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Bill > S2742
NJ S2742
NJ S2742Requires Medicaid fee-for-service coverage of managed long term services and supports when beneficiary is pending enrollment in managed care organization.
summary
Introduced
01/13/2026
01/13/2026
In Committee
01/13/2026
01/13/2026
Crossed Over
Passed
Dead
Introduced Session
2026-2027 Regular Session
Bill Summary
This bill requires Medicaid fee-for-service (FFS) coverage of managed long term services and supports when the beneficiary is pending enrollment in a managed care organization (MCO). In doing so, the bill codifies existing Medicaid policy established in Medicaid Newsletter, Vol. 24, No. 14. Specifically, the bill requires the Division of Medical Assistance and Health Services in the Department of Human Services to provide Medicaid coverage via the FFS delivery system for eligible services provided by an assisted living residence, a comprehensive personal care home, an assisted living program, or an adult family care provider to an individual who is determined eligible for the Medicaid Managed Long Term Services and Supports program, but who is pending enrollment in a MCO contracted by the division to provide health care services to Medicaid recipients. FFS coverage provided under the bill will begin on the date on which the individual is determined clinically and financially eligible for services provided under the Medicaid Managed Long Term Services and Supports program, and will end on the date on which the individual's enrollment in a Medicaid MCO becomes effective. The bill directs the Commissioner of Human Services to apply for such State plan amendments or waivers as may be necessary to implement the provisions of the bill and to secure federal financial participation for State Medicaid expenditures under the federal Medicaid program.
AI Summary
This bill requires that the state's Medicaid program, which provides health coverage to low-income individuals, continue to cover long-term care services through a traditional fee-for-service (FFS) system even when a person is waiting to be enrolled in a managed care organization (MCO). An MCO is a private company that contracts with the state to manage healthcare services for Medicaid recipients. Specifically, the bill mandates that the Division of Medical Assistance and Health Services will provide FFS coverage for services like those offered by assisted living residences or adult family care providers to individuals who are eligible for managed long-term care services but are in the process of joining an MCO. This FFS coverage will start as soon as someone is deemed eligible for these services and will end once their enrollment in the MCO is finalized, ensuring continuous care during the transition period. The Commissioner of Human Services is also directed to seek any necessary approvals or federal funding to implement these changes.
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 01/13/2026)
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/2026/S2742 |
| BillText | https://pub.njleg.gov/Bills/2026/S3000/2742_I1.HTM |
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