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Bill > A4569


NJ A4569

NJ A4569
Provides for improved system for eligibility determination for Medicaid and NJ FamilyCare.


summary

Introduced
10/15/2018
In Committee
06/13/2019
Crossed Over
Passed
Dead
01/08/2020

Introduced Session

2018-2019 Regular Session

Bill Summary

This bill requires the Commissioner of Human Services to develop an information technology platform for the intake, processing, and tracking of applications for benefits under the Medicaid and NJ FamilyCare programs. The goals of the system will be: to simplify the applications and eligibility determination processes for both applicants and eligibility determination staff; to standardize application of eligibility policy across the various agencies responsible for eligibility determination; to allow for real-time tracking of the status of applications; to allow the rapid exchange of data relevant to applications among various State and county agencies and contractors; and to provide a platform to expand the system to encompass other social service program applications and eligibility determinations as the technology permits. The bill requires the commissioner to establish a system to evaluate the performance of all entities responsible for intake and processing of applications for the Medicaid and NJ FamilyCare programs, including all county welfare agencies and the State's contracted health benefits coordinator. The system will allow for the measurement of a set of relevant common metrics related to applications intake and eligibility determination. The bill requires the commissioner to annually publish on the Department of Human Services website, the results, including those for each of the common metrics and by individual entity, of the performance system. The commissioner is to establish a system of rewards and penalties for all entities responsible for intake, processing of applications, and processing of redetermination applications that provides incentives for performance on these metrics. This system will provide incentives for county welfare agencies to streamline their processes and utilize the information technology platform required by the bill. The bill also requires the commissioner to designate a customer service liaison team, to be composed of employees of the department, to receive complaints that result from the eligibility application process. The customer service liaison team will have authority to review all records of the cases about which complaints are submitted; to interview individuals who submit complaints, the individuals who have assisted with their applications, and the State and county staff who have worked on their cases; and to recommend corrective actions to State and county agencies to address specific complaints and reduce future complaints. The bill would take effect on the first day of the sixth month next following enactment.

AI Summary

This bill requires the Commissioner of Human Services to develop an information technology platform to simplify and standardize the application and eligibility determination processes for the Medicaid and NJ FamilyCare programs. It establishes a performance evaluation system to measure key metrics related to applications, and a system of rewards and penalties to incentivize streamlined processes and use of the new technology platform. The bill also creates a customer service liaison team to address complaints about the eligibility application process. The bill aims to improve the efficiency and effectiveness of Medicaid and NJ FamilyCare eligibility determinations.

Committee Categories

Budget and Finance, Health and Social Services

Sponsors (7)

Last Action

Substituted by S499 (2R) (on 06/20/2019)

bill text


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