S.J. v. Division of Medical Assistance and Health Services, etc., A-5714-10T1, A-5803-10T2 and A-5804-10T1; Appellate Division; opinion by Harris, J.A.D.; decided and approved for publication June 13, 2012. Before Judges Fuentes, Graves and J.N. Harris. On appeal from the Department of Human Services, Division of Medical Assistance and Health Services. DDS No. 45-2-6607 [18 pp.]
Appellants S.J., R.H. and C.B. were precluded from receiving health-care benefits by the Division of Medical Assistance and Health Services’ closure to new applicants of the State Children’s Health Insurance Program (SCHIP), which operated under the NJ FamilyCare rubric. Although once eligible for NJ FamilyCare benefits as part of a program funded and administered by AFDC-related Medicaid, appellants lost their eligibility due to increased income. They appeal the division’s determinations that, after losing their AFDC-related Medicaid eligibility, they became new applicants for purposes of the SCHIP, and that under N.J.A.C. 10:78-3.4(b), which barred new enrollees after Feb. 28, 2010, they were precluded from receiving health-care benefits under the SCHIP. They contend that the division was obliged to transfer their entitlement and continue their health-care benefits under the auspices of the SCHIP within the NJ FamilyCare program.
