Healthcare (Medicaid)

in committee · New Jersey · Senate Feb 19, 2026

S 3523: Directs DHS to establish Children's Partial Hospitalization Pilot Program.

S 3523 establishes a 36-month pilot program to expand access to mental health care for children aged 5-14 in New Jersey. The bill directs the Department of Human Services to modify NJ FamilyCare reimbursement rules, allowing partial hospitalization services (intensive outpatient mental health treatment) to be provided at non-hospital locations instead of requiring hospital settings. One provider must be selected to participate, meeting specific criteria including exclusive service to this age group and approval through the Children’s System of Care. The program requires a final report to the Governor and Legislature within 36 months, evaluating clinical and budgetary outcomes before potential expansion. This change aims to increase access to lower-cost, structured care while leveraging federal Medicaid funds.

Topics ✓ HealthcareSupports HealthcareExpands mental health access for children via non-hospital partial hospitalization under NJ FamilyCare, improving patient access to services95% confidence

Sub-Topics Hospitals Medicaid Mental Health

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in committee · New Jersey · General Assembly Jan 13, 2026

A 926: Requires Medicaid coverage for assisted living services for individuals with serious mental illnesses.

This bill would require New Jersey Medicaid to cover assisted living services for individuals with serious mental illnesses. It amends the Medicaid statute to explicitly add these services as a covered benefit, expanding current coverage that primarily includes intermediate care facilities. This change would directly affect Medicaid beneficiaries with serious mental illnesses who currently lack access to Medicaid-funded assisted living care. The bill does not specify funding details but would expand the range of services Medicaid must provide under state law.

Topics ✓ HealthcareSupports HealthcareExpands Medicaid coverage for mental health services by requiring assisted living coverage, improving access for individuals with serious mental illnesses.95% confidence

Sub-Topics Long-Term Care Medicaid Mental Health

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in committee · New Jersey · General Assembly Jan 13, 2026

A 3745: Requires health insurance and Medicaid coverage for the treatment of stuttering.

This bill requires all health insurance plans and Medicaid in New Jersey to cover medically necessary speech therapy for stuttering, including both habilitative (helping develop speech skills) and rehabilitative (helping regain lost skills) therapy. It applies to all health insurance policies sold in New Jersey, including individual, group, and hospital service contracts, and mandates coverage whether therapy is provided in-person or via telehealth. Insurers must cover these services at the same level as other medical treatments, without additional restrictions. The law directly affects residents with stuttering who rely on insurance for speech therapy, ensuring they receive consistent coverage for this specific treatment.

Topics ✓ HealthcareSupports HealthcareMandates insurance/Medicaid coverage for stuttering therapy, expanding access to speech services under both habilitative and rehabilitative categories.95% confidence

Sub-Topics Hospitals Insurance Medicaid

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in committee · New Jersey · General Assembly Jan 13, 2026

A 2571: Establishes the "Food is Medicine NJ Pilot Program" in DHS; appropriates $5,000,000.

Bill A 2571 establishes New Jersey’s "Food is Medicine NJ Pilot Program" within the Department of Human Services (DHS), appropriating $5 million to provide nutrition services to Medicaid recipients. The program directly affects up to 10,000 high-risk Medicaid recipients: 3,000 with complex chronic conditions (like diabetes or heart failure) receive medically tailored meals, while 7,000 others at risk of diet-related illness get produce prescriptions and nutrition education. Key provisions require DHS to partner with healthcare providers and nonprofits to deliver these services, with a third-party evaluator measuring impacts on hospitalizations, health metrics (e.g., A1C levels), and Medicaid cost savings over three years. The pilot expires after the final evaluation report is submitted.

Topics ✓ HealthcareSupports HealthcareAllocates $5M for nutrition services to Medicaid recipients with chronic conditions, improving access to healthcare via medically tailored meals and produce prescriptions.95% confidence

Sub-Topics Medicaid

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in committee · New Jersey · General Assembly Jun 23, 2026

A 1207: Requires unrestricted Medicaid coverage for ovulation enhancing drugs and medical services related to administering such drugs for certain beneficiaries experiencing infertility.

This bill would require New Jersey Medicaid to cover ovulation-enhancing drugs and related medical services without restrictions for beneficiaries experiencing infertility. It directly affects low-income New Jersey residents enrolled in Medicaid who seek infertility treatment. The key provision amends Medicaid law to explicitly include these services as a standard benefit, removing prior authorization requirements. This change would expand current coverage to ensure these treatments are accessible as routine care for eligible individuals.

Topics ✓ HealthcareSupports HealthcareExpands Medicaid coverage for infertility treatments by removing prior authorization, improving access to reproductive healthcare services.95% confidence

Sub-Topics Medicaid

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in committee · New Jersey · General Assembly Jan 13, 2026

A 2150: Requires Medicaid and NJ FamilyCare managed care organizations to offer patient-centered medical home model or other alternative payment model to primary care providers.

Bill A 2150 requires Medicaid and NJ FamilyCare managed care organizations to offer a patient-centered medical home model (a team-based care approach led by a primary care provider for comprehensive, continuous care) or an alternative payment model that rewards high-quality, cost-efficient care to primary care providers in their network. Managed care organizations must annually report detailed information about their chosen model - including financial structures, quality metrics, and provider participation - to the state and make this public. The state will establish standardized quality metrics that all such models must use for provider payments, ensuring consistency across the system. This policy directly affects Medicaid and NJ FamilyCare managed care organizations and the primary care providers serving Medicaid and NJ FamilyCare enrollees.

Topics ✓ HealthcareSupports HealthcareRequires Medicaid MCOs to adopt patient-centered medical home model, promoting high-quality, cost-efficient primary care access and reporting on quality metrics.95% confidence

Sub-Topics Medicaid Primary Care

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in committee · New Jersey · General Assembly Jan 13, 2026

A 2461: Requires DOT to establish paratransit brokerage program to consolidate provision of paratransit services under State Medicaid program and NJT Access Link.

This bill requires New Jersey's Department of Transportation (DOT) to create a paratransit brokerage program that consolidates Medicaid medical transportation and ADA paratransit services under a single management system. The program would use an online platform to let riders schedule trips, allow competing transportation providers (like NJ Transit and county agencies) to bid for service requests, and monitor service quality. It directly affects Medicaid beneficiaries needing non-emergency medical transport and people with disabilities relying on ADA paratransit services. The goal is to reduce costs and improve efficiency by streamlining how these essential transportation services are delivered across the state.

Topics ✓ HealthcareSupports HealthcareBill consolidates Medicaid medical transportation under State Medicaid program, improving access for beneficiaries to healthcare services via streamlined scheduling and provider competition.95% confidence ✓ TransportationSupports TransportationBill mandates DOT to consolidate Medicaid/ADA paratransit services into a single brokerage program, improving coordination, accessibility, and service quality for public transit users.95% confidence

Sub-Topics Medicaid

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in committee · New Jersey · General Assembly Jan 13, 2026

A 1909: Requires DHS to disregard certain federal pension benefits for veterans in making Medicaid eligibility determinations.

This New Jersey bill requires the Department of Human Services (DHS) to disregard certain federal pension benefits when determining Medicaid eligibility for veterans. It directly affects veterans who receive federal pensions but apply for Medicaid, as these pension payments would no longer count toward their income limit. The key provision amends existing Medicaid rules to exclude these specific benefits from income calculations during eligibility reviews. This change ensures veterans' pension income does not disqualify them from Medicaid coverage they otherwise qualify for under federal and state standards.

Topics ✓ HealthcareSupports HealthcareExcludes veterans' pension income from Medicaid eligibility calculations, expanding access to healthcare coverage for veterans who would otherwise be disqualified due to pension income.95% confidence ✓ VeteransSupports VeteransExcludes veterans' federal pensions from Medicaid income calculations, increasing eligibility for healthcare benefits.95% confidence

Sub-Topics Medicaid Veteran Benefits Veteran Education Veteran Healthcare

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in committee · New Jersey · General Assembly Jan 13, 2026

A 3103: Requires DHS to establish a pilot program covering menstrual hygiene products under Medicaid and NJ FamilyCare.

This bill requires New Jersey's Department of Human Services to create a pilot program providing free menstrual hygiene products (tampons, menstrual cups, and sanitary napkins) to eligible Medicaid and NJ FamilyCare enrollees. Eligible individuals would receive products at no cost by presenting their Medicaid card at participating pharmacies, with quantities and frequency determined by health experts. The program depends on federal approval of a waiver under Section 1115 of the Social Security Act to secure federal funding. The bill does not take effect until this federal waiver is approved.

Topics ✓ HealthcareSupports HealthcareExpands Medicaid coverage to include free menstrual hygiene products, improving access to essential health items under public health programs.95% confidence

Sub-Topics Medicaid

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in committee · New Jersey · General Assembly Jan 13, 2026

A 2836: Increases resource threshold for certain Medicaid eligibility groups.

This bill (A2836) increases the asset limits for certain New Jersey Medicaid applicants who qualify as "medically needy." It directly affects low-income residents in specific groups, including pregnant women, children under 21, seniors 65+, and blind or disabled adults, who have higher asset thresholds than standard Medicaid applicants. The key change raises the resource standard for households: for households of three or more people, the limit increases by $20,000 per additional person (from $100 previously), setting new caps at $40,000 for one-person households and $60,000 for two-person households. This adjustment aims to align New Jersey's Medicaid eligibility with federal guidelines and expand access for qualifying residents with modest assets. The bill is currently pending in the Assembly Aging and Human Services Committee.

Topics ✓ HealthcareSupports HealthcareIncreases Medicaid asset thresholds for vulnerable groups (pregnant women, children, seniors, disabled), expanding eligibility and access to healthcare coverage for low-income residents.95% confidence

Sub-Topics Medicaid

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