Bill Text: NJ A2868 | 2024-2025 | Regular Session | Introduced
Bill Title: Increases Medicaid reimbursement for in-person partial care and intensive outpatient behavioral health and substance use disorder treatment services, and associated transportation services, for adults.
Spectrum: Slight Partisan Bill (Democrat 4-2)
Status: (Introduced) 2024-01-09 - Introduced, Referred to Assembly Aging and Human Services Committee [A2868 Detail]
Download: New_Jersey-2024-A2868-Introduced.html
STATE OF NEW JERSEY
221st LEGISLATURE
PRE-FILED FOR INTRODUCTION IN THE 2024 SESSION
Sponsored by:
Assemblyman ANTHONY S. VERRELLI
District 15 (Hunterdon and Mercer)
Assemblyman LOUIS D. GREENWALD
District 6 (Burlington and Camden)
Assemblyman REGINALD W. ATKINS
District 20 (Union)
Co-Sponsored by:
Assemblywoman Swift
SYNOPSIS
Increases Medicaid reimbursement for in-person partial care and intensive outpatient behavioral health and substance use disorder treatment services, and associated transportation services, for adults.
CURRENT VERSION OF TEXT
Introduced Pending Technical Review by Legislative Counsel.
An Act concerning Medicaid reimbursement for certain behavioral health and addiction services and supplementing Title 30 of the Revised Statutes.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. a. As used in this section:
"Adult" means an individual aged 21 years and older.
"Intensive Outpatient Services" means comprehensive, individualized, structured, non-residential treatment sessions for an adult with severe mental illness or substance use disorder provided at a licensed outpatient facility for a minimum of nine hours per week.
"Partial care services" means comprehensive, individualized, structured, non-residential behavioral health care and support services for an adult with severe mental illness or substance use disorder provided at a licensed outpatient facility for a minimum of two hours per week and a maximum of 25 hours per week in order to facilitate community integration and prevent hospitalization and relapse. Partial care services may include, but are not limited to: psychiatric care, individual and group counseling, case management, and prevocational services.
b. The reimbursement rates for in-person partial care and intensive outpatient services within the Medicaid program, established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.), whether such services are provided in the Medicaid fee-for-service delivery system or through the Medicaid managed care delivery system, shall be no less than the applicable established State Medicaid rate as of the effective date of this act, increased by 35 percent. Rates increased under this subsection shall include, but shall not be limited to: per diem and hourly reimbursement rates for partial care and intensive outpatient services, as well as services provided during partial care and intensive outpatient treatment, such as intake evaluation, individual counseling, and group counseling.
c. The aggregate reimbursement rate for transportation services and mileage to or from a partial care or intensive outpatient services provider within the Medicaid program, established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.), whether such services are provided in the Medicaid fee-for-service delivery system or through the Medicaid managed care delivery system, shall be no less than $10 for each one-way trip.
d. The Medicaid reimbursement rates established pursuant to this act shall apply to services provided to an adult Medicaid beneficiary on or after the effective date of this act.
2. The Commissioner of Human Services shall apply for such State plan amendments or waivers as may be necessary to implement the provisions of this act and to secure federal financial participation for State Medicaid expenditures under the federal Medicaid program.
3. The Commissioner of Human Services, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt rules and regulations necessary to implement the provisions of this act.
4. This act shall take effect on the first day of the fourth month next following the date of enactment, but the Commissioner of Human Services may take such anticipatory administrative action in advance thereof as may be necessary for the implementation of this act.
STATEMENT
This bill increases Medicaid reimbursement rates for in-person partial care behavioral health and substance use disorder (SUD) treatment services and intensive outpatient services by 35 percent, when such services are provided to an adult Medicaid enrollee on an in-person basis. The bill also provides that the aggregate Medicaid reimbursement rate for transportation services and mileage to or from a partial care services provider and intensive outpatient services is to be no less than $10 for each one-way trip, an increase of $3 from the current $7 rate, which is composed of $4.50 for transportation services and $2.50 for mileage. These rate increases will apply to services provided through the fee-for-service or managed care delivery system on or after the effective date of this bill.
