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Bill > A5515
NJ A5515
NJ A5515Establishes minimum NJ FamilyCare reimbursement rate for certain out-of-state hospitals that provide services to NJ FamilyCare pediatric beneficiaries.
summary
Introduced
05/25/2023
05/25/2023
In Committee
05/25/2023
05/25/2023
Crossed Over
Passed
Dead
01/08/2024
01/08/2024
Introduced Session
2022-2023 Regular Session
Bill Summary
Establishes minimum NJ FamilyCare reimbursement rate for certain out-of-state hospitals that provide services to NJ FamilyCare pediatric beneficiaries.
AI Summary
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 network adequacy for pediatric primary care physicians, specialists, and certain subspecialists. The bill allows for waivers from the network adequacy requirements in certain circumstances and requires managed care organizations to establish a grievance process for provider network adequacy issues.
Committee Categories
Education
Sponsors (6)
Bill Moen (D)*,
Sterley Stanley (D)*,
Lisa Swain (D)*,
Paul Moriarty (D),
Bill Spearman (D),
Edward Thomson (R),
Last Action
Introduced, Referred to Assembly Women and Children Committee (on 05/25/2023)
Official Document
bill text
bill summary
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bill summary
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bill summary
| Document Type | Source Location |
|---|---|
| State Bill Page | https://www.njleg.state.nj.us/bill-search/2022/A5515 |
| BillText | https://pub.njleg.gov/Bills/2022/A6000/5515_I1.HTM |
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