This bill requires New Jersey Medicaid to cover home blood pressure monitors and cuffs for pregnant individuals at risk of preeclampsia. It directly affects pregnant Medicaid beneficiaries in New Jersey identified as high-risk for this condition, which involves dangerous blood pressure spikes during pregnancy. The key provision adds these specific monitoring devices to Medicaid's covered services list, eliminating out-of-pocket costs for patients. This policy change expands existing Medicaid maternity coverage to include home monitoring for a preventable complication.
This bill requires New Jersey's Medicaid managed care organizations to automatically include lower-cost generic and biosimilar drugs on their formularies with better cost-sharing (like lower copays) when they are cheaper than the original brand drugs. It directly affects insurers managing Medicaid plans and their enrollees, ensuring patients pay less for equivalent treatments. Key provisions mandate that if a generic drug's price is lower than its reference brand at launch, insurers must list it with favorable cost-sharing and remove barriers like prior authorization. The bill does not force insurers to stop covering brand drugs but ensures cheaper alternatives are prioritized for cost savings. It applies only when cheaper options are available and respects medical appropriateness decisions by insurers.
ACR 118 is a non-binding resolution urging New Jersey's Governor to declare a public health emergency due to the federal "One Big Beautiful Bill Act" (HR1). The resolution claims this federal law includes over $1 trillion in cuts to healthcare and social programs like Medicaid, SNAP, and WIC, which New Jersey relies on to support low-income residents. It also highlights that New Jersey paid approximately $68 billion more in federal taxes than it received in federal aid during the 2024 fiscal year. As a concurrent resolution, it does not create law but formally requests the Governor take action to address these impacts on state residents.
This bill, introduced by Assemblywoman Shanique Speight, would require New Jersey Medicaid to cover remote stress tests for pregnant women. It amends Medicaid coverage rules to explicitly include these tests as part of "comprehensive maternity care," ensuring they are covered without cost-sharing for Medicaid enrollees. Remote stress tests are non-invasive monitoring tools used to assess cardiovascular health during pregnancy, typically conducted via wearable devices or telehealth. This change directly affects pregnant women enrolled in New Jersey Medicaid, providing access to this specific monitoring service without out-of-pocket costs.
This bill establishes minimum hourly Medicaid reimbursement rates for private duty nursing (PDN) services provided in home settings. It sets a $60 minimum rate for registered nurses and $48 for licensed practical nurses, replacing current maximum rates of $40 and $28 that were deemed insufficient to cover service costs. The law requires the Commissioner of Human Services to seek federal waivers within 180 days to implement these changes and secure matching federal funding. It directly affects nurses providing home-based care for Medicaid beneficiaries, aiming to ensure sustainable reimbursement for these services.
This bill would expand Medicare coverage to all New Jersey residents, regardless of age, health, or disability status, replacing current Medicaid and other state/local health programs with a unified New Jersey Medicare program. It requires the state to apply to federal Centers for Medicare & Medicaid Services (CMS) for a waiver to modify Medicare rules, with CMS estimating costs and adjusting premiums based on existing Medicare/Medicaid payments. The bill prohibits health insurers from offering plans covering services already provided by Medicare to prevent duplication. This would directly affect all New Jersey residents and health insurance providers in the state, as it would eliminate redundant coverage options.
This bill increases Medicaid reimbursement rates for certain mental health services to at least the Medicare rate. It directly affects Medicaid-eligible patients (adults and children) and providers like licensed substance abuse treatment centers or mental health professionals offering evidence-based outpatient counseling. The key provision requires that services must be proven effective (listed in federal registries or approved by state officials) and limited to individual/group therapy in outpatient settings. This policy change aims to improve payment for specific behavioral health treatments under New Jersey's Medicaid program.
This bill authorizes paramedics and other advanced life support providers in New Jersey to administer blood products (like whole blood or packed red blood cells) during emergencies outside hospitals, under supervision by a trauma-trained physician. It requires providers to complete state-approved training, use FDA-approved equipment for storage and transport, and have two trained personnel present during transfusions. The law mandates that Medicaid and private insurers cover these pre-hospital blood transfusions at the same rate as hospital-based services, with the state creating grants to help EMS agencies cover initial equipment and training costs. It directly affects emergency medical services agencies, their certified providers, and patients experiencing severe bleeding from trauma or postpartum hemorrhage.
This bill (NJ A2749) requires health insurance plans and Medicaid (NJ FamilyCare) to cover preventive behavioral health services for children under 18, including screenings and early intervention without requiring a formal mental health diagnosis. It mandates insurers to accept "at-risk diagnosis" billing - using Social Determinants of Health Z-codes instead of standard mental health codes - to pay for preventive care like therapy or screenings for children showing potential behavioral health needs. The coverage must be provided at the same level as other medical services, applying to all health plans sold in New Jersey, state employee health programs, and Medicaid managed care organizations. The bill was withdrawn after being approved as P.L.2025, c.369.
This bill establishes a minimum daily Medicaid reimbursement rate of $950 for pediatric special care nursing facilities (SCNFs) participating in New Jersey's Medicaid or FamilyCare programs. It directly affects four facilities in New Jersey that provide specialized long-term care to medically fragile children and youth up to age 21. The law requires the state to appropriate funds from the General Fund to cover this rate increase, aiming to close a 63.5% gap between the highest and lowest existing reimbursement rates for these facilities. The policy change ensures these facilities receive consistent funding while maintaining compliance with state and federal licensing and quality standards.
