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NJ A4012
NJ A4012Establishes minimum Medicaid reimbursement rate for structured day program services provided to beneficiary eligible for brain injury services.
summary
Introduced
03/07/2024
03/07/2024
In Committee
06/17/2024
06/17/2024
Crossed Over
Passed
Dead
01/12/2026
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)
Garnet Hall (D)*,
Verlina Reynolds-Jackson (D)*,
William Sampson (D)*,
Bob Auth (R),
John Azzariti (R),
Rosaura Bagolie (D),
Al Barlas (R),
Brian Bergen (R),
Clinton Calabrese (D),
Aura Dunn (R),
Dawn Fantasia (R),
Vicky Flynn (R),
Robert Karabinchak (D),
Michele Matsikoudis (R),
Antwan McClellan (R),
Nancy Muñoz (R),
Gregory Myhre (R),
Jessica Ramirez (D),
Gabriel Rodriguez (D),
Brian Rumpf (R),
Alexander Schnall (D),
Shanique Speight (D),
Jay Webber (R),
Last Action
Reported and Referred to Assembly Appropriations Committee (on 06/17/2024)
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/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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