Bill > S3913

This bill establishes a minimum NJ FamilyCare reimbursement rate of 125% of the Medicaid fee-for-service rate for out-of-state hospitals that provide care to at least 10,000 unique NJ FamilyCare pediatric beneficiaries annually. It also requires the Division of Medical Assistance and Health Services to amend Medicaid managed care organization contract provisions to ensure adequate access to pediatric primary care physicians, medical specialists, and certain subspecialists for Medicaid and NJ FamilyCare enrollees. The bill also establishes a process for managed care organizations to seek waivers of network adequacy requirements and requires reporting on out-of-network contracts and waivers.

Health and Social Services

https://www.njleg.state.nj.us/bill-search/2022/S3913