Bill > S1733

Introduced Session

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.

Committee Categories

Fred Madden (D)*,  Loretta Weinberg (D)*, 

Referred to Senate Budget and Appropriations Committee (on 06/03/2019)