Establishes Medicaid Managed Care Organization Oversight Program.
This bill establishes a Medicaid Managed Care Organization (MCO) Oversight Program within New Jersey's Department of Human Services to ensure quality care for Medicaid and NJ FamilyCare enrollees. It requires MCOs (the five private insurers contracted to provide care) to submit quarterly data on providers and beneficiaries, including updated contact information and directory accuracy. The program must independently verify 20% of provider location data annually and confirm all directory providers are Medicaid-eligible, while also checking that provider panel sizes comply with limits. MCOs failing to submit required data face minimum $50,000 fines per violation, with potential contract termination after an administrative hearing.
Bill status
in committee
1 of 4 stages cleared
Introduction
Feb 2024
Committee Review
Floor Vote
Governor
Introduced Feb 8, 2024
Last action Feb 8, 2024
Floor votes
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Full legislative history
Actions timeline
Total actions
1
Key actions
0
Committee
0
Feb 8, 2024
Introduced
Introduced in the Assembly, Referred to Assembly Aging and Human Services Committee
lower
3 primary · 0 co-sponsors
Sponsors
Role
Legislator
Party
State
District
P
Shanique Speight
DDemocratic
P
Sterley Stanley
DDemocratic
P
Verlina Reynolds-Jackson
DDemocratic
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