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Bill > S2738


NJ S2738

NJ S2738
Establishes minimum NJ FamilyCare reimbursement rate for certain out-of-state hospitals that provide services to NJ FamilyCare pediatric beneficiaries.


summary

Introduced
02/15/2024
In Committee
02/15/2024
Crossed Over
Passed
Dead
01/12/2026

Introduced Session

2024-2025 Regular Session

Bill Summary

This bill amends existing statutory law, which codifies and establishes certain network adequacy standards for pediatric primary and specialty care in the Medicaid program, to establish a minimum NJ FamilyCare reimbursement rate for certain out-of-state hospitals that provide services to NJ FamilyCare pediatric beneficiaries. Specifically, under the bill, an out-of-state hospital, licensed under the laws and regulations of the state in which the hospital is located, that provides care to 10,000 or more unique NJ Family Care pediatric beneficiaries within its hospital system annually, is to receive a reimbursement rate under NJ FamilyCare that is at least 125 percent of the Medicaid fee-for-service reimbursement rate provided in the state where the hospital is licensed.

AI Summary

This bill amends existing statutory law to establish a minimum NJ FamilyCare reimbursement rate for certain out-of-state hospitals that provide services to NJ FamilyCare pediatric beneficiaries. Specifically, an out-of-state hospital that provides care to 10,000 or more unique NJ FamilyCare pediatric beneficiaries annually will receive a reimbursement rate of at least 125% of the Medicaid fee-for-service rate in the state where the hospital is licensed. The bill also codifies and establishes certain network adequacy standards for pediatric primary and specialty care in the Medicaid program.

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 02/15/2024)

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