Healthcare (Medicaid)

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

Track

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

Track

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

Track

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

Track

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

Track

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

A 3476: Increases Medicaid reimbursement rates for private duty nursing services by $4.

This bill increases Medicaid reimbursement rates for private duty nursing (PDN) services by $4 per hour. It sets a minimum rate of $65 per hour for registered nurses (up from $61) and $53 per hour for licensed practical nurses (up from $49), applying to both fee-for-service and managed care Medicaid delivery systems. The change directly affects nurses providing in-home PDN services and requires the state to seek federal approval for the rate adjustment. The policy change takes effect immediately upon enactment.

Topics ✓ HealthcareSupports HealthcareIncreases Medicaid reimbursement rates for nursing services, directly boosting funding for healthcare providers under Medicaid coverage.95% confidence

Sub-Topics Medicaid

Track

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

A 3066: Requires DHS to review, and implement certain improvements to, Medicaid Managed Long-Term Services and Supports Program and to establish public-facing report card of managed care organization's coordination of program.

This bill requires New Jersey's Medicaid program to review and improve its Managed Long-Term Services and Supports (MLTSS) Program, which coordinates long-term care for Medicaid members. It directs the state to assess quality oversight, barriers to moving members from nursing homes to community settings, and successful payment models nationwide. The state must then mandate managed care organizations (MCOs) to reduce caseloads for nursing home residents, conduct more frequent face-to-face visits, annually review member preferences for community transitions, and create transition teams for complex moves. Additionally, the state must create public report cards on its website showing MCO performance metrics, enrollment data, disenrollment rates, member feedback, and quality ratings to help Medicaid members choose providers. The report cards must be updated annually, and the state must submit a progress report to the legislature within 18 months.

Topics ✓ HealthcareSupports HealthcareRequires DHS to improve Medicaid MLTSS program, mandate MCOs to reduce caseloads and increase visits, strengthening long-term care coordination and oversight.95% confidence

Sub-Topics Long-Term Care Medicaid

Track

in committee · New Jersey · General Assembly Feb 19, 2026

A 4349: Requires health insurance and Medicaid coverage for family planning and reproductive health care services; prohibits adverse actions by medical malpractice insurers in relation to performance of legally protected health care services.

This bill requires health insurance plans and Medicaid in New Jersey to cover all reproductive health care services, including family planning and abortion. It also prohibits medical malpractice insurers from raising premiums or canceling coverage for providers who offer these legally protected services. The law applies to all health insurance companies, Medicaid, and malpractice insurers operating in the state. By mandating coverage and preventing insurance penalties, the bill aims to remove financial barriers to reproductive health care access for all residents.

Topics ✓ HealthcareSupports HealthcareMandates insurance/Medicaid coverage for reproductive health services including abortion and prohibits malpractice insurer penalties against providers.95% confidence

Sub-Topics Insurance Medicaid Women's Health

Track

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

A 2250: Establishes commission to examine impact of federal funding cuts on State's Medicaid program.

This bill establishes a nine-member commission within New Jersey’s Department of Human Services to analyze how projected federal Medicaid funding cuts affect the state’s Medicaid services. The commission will monitor federal and statewide Medicaid trends, assess the impact of federal policy changes, and recommend legislative or other actions to address these changes. It consists of the Medicaid program director (ex-officio), four legislative members appointed by chamber leaders, and four public members appointed by the governor. Within 12 months of its first meeting and annually thereafter, the commission must submit written reports to the governor and legislature detailing its analysis and recommendations, which will be posted publicly online. The bill does not change Medicaid funding or eligibility but creates a process to evaluate federal policy impacts.

Topics ✓ HealthcareSupports HealthcareEstablishes commission to analyze federal Medicaid funding cuts' impact and recommend protective actions, safeguarding healthcare coverage.90% confidence

Sub-Topics Medicaid

Track

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

A 2039: Requires Division of Developmental Disabilities to make comprehensive list of its programs available to public.

This bill requires New Jersey's Division of Developmental Disabilities (DDD) to create and maintain a publicly accessible list of all its programs and services for individuals with developmental disabilities. The list must include detailed descriptions of each program (like home-based supports, group homes, and self-directed services), eligibility requirements (including Medicaid needs and care level assessments), and information on transitional planning and guardianship. DDD must post this list on its website, provide it in print upon request, and update it regularly to reflect current offerings. It also mandates that DDD promote webinars or presentations to help people access these services.

Topics ✓ HealthcareSupports HealthcareBill requires public listing of developmental disability programs including Medicaid eligibility, improving access to healthcare services for individuals with disabilities.85% confidence

Sub-Topics Medicaid

Track