This bill establishes a minimum daily reimbursement rate of $950 for pediatric skilled care nursing facilities (SCNFs) participating in New Jersey's Medicaid or NJ FamilyCare programs. It directly affects four facilities providing specialized long-term care to medically fragile children and youth up to age 21: the Pediatric Long Term Care Center (Mountainside/Toms River), Phoenix Center (Haskell), and Voorhees Pediatric Facility. Facilities must comply with state/federal licensure, safety, and quality standards to qualify for this rate. The bill appropriates necessary funds from the General Fund to cover this reimbursement increase.
S 3408 extends Medicaid coverage for eligible pregnant women in New Jersey to 365 days, beginning on the last day of pregnancy, replacing the current 60-day postpartum period. This change directly affects pregnant women enrolled in Medicaid, ensuring continuous health coverage for a full year after childbirth without requiring reapplication. The bill codifies this extended coverage period into state law, making it permanent rather than relying on temporary administrative policies. This provision aims to support maternal health by maintaining uninterrupted access to medical care during the critical postpartum period.
This bill requires New Jersey's Medicaid program (NJ FamilyCare) to reimburse licensed pharmacists for medication management services provided to enrolled children. It expands existing pediatric care coverage under NJ FamilyCare to specifically include these pharmacist-delivered services, which help children manage complex medication regimens. The policy change directly affects pediatric Medicaid beneficiaries and pharmacists who provide these services. It mandates state reimbursement for this specific health service without altering eligibility criteria for families.
This bill requires New Jersey's Medicaid program to cover emergency contraceptives without needing a prescription or additional authorization. Currently, Medicaid only covers these medications when obtained with a prescription, forcing enrollees to pay out-of-pocket for over-the-counter options. The law mandates that all Medicaid managed care organizations include this coverage as a standard benefit. It directly affects Medicaid enrollees in New Jersey seeking accessible emergency contraception without unnecessary provider visits.
This bill establishes new standards for non-emergency medical transportation under New Jersey's Medicaid program. It requires providers to maintain insurance, register vehicles properly, conduct regular inspections, and ensure transport is available within 15 minutes of scheduled times. Vehicles exceeding 150,000 miles must pass enhanced safety checks covering brakes, tires, electrical systems, and structural integrity. These rules directly affect Medicaid beneficiaries needing transport, the brokers managing the program, and transportation providers operating in the state.
This bill (A 3826) proposes key changes to New Jersey's behavioral health care system. It requires Medicaid to pay residential behavioral health providers at rates matching Medicare (100% of Medicare rates starting July 2024), mandates annual cost-of-living adjustments based on the Consumer Price Index, and creates two new grant programs: one for facility maintenance and another to fund training and internships for behavioral health professionals. These provisions directly affect residential behavioral health providers, Medicaid beneficiaries, and the behavioral health workforce by increasing provider payments and supporting facility upkeep and staff development. The bill aims to improve access to and quality of care within the state's Medicaid program.
This bill requires New Jersey Medicaid to cover home blood pressure monitors and cuffs for pregnant individuals at risk of preeclampsia. It directly affects pregnant Medicaid beneficiaries in New Jersey identified as high-risk for this condition, which involves dangerous blood pressure spikes during pregnancy. The key provision adds these specific monitoring devices to Medicaid's covered services list, eliminating out-of-pocket costs for patients. This policy change expands existing Medicaid maternity coverage to include home monitoring for a preventable complication.
This bill requires New Jersey's Medicaid managed care organizations to automatically include lower-cost generic and biosimilar drugs on their formularies with better cost-sharing (like lower copays) when they are cheaper than the original brand drugs. It directly affects insurers managing Medicaid plans and their enrollees, ensuring patients pay less for equivalent treatments. Key provisions mandate that if a generic drug's price is lower than its reference brand at launch, insurers must list it with favorable cost-sharing and remove barriers like prior authorization. The bill does not force insurers to stop covering brand drugs but ensures cheaper alternatives are prioritized for cost savings. It applies only when cheaper options are available and respects medical appropriateness decisions by insurers.
This bill, introduced by Assemblywoman Shanique Speight, would require New Jersey Medicaid to cover remote stress tests for pregnant women. It amends Medicaid coverage rules to explicitly include these tests as part of "comprehensive maternity care," ensuring they are covered without cost-sharing for Medicaid enrollees. Remote stress tests are non-invasive monitoring tools used to assess cardiovascular health during pregnancy, typically conducted via wearable devices or telehealth. This change directly affects pregnant women enrolled in New Jersey Medicaid, providing access to this specific monitoring service without out-of-pocket costs.
This bill establishes minimum hourly Medicaid reimbursement rates for private duty nursing (PDN) services provided in home settings. It sets a $60 minimum rate for registered nurses and $48 for licensed practical nurses, replacing current maximum rates of $40 and $28 that were deemed insufficient to cover service costs. The law requires the Commissioner of Human Services to seek federal waivers within 180 days to implement these changes and secure matching federal funding. It directly affects nurses providing home-based care for Medicaid beneficiaries, aiming to ensure sustainable reimbursement for these services.
