New Jersey 2024-2025 Regular Session

New Jersey Assembly Bill A4012

Introduced
3/7/24  
Refer
3/7/24  

Caption

Establishes minimum Medicaid reimbursement rate for structured day program services provided to beneficiary eligible for brain injury services.

Impact

The proposed legislation is positioned to improve access to necessary brain injury services by ensuring that structured day program services, which can play a crucial role in rehabilitating individuals with such injuries, are adequately funded. By establishing specific reimbursement rates—approximately $3.65 per 15 minutes of service for structured day programs—the bill aligns financial support with the average reimbursement rates for similar services under the Division of Developmental Disabilities, helping to provide a more consistent standard of care across various service types.

Summary

Assembly Bill A4012 aims to establish a minimum Medicaid reimbursement rate specifically for structured day program services provided to beneficiaries eligible for brain injury services. This bill expands the current framework surrounding Medicaid reimbursement for brain injury treatment by including structured day programs, which were previously excluded under existing law that was limited to community residential services. The inception of this bill introduces a significant update to the Medicaid system as it relates to the treatment and support of individuals who have experienced brain injuries, whether traumatic or non-traumatic in nature.

Contention

Notable points of contention include the potential impact of this legislation on budget considerations within state-funded healthcare programs and its effect on service providers. While proponents argue that enhanced reimbursement rates will lead to better service availability and quality, critics may raise concerns regarding the financial sustainability of these changes within the broader context of Medicaid funding. Additionally, there could be discussions on whether this adjustment sufficiently addresses the specific needs of different populations requiring brain injury rehabilitation, especially around effective allocation of resources to varied service levels.

Companion Bills

NJ S2535

Same As Establishes minimum Medicaid reimbursement rate for structured day program services provided to beneficiary eligible for brain injury services.

NJ A5397

Carry Over Establishes minimum Medicaid reimbursement rate for structured day program services provided to beneficiary eligible for brain injury services.

NJ S3767

Carry Over Establishes minimum Medicaid reimbursement rate for structured day program services provided to beneficiary eligible for brain injury services.

Previously Filed As

NJ A4485

Establishes minimum Medicaid reimbursement rate for structured day program services provided to beneficiary eligible for brain injury services.

NJ S438

Establishes minimum Medicaid reimbursement rate for structured day program services provided to beneficiary eligible for brain injury services.

NJ A2202

Establishes pilot program to provide Medicaid coverage of remote maternal health services for eligible beneficiaries.

NJ A3441

Establishes minimum Medicaid reimbursement rates for private duty nursing services.

NJ S915

Establishes pilot program to provide Medicaid coverage of remote maternal health services for eligible beneficiaries.

NJ S3282

Establishes minimum Medicaid reimbursement rates for private duty nursing services.

NJ S1073

Establishes minimum NJ FamilyCare reimbursement rate for certain out-of-state hospitals that provide services to NJ FamilyCare pediatric beneficiaries.

NJ S1774

Establishes minimum Medicaid reimbursement rates for certain ambulance transportation services.

NJ A4931

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

NJ A4342

Establishes program for certain individuals to become certified homemaker-home health aides and provide services to certain Medicaid and Medicaid-Medicare dually eligible enrollees under increased reimbursement rates.

Similar Bills

NJ A4485

Establishes minimum Medicaid reimbursement rate for structured day program services provided to beneficiary eligible for brain injury services.

NJ S438

Establishes minimum Medicaid reimbursement rate for structured day program services provided to beneficiary eligible for brain injury services.

CT HB05561

An Act Concerning A Five-year Medicaid Rate Review, Dental Representation On A Medical Assistance Oversight Council, Biomarker Testing And Opioid Prescription Coverage Requirements And A Study Concerning Payment Of Spouses For State-subsidized Home Care.

HI SB2089

Relating To Mental Health.

NJ A4265

Requires Medicaid reimbursement rates for certain primary and mental health care services match reimbursement rates under Medicare.

NJ S3802

Requires Medicaid reimbursement rates for certain primary and mental health care services match reimbursement rates under Medicare.

NJ A985

"Medicaid Transportation Brokerage Program Oversight and Accountability Act"; establishes vehicle, staffing, and performance standards, and review and reporting requirements for non-emergency medical transport provided under State's non-emergency medical transportation brokerage program.

NJ A4931

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