Bill

Bill > A4575


NJ A4575

Establishes minimum Medicaid reimbursement rates for private duty nursing services.


summary

Introduced
10/15/2018
In Committee
10/15/2018
Crossed Over
Passed
Dead
01/08/2020

Introduced Session

2018-2019 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 Medicaid reimbursement rates for private duty nursing (PDN) services in New Jersey. It sets the minimum rate at $60 per hour for registered professional nurses and $48 per hour for licensed practical nurses, which is higher than the existing maximum reimbursement rates of $40 and $28 per hour, respectively. The bill requires the Commissioner of Human Services to apply for any necessary state plan amendments or waivers to implement the new rates and secure federal funding. The Commissioner is also directed to adopt regulations to effectuate the provisions of the bill.

Committee Categories

Health and Social Services

Sponsors (8)

Last Action

Introduced, Referred to Assembly Health and Senior Services Committee (on 10/15/2018)

bill text


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