, the responsibilities and oversight associated with N.J.S.A. 26:2S-10.1 through 10.3 (P.L. 2000, c. 121) were under the jurisdiction of the Department of Health and Senior Services. Pursuant to Reorganization Plan 005-2005, jurisdiction was transferred to the Department of Banking and Insurance as of August 29, 2005. Reorganization Plan 005-2005 was published in the August 1, 2005 New Jersey Register at 2737(a). 2 2005 and until further notice, the service area of Children’s Hospital Home Care in New Jersey as a designated hemophilia home treatment provider, includes the following counties in full, without limitation by zip code or other geographic boundary: Atlantic, Burlington, Camden, Cape May, Cumberland, Gloucester, Hunterdon, Mercer, Middlesex, Monmouth, Ocean, Salem and Somerset. A public notice setting forth this information will be published in the New Jersey Register shortly. A copy of this Bulletin and, upon publication in the New Jersey Register, a copy of the public notice, will be posted on the Department’s website at http://www.state.nj.us/dobi/legsregs.htm. Carriers may refer to OMC Bulletin 2005-02 (also posted on the Department’s website) or the August 1, 2005 public notice from the Department of Health and Senior Services for additional information related to the provision of hemophilia services, other designated hemophilia home treatment providers, and State-recognized outpatient hemophilia treatment centers. 1/13/06 /s/ Donald Bryan Date Donald Bryan Acting Commissioner INOORD/BULLETIN Revise CHOP geo.doc