Healthcare (Medicaid) in New Jersey

in committee · New Jersey · Senate Jun 15, 2026

S 4470: Eliminates 16 hour per 24-hour period coverage limit on private duty nursing services for certain Medicaid enrollees who are 21 years of age or older.

This bill removes the existing 16-hour daily limit on private duty nursing services for Medicaid recipients in New Jersey who are 21 years of age or older. Under the new rules, eligible individuals whose medical condition is deemed severe enough by the Commissioner of Human Services could receive up to 24 hours of care in a single day. The legislation also directs the state health official to seek necessary federal approvals and update regulations to allow for this increased coverage.

Topics ✓ Healthcare

Sub-Topics Medicaid

in committee · New Jersey · Senate Jun 8, 2026

S 4434: Requires health insurance and Medicaid reimbursement of clinical laboratories regardless of managed care plan participation.

This bill requires health insurance companies and Medicaid programs in New Jersey to pay clinical laboratories for services regardless of whether those labs are part of a managed care network. Under the new rules, non-participating labs must be reimbursed at the same rate as participating ones, though insurers retain the right to review services for medical necessity. The legislation also prohibits state Medicaid officials from forcing laboratories to join the managed care system as a condition for receiving payment or transitioning from a fee-for-service model. These changes directly affect insurance carriers, managed care organizations, and licensed clinical laboratories by mandating coverage and equal pay rates for out-of-network providers.

Topics ✓ Healthcare

Sub-Topics Insurance Medicaid

in committee · New Jersey · Senate Jun 22, 2026

S 4493: Establishes "Oral Health Equity Act."

This bill creates the Oral Health Equity Act to improve access to dental care for uninsured and underinsured residents in New Jersey's medically underserved areas. It directs the Department of Human Services to partner with community oral health centers to provide comprehensive services, including initial exams, restorative treatment, and regular follow-up visits. The legislation ensures these centers receive reimbursement rates equal to or higher than those given to federally qualified health centers and requires the state to seek necessary Medicaid waivers to fund the program.

Topics ✓ Healthcare

Sub-Topics Medicaid

in committee · New Jersey · Senate May 14, 2026

S 4237: Establishes "Kidney Disease Study Commission."

This bill creates the Kidney Disease Study Commission within New Jersey's Department of Health to investigate kidney disease disparities affecting minority and underserved populations. The nine-member commission will include state officials and six public appointees tasked with researching the causes of higher disease rates and lower transplant success in these communities, while also examining treatment patterns under Medicaid and private insurance. To carry out its work, the commission will hold public hearings, utilize state resources, and submit annual reports to the Governor and Legislature detailing its findings and recommendations for future action.

Topics ✓ Healthcare

Sub-Topics Medicaid

in committee · New Jersey · Senate May 11, 2026

S 4201: Authorizes coverage of prescriptive hormone replacement therapy.

This New Jersey bill requires private health plans, state-purchased insurance contracts, and Medicaid to cover a 12-month supply of prescription hormone replacement therapy for individuals who do not need refrigeration. The legislation defines these drugs as FDA-approved medications used to regulate hormone levels but explicitly excludes certain weight-loss drugs. While the law mandates this coverage, it allows for specific exceptions, such as limiting refills during the last quarter of a plan year if a full supply was already provided, or temporarily reducing supplies to 90 days during acute drug shortages. Additionally, insurance providers retain the ability to use standard drug management strategies to oversee how these medications are prescribed and dispensed.

Topics ✓ Healthcare

Sub-Topics Medicaid

in committee · New Jersey · Senate May 11, 2026

S 4190: Requires DHS to submit Medicaid State plan amendment to federal government requesting approval to create Health Home Program for certain Medicaid beneficiaries with sickle cell disease.

This bill requires the New Jersey Department of Human Services to request federal approval for a new Health Home Program specifically for Medicaid recipients with sickle cell disease who are at risk of developing a second chronic condition. Once approved, the state must implement this program within 180 days, which involves coordinating primary, acute, behavioral, and long-term care services to address the needs of these patients as a whole. The legislation also mandates the creation of necessary rules and regulations to support the program's operation.

Topics ✓ Healthcare

Sub-Topics Long-Term Care Medicaid

in committee · New Jersey · Senate May 21, 2026

S 4311: "Self-Directed Care Access Act"; requires DHS to establish common intake system and application process for Medicaid self-directed care programs.

This bill directs New Jersey's Department of Human Services to create a single online portal that allows individuals to apply for and manage their own home and community-based services through various Medicaid waiver programs. The system will include a standardized application form and an automated screening process that matches eligible applicants with the appropriate self-directed care options. Additionally, the bill requires uniform documentation rules to simplify the hiring process for personal care workers hired directly by program participants. These changes aim to streamline access to existing services while remaining subject to necessary federal approvals.

Topics ✓ Healthcare ✓ Technology

Sub-Topics Medicaid Digital Government

in committee · New Jersey · General Assembly May 7, 2026

A 4895: 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, directly affecting eligible residents who need such support. It also creates a formal training and certification program to standardize the qualifications of professionals working in violence prevention. By adding these specific services to Medicaid benefits and establishing a credentialing system, the legislation aims to expand access to prevention resources while ensuring providers meet defined standards.

Topics ✓ Criminal Justice ✓ Healthcare

Sub-Topics Medicaid Medical Licensing

in committee · New Jersey · Senate Jun 1, 2026

S 4335: Prohibits surcharge on transportation network company riders for certain paratransit service.

This bill prohibits transportation network companies, such as ride-sharing apps, from charging the standard $0.50 surcharge on trips designated as paratransit service. It directly affects riders who use these apps for specialized transportation needs, including those with disabilities, seniors, and Medicaid beneficiaries, by exempting their prearranged rides from the fee. The legislation also clarifies that companies are not personally liable for these specific paratransit rides. By removing this financial barrier, the bill ensures that essential accessible transportation remains affordable for eligible users.

Topics ✓ Healthcare ✓ Transportation

Sub-Topics Medicaid

in committee · New Jersey · General Assembly May 7, 2026

A 4931: Requires DHS to issue guidance on housing-related services for Medicaid beneficiaries.

This bill requires New Jersey's Department of Human Services to create guidance connecting Medicaid recipients with housing-related services and resources. The legislation mandates the development of a memorandum of understanding between health agencies and housing organizations to align eligibility rules and track outcomes like housing stability and health improvements. Additionally, the state must provide technical assistance to help housing providers understand how to receive Medicaid reimbursement for their services. Finally, the bill requires a report to be submitted to the Governor and Legislature within two years detailing the progress of these coordination efforts and any necessary changes to state funding plans.

Topics ✓ Healthcare ✓ Housing

Sub-Topics Medicaid Homelessness Property Development Tenant Rights

All healthcare bills