Bill Text: NJ A4020 | 2022-2023 | Regular Session | Introduced
Bill Title: Requires Medicaid managed care organizations to notify certain beneficiaries of maximum coverage for personal care service hours.
Spectrum: Slight Partisan Bill (Republican 2-1)
Status: (Introduced - Dead) 2022-05-16 - Introduced, Referred to Assembly Human Services Committee [A4020 Detail]
Download: New_Jersey-2022-A4020-Introduced.html
Sponsored by:
Assemblywoman KIM EULNER
District 11 (Monmouth)
Assemblywoman MARILYN PIPERNO
District 11 (Monmouth)
SYNOPSIS
Requires Medicaid managed care organizations to notify certain beneficiaries of maximum coverage for personal care service hours.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning notification of personal care service hours provided under Medicaid 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 managed care organization contracted with the Division of Medical Assistance and Health Services within the Department of Human Services to provide benefits under the Medicaid program, established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.), shall notify any beneficiary who is enrolled in the managed care organization's Medicaid plan, and who is determined eligible to receive a personal care service benefit, of: the maximum number of hours per week that the beneficiary is eligible for coverage of personal care services; the additional benefits under the Medicaid program that the beneficiary is eligible for coverage; and, based upon information available to the managed care organization, any other non-Medicaid health service provided via a State program that the beneficiary may be eligible for coverage.
The managed care organization shall communicate this notification information in writing, following the initial determination of the beneficiary's personal care service benefit and following any redetermination of that benefit.
2. This act shall take effect immediately and shall apply to any managed care organization contract which provides benefits under the Medicaid program executed or renewed by the Division of Medical Assistance and Health Services in the Department of Human Services on or after the effective date of this act.
STATEMENT
This bill requires Medicaid managed care organizations to notify certain beneficiaries of maximum coverage for personal care service hours. Specifically, a managed care organization contracted with the Division of Medical Assistance and Health Services within the Department of Human Services to provide benefits under the Medicaid program is required to notify any beneficiary who is enrolled in the managed care organization's Medicaid plan and who is determined eligible to receive a personal care service benefit of:
(1) the maximum number of hours per week that the beneficiary is eligible for coverage of personal care services;
(2) the additional benefits under the Medicaid program that the beneficiary is eligible for coverage; and
(3) based upon information available to the managed care organization, any other non-Medicaid health service provided via a State program that the beneficiary may be eligible for coverage.
The managed care organization is to communicate this notification information in writing, following the initial determination of the beneficiary's personal care service benefit and following any redetermination of that benefit.
