S 1818 New Jersey Senate · 2024-2025 Regular Session

Establishes Medicaid Managed Care Organization Oversight Program.

This bill establishes a new Medicaid Managed Care Organization (MCO) Oversight Program within New Jersey's Department of Human Services. It directly affects Medicaid and NJ FamilyCare enrollees (approximately 1.5 million people), the five health plans contracted to provide their care (MCO contractors), and the state agency managing the program. Key provisions require MCOs to submit quarterly provider and beneficiary data, verify 20% of provider information annually for accuracy, confirm all providers in public directories are Medicaid-eligible, and report provider claim inactivity. The program can impose fines of $50,000 per violation and bar non-compliant MCOs from participating, with annual reports to the Legislature.
Bill status in committee 1 of 4 stages cleared
Introduction
Jan 2024
Committee Review
Floor Vote
Governor
Introduced Jan 9, 2024 Last action Jan 9, 2024
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Jan 9, 2024
Introduced
Introduced in the Senate, Referred to Senate Health, Human Services and Senior Citizens Committee
upper
1 primary · 0 co-sponsors

Sponsors

Role
Legislator
Party
State
District
P
Photo of Angela McKnight
Angela McKnight
DDemocratic
NJ
31