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Bill > S920


NJ S920

NJ S920
Establishes minimum Medicaid reimbursement rates for private duty nursing services.


summary

Introduced
01/09/2024
In Committee
01/09/2024
Crossed Over
Passed
Dead
01/12/2026

Introduced Session

2024-2025 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 establishes minimum reimbursement rates for private duty nursing (PDN) services, which are continuous, individualized nursing care provided by licensed nurses in a patient's home. Specifically, it mandates that Medicaid must pay at least $60 per hour when a registered professional nurse (RN) provides these services and at least $48 per hour when a licensed practical nurse (LPN) provides them. This aims to address current state regulations that set maximum reimbursement rates too low to cover the actual costs of providing PDN services, potentially discouraging nurses from offering them. To implement these new minimum rates and ensure federal funding through the Medicaid program, the Commissioner of Human Services is required to seek necessary state plan amendments or waivers from the federal government within 180 days of the bill's enactment, and will also adopt rules and regulations to put these changes into effect.

Committee Categories

Health and Social Services

Sponsors (1)

Last Action

Introduced in the Senate, Referred to Senate Health, Human Services and Senior Citizens Committee (on 01/09/2024)

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