Healthcare (Medicaid)

died · New Jersey · Senate Jan 13, 2026

S 3008: Requires health insurance and Medicaid coverage for screening, prevention, and treatment services of behavioral health issues affecting children.

This bill requires health insurance companies and Medicaid programs in New Jersey to cover screening, prevention, and treatment services for children's behavioral health issues without needing a formal mental health diagnosis. It allows providers to use "at-risk diagnosis" billing codes (like Social Determinants of Health Z-codes) for services such as early screenings and therapy for children under 18. The coverage must be provided at the same level as other medical services, including for children showing potential issues before a diagnosis is made. This applies to all private health plans, state employee health benefits, school employee health plans, and NJ FamilyCare Medicaid programs.

Topics ✓ HealthcareSupports HealthcareMandates insurance/Medicaid coverage for children's behavioral health without diagnosis requirement, requires parity with medical services, directly expanding mental health access and coverage.95% confidence

Sub-Topics Insurance Medicaid Mental Health

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in committee · New Jersey · Senate Jan 13, 2026

S 2983: Establishes requirements for sanctions and other actions involving low-performing nursing homes.

This bill requires New Jersey to take action against nursing homes that receive three consecutive one-star ratings from the federal Centers for Medicare and Medicaid Services (CMS). After two consecutive one-star ratings, the state must warn the facility and may impose sanctions like restricting new Medicaid admissions or reducing payments. For three consecutive one-star ratings, the state must mandate an 18-month improvement plan and may impose severe sanctions, including banning new admissions, removing Medicaid residents, or stopping payments. The bill directly affects nursing homes participating in New Jersey's Medicaid program that fail to meet quality standards, with consequences tied to federal CMS rating outcomes.

Topics ✓ HealthcareSupports HealthcareMandates improvement plans and sanctions for low-performing nursing homes to ensure quality care standards, protecting patient safety and care access.85% confidence

Sub-Topics Long-Term Care Medicaid Medicare

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in committee · New Jersey · Senate Jan 13, 2026

S 2742: Requires Medicaid fee-for-service coverage of managed long term services and supports when beneficiary is pending enrollment in managed care organization.

This bill requires New Jersey's Medicaid program to provide traditional fee-for-service coverage for long-term care services (like those from assisted living residences or personal care homes) to beneficiaries who are eligible for Medicaid's managed long-term services program but are still waiting to enroll in a managed care organization (MCO). Coverage begins when eligibility is confirmed and ends when MCO enrollment starts, preventing service gaps during the transition. It applies directly to Medicaid beneficiaries in this pending enrollment phase. The bill codifies an existing Medicaid policy, ensuring consistent coverage without creating new benefits.

Topics ✓ HealthcareSupports HealthcarePrevents coverage gaps for Medicaid beneficiaries during MCO transition, ensuring continuous access to long-term care services.95% confidence

Sub-Topics Long-Term Care Medicaid

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in committee · New Jersey · Senate Feb 2, 2026

S 3221: Increases amount of cigarette and other tobacco products tax revenues dedicated to anti-smoking initiatives from one to three percent.

This bill increases the percentage of cigarette and tobacco tax revenues dedicated to anti-smoking programs in New Jersey from 1% to 3%. It directs these funds - projected to rise from approximately $5 million to $15 million annually - to the Department of Health for evidence-based tobacco control programs. These programs must align with CDC best practices and focus on preventing youth smoking, reducing secondhand smoke exposure, and promoting cessation, with priority given to Medicaid populations and youth initiatives. The change applies to revenues collected under the Cigarette Tax Act and Tobacco Products Tax Act, effective for fiscal years beginning July 1, 2025.

Topics ✓ Budget & TaxesSupports Budget & TaxesIncreases tobacco tax revenue allocation to anti-smoking programs from 1% to 3%, directing $5M→$15M annually to public health initiatives.95% confidence ✓ HealthcareSupports HealthcareIncreases public health funding for tobacco control programs targeting youth smoking prevention and Medicaid populations, aligning with CDC health initiatives.95% confidence

Sub-Topics Medicaid

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in committee · New Jersey · Senate Jan 13, 2026

S 1765: Requires Medicaid coverage for community violence prevention services; establishes training and certification program for violence prevention professionals.

This bill requires New Jersey's Medicaid program to cover community violence prevention services for eligible recipients. It adds these services to Medicaid coverage under existing "preventative and rehabilitative services" (Section 12 of the amended law), directly affecting Medicaid beneficiaries and violence prevention providers. The bill also establishes a state training and certification program for professionals working in violence prevention. This creates a new pathway for Medicaid reimbursement for evidence-based community violence intervention programs. The legislation is currently pending in the Senate Health Committee.

Topics ✓ HealthcareSupports HealthcareExpands Medicaid coverage to include community violence prevention services, directly advancing healthcare access under preventative/rehabilitative services.95% confidence

Sub-Topics Medicaid

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in committee · New Jersey · Senate Jan 13, 2026

S 249: Establishes MOM Project oral health three-year pilot program in DOH; appropriates $4,150,000.

S 249 establishes a three-year oral health pilot program (the "MOM Project") in New Jersey's Department of Health, targeting low-income pregnant women and new mothers who live in medically underserved areas and are not enrolled in Medicaid. The program provides free oral health education (at least three hours covering hygiene, nutrition, and disease prevention), followed by one year of dental care including cleanings, risk assessments, and necessary treatments through community health centers. It appropriates $4.15 million to fund outreach, education, and dental services, requiring participating centers to partner with nonprofit maternal health groups to develop personalized treatment plans. The initiative aims to improve oral health outcomes for mothers and infants while collecting data on the program's impact.

Topics ✓ HealthcareSupports HealthcareFunds oral health program for underserved pregnant women, expanding access to dental care through community health centers with $4.15M appropriation.90% confidence

Sub-Topics Medicaid Public Health Women's Health

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in committee · New Jersey · Senate Jan 13, 2026

S 2943: Requires DOBI to establish integrated enrollment platform for State-based health insurance exchange and NJ FamilyCare program.

S 2943 requires New Jersey's Department of Banking and Insurance (DOBI) to create an integrated enrollment platform connecting the state's health insurance exchange with the NJ FamilyCare program (which includes Medicaid and CHIP). This directly affects New Jersey residents applying for health coverage through the Individual Health Coverage Program, Small Employer Health Benefits Program, or NJ FamilyCare. The bill mandates DOBI, in coordination with the Department of Human Services, to integrate the exchange with Medicaid eligibility systems so applicants can determine eligibility for all programs through one platform. It also establishes a nine-member advisory committee with health insurance expertise to guide implementation, including consumer advocates and industry representatives.

Topics ✓ HealthcareSupports HealthcareIntegrates health insurance exchange and NJ FamilyCare enrollment, improving access to coverage for residents through streamlined application process.85% confidence

Sub-Topics Children's Health Insurance Medicaid

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in committee · New Jersey · Senate Jan 13, 2026

S 836: Requires 10 percent increase in respite care services for eligible individual under State Respite Care Program with implantable cardioverter defibrillator and enrolled in NJ FamilyCare.

This bill increases the maximum annual respite care funding limit by 10% for individuals enrolled in NJ FamilyCare who have an implantable cardioverter defibrillator (ICD). It specifically raises the current $6,559.63 annual cap to $7,215.60 for this subgroup, ensuring they receive 10% more respite care services than the standard limit. The policy directly affects eligible New Jersey residents with ICDs who qualify for NJ FamilyCare (the state's Medicaid program). The change modifies existing funding rules under the Statewide Respite Care Program without creating new eligibility criteria or services.

Topics ✓ HealthcareSupports HealthcareBill increases respite care funding by 10% ($6,559.63 → $7,215.60) for ICD patients in NJ FamilyCare, directly expanding healthcare access and funding for a vulnerable group.95% confidence

Sub-Topics Medicaid

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in committee · New Jersey · Senate Jan 13, 2026

S 2492: Increases access to substance use disorder treatment; Requires Medicaid coverage for substance use disorder services provided by community-based organizations.

This bill requires New Jersey's Medicaid program to cover substance use disorder treatment services provided by community-based organizations (CBOs), directly expanding access for Medicaid recipients. It establishes new standards for opioid treatment programs, including allowing "medication units" (geographically separate clinics or mobile units) to administer medication-assisted treatment like methadone or buprenorphine. The bill also prohibits treatment programs from denying care based on a patient's refusal of counseling or missing doses, and sets limits on mandatory drug screenings. These changes aim to make treatment more accessible while maintaining clinical standards for opioid use disorder care.

Topics ✓ HealthcareSupports HealthcareRequires Medicaid coverage for CBO substance use treatment, expanding access and funding for mental health services per bill's explicit mandate.95% confidence

Sub-Topics Medicaid Substance Abuse

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in committee · New Jersey · Senate Jan 13, 2026

S 1792: Establishes program to subsidize purchase price of medical cannabis for registered qualifying patients enrolled in Medicaid or NJ FamilyCare programs.

This bill, S 1792, creates a funding mechanism to subsidize medical cannabis costs for Medicaid and NJ FamilyCare enrollees. It amends the Cannabis Regulatory Fund to allocate monies specifically for reimbursing dispensaries and clinical registrants who provide discounted or subsidized cannabis to qualifying patients. The key provision requires the Cannabis Regulatory Commission to reimburse these providers for the cost difference between the standard price and the subsidized price paid by enrolled patients. The bill is pending before the Legislature and has not yet been enacted.

Topics ✓ HealthcareSupports HealthcareSubsidizes medical cannabis costs for Medicaid/NJ FamilyCare enrollees, improving access to healthcare services through public insurance programs.95% confidence

Sub-Topics Medicaid

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