S 438 New Jersey Senate · 2026-2027 Regular Session

Establishes minimum Medicaid reimbursement rate for structured day program services provided to beneficiary eligible for brain injury services.

This bill establishes a new minimum Medicaid reimbursement rate for structured day program services provided to Medicaid beneficiaries with brain injuries. It requires these rates to match the average reimbursement for Day Habilitation Services (Tiers D and E) under the Division of Developmental Disabilities program, raising payments from $3.65 to $9.09 per 15-minute service unit. The policy directly affects approved brain injury service providers and beneficiaries receiving structured day care for traumatic or non-traumatic brain injuries. It expands existing Medicaid reimbursement rules, which previously only covered community residential services for brain injury care.

Issues: ✓ Healthcare

Bill status in committee 1 of 4 stages cleared

Introduction

Jan 2026

Committee Review

Floor Vote

Governor

Introduced Jan 13, 2026 Last action May 11, 2026

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What changed between versions

Technical Review Of Prefiled Bill → Introduced · 3 edits · Jan 13, 2026

MINOR

The bill was formally introduced after technical review, with a statement added explaining its purpose. The substantive policy change expands the scope of minimum Medicaid reimbursement rate requirements for brain injury services to include structured day program services, which were previously not covered. The bill sets a specific rate floor requiring these services to be reimbursed at the level of Day Habilitation Services Tiers D and E (currently $9.09 per 15 minutes), up from the current $3.65 per 15 minutes.

Scope change

The bill's scope expands to cover structured day program services for brain injury patients under minimum Medicaid reimbursement rate requirements, which previously applied only to community residential services.

SCOPE

Structured day program services for brain injury patients are now included in the minimum Medicaid reimbursement rate requirements, expanding beyond the previously covered community residential services.

FISCAL

The bill requires that Medicaid per diem or encounter reimbursement rates for Structured Day Program Services provided to brain injury patients equal the average of Day Habilitation Services Tiers D and E rates (currently $9.09 per 15 minutes), rather than the current rate of $3.65 per 15 minutes.

TECHNICAL

The bill moved from technical review status to introduced status, two senators were removed from the sponsor list, and a legislative statement was added describing the bill's purpose and effect.

Floor votes

How they voted

No floor votes recorded yet.

Full legislative history

Actions timeline

Total actions

Key actions

Committee

May 11, 2026

Committee

Referred to Senate Budget and Appropriations Committee

upper

Jan 13, 2026

Introduced

Introduced in the Senate, Referred to Senate Health, Human Services and Senior Citizens Committee

upper

2 primary · 14 co-sponsors