NJ A2229

Bill

"Healthy Smiles Act"; increases NJ FamilyCare fee-for-service reimbursement rates for pediatric dental services; requires NJ FamilyCare managed care rates for identical services be no less than fee-for-service rates.

Introduced
01/13/2026

In Committee
01/13/2026

Crossed Over

Passed

Dead

Introduced Session

2026-2027 Regular Session

Bill Summary

This bill makes certain adjustments to the NJ FamilyCare reimbursement rates for oral health services and supplies. The bill requires that, commencing upon July 1, 2025 or 60 days following the enactment of this bill, whichever is later, the NJ FamilyCare fee-for-service reimbursement rates for covered pediatric oral health services and supplies will be increased by 20 percent from the reimbursement rates in use for identical services at the time of the bill's adoption. Commencing one year after the implementation of the increased reimbursement rates, and annually thereafter, the bill directs the Commissioner of Human Services (commissioner) to adjust the existing fee-for-service reimbursement rates according to changes in the Consumer Price Index (CPI) for All Urban Consumers as published by the United States Department of Labor for the Northeast region of the country in the previous January over the immediately preceding 12-month period. For reference, in November 2024, the most recent time this data was assessed over a 12-month period, the CPI increased by 3.5 percent. Finally, the commissioner is required to ensure that every contract entered into on and after the effective date of this bill between the State and a managed care organization (MCO) for the provision of NJ FamilyCare services provides that the reimbursement rates for pediatric oral health services and supplies are equal to or greater than the NJ FamilyCare fee-for-service reimbursement rates for the identical services and supplies. Under the bill, an MCO in violation of this provision would be liable for a civil penalty of not more than $10,000 for each day that the non-compliant reimbursement rate was issued. Any penalties assessed are to be collected by the commissioner in the name of the State in a summary proceeding in accordance with State law. The commissioner's determination regarding violations is the final agency decision, subject to review by the Appellate Division of the Superior Court.

AI Summary

This bill, known as the "Healthy Smiles Act," aims to improve access to dental care for children enrolled in NJ FamilyCare, New Jersey's program for low-income families and children, by increasing reimbursement rates for pediatric dental services. Starting either July 1, 2025, or 60 days after the bill becomes law, whichever is later, the state will increase its direct payments to dental providers for children's dental services by 20 percent. Furthermore, beginning one year after these increases take effect and annually thereafter, the Commissioner of Human Services will adjust these direct payment rates based on changes in the Consumer Price Index (CPI) for the Northeast region, a measure of inflation. Crucially, the bill mandates that contracts with managed care organizations (MCOs), which are private companies that administer NJ FamilyCare services, must ensure that the rates they pay to dentists for these same pediatric services are at least as high as the state's direct payment rates. MCOs that fail to comply face daily penalties of up to $10,000, with the Commissioner having the final say on violations, subject to court review. This legislation addresses concerns that low reimbursement rates have historically limited provider participation and access to care for New Jersey children, who face higher rates of untreated tooth decay compared to national averages.

Committee Categories

Education

Sponsors (5)

Shama Haider (D)*, Carmen Morales (D)*, Shanique Speight (D)*, Aura Dunn (R), Verlina Reynolds-Jackson (D),

Last Action

Introduced, Referred to Assembly Children, Families and Food Security Committee (on 01/13/2026)

Official Document

https://www.njleg.state.nj.us/bill-search/2026/A2229

(3 Companion Bills)

Version:

Document Type	Source Location
State Bill Page	https://www.njleg.state.nj.us/bill-search/2026/A2229
BillText	https://pub.njleg.gov/Bills/2026/A2500/2229_I1.HTM

Bill	Bill Name	Last Action	Type
A5471	"Healthy Smiles Act"; increases NJ FamilyCare fee-for-service reimbursement rates for pediatric dental services; requires NJ FamilyCare managed care rates for identical services be no less than fee-for-service rates.	Introduced, Referred to Assembly Children, Families and Food Security Committee	Carry Over
S3011	"Healthy Smiles Act"; increases NJ FamilyCare fee-for-service reimbursement rates for pediatric dental services; requires NJ FamilyCare managed care rates for identical services be no less than fee-for-service rates.	Introduced in the Senate, Referred to Senate Health, Human Services and Senior Citizens Committee	Same As
S4298	"Healthy Smiles Act"; increases NJ FamilyCare fee-for-service reimbursement rates for pediatric dental services; requires NJ FamilyCare managed care rates for identical services be no less than fee-for-service rates.	Introduced in the Senate, Referred to Senate Health, Human Services and Senior Citizens Committee	Carry Over

Bill > A2229

summary

Introduced Session

Bill Summary

AI Summary

Committee Categories

Sponsors (5)

Last Action

Official Document

bill text

bill summary

bill summary

bill summary