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Bill > A3441


NJ A3441

NJ A3441
Establishes minimum Medicaid reimbursement rates for private duty nursing services.


summary

Introduced
01/13/2026
In Committee
01/13/2026
Crossed Over
Passed
Dead

Introduced Session

2026-2027 Regular Session

Bill Summary

This bill would establish minimum Medicaid reimbursement rates for private duty nursing (PDN) services. PDN services are individualized nursing services that are provided by licensed nurses, on a continuous and non-intermittent basis, to certain beneficiaries in the home setting. The bill provides that the minimum Medicaid reimbursement rate for such services is to be no less than $60 per hour when a registered professional nurse provides the services, and no less than $48 per hour when a licensed practical nurse provides the services. Existing State regulation, at N.J.A.C.10:60-11.2, establishes a maximum Medicaid reimbursement rate for PDN services. Specifically, the regulation provides for reimbursement of PDN services at a rate of not more than $40 per hour when a registered professional nurse provides the services, and not more than $28 when a licensed practical nurse provides the services. These maximum reimbursement rates, however, are insufficient to cover the costs of service provision, and may effectively dissuade nurses from providing PDN services in the State. The bill would require the Commissioner of Human Services to apply for such State plan amendments or waivers as may be necessary to implement the bill's provisions and secure federal financial participation for State Medicaid expenditures under the federal Medicaid program.

AI Summary

This bill establishes minimum hourly reimbursement rates for private duty nursing (PDN) services under the state's Medicaid program, which provides health coverage for low-income individuals. PDN services are continuous, individualized nursing care provided in a patient's home by licensed nurses. Specifically, the bill mandates that Medicaid must pay at least $60 per hour when a registered professional nurse (RN) provides these services and at least $48 per hour when a licensed practical nurse (LPN) provides them. This is a significant change from current regulations, which set maximum reimbursement rates of $40 per hour for RNs and $28 per hour for LPNs, rates that are considered too low to cover the actual costs of providing care and may discourage nurses from offering these services. To implement these new minimum rates, the Commissioner of Human Services is required to seek necessary approvals, such as amendments to the state's Medicaid plan or waivers from federal authorities, to ensure continued federal funding for these increased state Medicaid expenditures. The Commissioner will also adopt new rules and regulations to put these changes into effect.

Committee Categories

Health and Social Services

Sponsors (5)

Last Action

Introduced, Referred to Assembly Health Committee (on 01/13/2026)

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