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NJ A4012

NJ A4012
Establishes minimum Medicaid reimbursement rate for structured day program services provided to beneficiary eligible for brain injury services.


summary

Introduced
03/07/2024
In Committee
06/17/2024
Crossed Over
Passed
Dead
01/12/2026

Introduced Session

2024-2025 Regular Session

Bill Summary

This bill amends existing law, which established minimum Medicaid reimbursement rates for brain injury services, to include structured day program services. Current law is limited to community residential services. Under existing law, "brain injury service" means community-based services, residential services, day care services, and home care services provided to a Medicaid beneficiary requiring treatment for traumatic or non-traumatic brain injuries, regardless of whether such services are provided through the Medicaid fee-for-service delivery system or the managed care delivery system. Specifically, the bill requires the Medicaid per diem or encounter reimbursement rates for Structured Day Program Services provided to a Medicaid beneficiary requiring treatment for a brain injury, approximately $3.65 for every 15 minutes of services, when such services are provided by an approved brain injury service provider, to be equal to the average of the reimbursement rates for Day Habilitation Services - Tiers D and Tier E provided to a Medicaid beneficiary eligible for services provided by the Division of Developmental Disabilities in the Department of Human Services, currently at $9.38 for every 15 minutes of service.

AI Summary

This bill amends existing law to include structured day program services in the minimum Medicaid reimbursement rates for brain injury services. The bill sets the reimbursement rate for structured day program services provided to Medicaid beneficiaries requiring treatment for a brain injury to be equal to the average of the reimbursement rates for day habilitation services provided to Medicaid beneficiaries eligible for services from the Division of Developmental Disabilities. The bill defines key terms such as "brain injury service," "brain injury service provider," and "traumatic and non-traumatic brain injury," and requires the Commissioner of Human Services to adopt rules and regulations to implement the provisions of the bill.

Committee Categories

Budget and Finance, Health and Social Services

Sponsors (23)

Last Action

Reported and Referred to Assembly Appropriations Committee (on 06/17/2024)

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/2024/A4012
Fiscal Note - Fiscal Estimate 7/2/24; as introduced https://pub.njleg.gov/Bills/2024/A4500/4012_E1.PDF
Analysis - Statement AHE 6/17/24 https://pub.njleg.gov/Bills/2024/A4500/4012_S1.PDF
BillText https://pub.njleg.gov/Bills/2024/A4500/4012_I1.HTM
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