Bill > A5132

This bill aims to protect clinical laboratories' ability to offer discounts to patients experiencing financial hardship without risking penalties under New Jersey's Medicaid (NJ FamilyCare) reimbursement regulations. The bill defines financial hardship as having a gross household income at or below 200 percent of the federal poverty level or facing exceptional expenses that substantially impair financial stability. Currently, if a laboratory offers a lower price to an uninsured or vulnerable patient, they are required to reduce their NJ FamilyCare reimbursement rates for that service and could be considered in violation of anti-rebate regulations. The bill would allow laboratories to provide discounted services to patients demonstrating financial hardship without affecting their NJ FamilyCare reimbursement rates or facing legal consequences. Additionally, the bill retroactively dismisses any pending audits or investigations related to previous discounting practices and vacates any previous reports or judgments against laboratories for such actions. The legislation is particularly focused on protecting access to critical laboratory services, especially for vulnerable populations like substance use disorder patients, those in drug court, newly released inmates, and individuals required to complete medical testing for various programs.

Education, Health and Social Services

https://www.njleg.state.nj.us/bill-search/2024/A5132