Provides for certain pediatric NJ FamilyCare beneficiaries to maintain private duty nursing hours when transitioning to Managed Long Term Services and Supports; codifies and expands appeals provisions for private duty nursing services.

This bill ensures pediatric NJ FamilyCare beneficiaries transitioning from the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program to the Managed Long Term Services and Supports (MLTSS) program automatically retain their previous weekly private duty nursing hours and can carry forward unused hours. It requires managed care organizations to justify any reduction in nursing hours solely based on changed medical need (not other factors) and mandates that benefits continue during appeals for 30 days after an adverse decision. The bill also directs the state to review past transitions (within 5 years) to identify beneficiaries eligible for increased nursing hours and expands appeal protections by extending the appeal window from 10 to 30 days. These changes aim to prevent coverage gaps and streamline access to necessary nursing services during program transitions.