Bill

Bill > A1406


NJ A1406

Establishes minimum Medicaid reimbursement rates for private duty nursing services.


summary

Introduced
01/14/2020
In Committee
01/14/2020
Crossed Over
Passed
Dead
01/11/2022

Introduced Session

2020-2021 Regular Session

Bill Summary

This bill would establish minimum Medicaid reimbursement rates for private duty nursing (PDN) services. PDN services are individualized nursing services that are provided by licensed nurses, on a continuous and non-intermittent basis, to certain beneficiaries in the home setting. The bill provides that the minimum Medicaid reimbursement rate for such services is to be no less than $60 per hour when a registered professional nurse provides the services, and no less than $48 per hour when a licensed practical nurse provides the services. Existing State regulation, at N.J.A.C.10:60-11.2, establishes a maximum Medicaid reimbursement rate for PDN services. Specifically, the regulation provides for reimbursement of PDN services at a rate of not more than $40 per hour when a registered professional nurse provides the services, and not more than $28 when a licensed practical nurse provides the services. These maximum reimbursement rates, however, are insufficient to cover the costs of service provision, and may effectively dissuade nurses from providing PDN services in the State. The bill would require the Commissioner of Human Services to apply for such State plan amendments or waivers as may be necessary to implement the bill's provisions and secure federal financial participation for State Medicaid expenditures under the federal Medicaid program.

AI Summary

This bill would establish minimum Medicaid reimbursement rates for private duty nursing (PDN) services, which are individualized nursing services provided by licensed nurses on a continuous basis in the home setting. The bill sets the minimum reimbursement rate at $60 per hour for registered professional nurses and $48 per hour for licensed practical nurses. This is higher than the current maximum reimbursement rates of $40 per hour for registered nurses and $28 per hour for licensed practical nurses, which are considered insufficient to cover the costs of providing these services. The bill requires the Commissioner of Human Services to apply for any necessary state plan amendments or waivers to implement the new reimbursement rates and secure federal funding for the state's Medicaid program.

Committee Categories

Health and Social Services

Sponsors (9)

Last Action

Introduced, Referred to Assembly Health Committee (on 01/14/2020)

bill text


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