Healthcare (Medicare) in New Jersey

in committee · New Jersey · General Assembly Jan 13, 2026

A 3127: Establishes certain requirements for Medicare supplement policy premiums.

This New Jersey bill (A 3127) requires Medicare supplement insurance policies sold in the state to include two key provisions: (1) limiting premium increases to once per calendar year, and (2) allowing policyholders to pay their annual premium in advance. It directly affects Medicare supplement insurers and policyholders in New Jersey by setting these specific terms for premium adjustments and payment options. The bill also mandates that insurers file annual rates demonstrating compliance with state loss ratio standards, but the core policy changes focus on consumer protections regarding premium timing. These requirements apply to policies issued or renewed after the bill's effective date.

Topics ✓ Healthcare

Sub-Topics Insurance Medicare

in committee · New Jersey · General Assembly Jan 13, 2026

A 1824: Requires availability of electronic fund transfers by health insurance carriers to reimburse covered persons.

This bill requires New Jersey health insurance companies (and their vendors) to offer electronic fund transfers (EFT) as a standard option for reimbursing policyholders for covered medical costs. It mandates that insurers notify policyholders about any fees for EFT and provide clear website instructions to select this payment method. Insurers violating these rules face enforcement by the Department of Banking and Insurance, including fines and orders to reimburse policyholders for any fees they incurred. The law applies to all health benefits plans (excluding Medicare Supplement, workers' comp, and similar coverage) for claims submitted after its effective date.

Topics ✓ Healthcare

Sub-Topics Insurance Medicare

in committee · New Jersey · General Assembly Jan 13, 2026

A 3057: Requires nursing homes to submit certain cost reports to DOH in annual financial report.

This bill requires New Jersey nursing homes to submit their most recent federal Medicare/Medicaid cost reports as part of their annual financial filings with the Department of Health, due within 90 days after their fiscal year ends. It also mandates detailed ownership disclosures for all owners (revising the prior 10% threshold to any ownership interest) and requires the Department to compile aggregated spending data - without naming specific facilities - into an annual public report published online. The report will include regional and county expenditure totals across categories like staffing and supplies. This amends existing annual reporting rules to add federal cost report requirements and enhance transparency around nursing home ownership and spending.

Topics ✓ Healthcare

Sub-Topics Long-Term Care Medicaid Medicare

in committee · New Jersey · Senate Feb 19, 2026

S 3556: Establishes initiatives related to behavioral health care, including increasing reimbursement rates, providing cost-of-living adjustments, establishing grant programs for facility upkeep and provider training, and relaxing clinical supervision requirements.

This bill increases Medicaid reimbursement rates for residential behavioral health services to at least 100% of the Medicare rate, starting July 1, 2024. It also requires annual cost-of-living adjustments for residential behavioral health providers based on the Consumer Price Index and creates a new fund to provide grants for facility repairs, maintenance, and provider training. These changes directly affect residential behavioral health service providers who receive Medicaid payments and the Department of Human Services, which administers the program. The bill aims to improve access to and quality of behavioral health care by strengthening financial support for providers.

Topics ✓ Healthcare

Sub-Topics Medicaid Medicare Mental Health

in committee · New Jersey · General Assembly Jan 13, 2026

A 2428: Establishes "Comprehensive Geriatric Fall Prevention Pilot Program" in DHS; appropriates $11.7 million.

This bill establishes a three-year "Comprehensive Geriatric Fall Prevention Pilot Program" within New Jersey's Department of Human Services, targeting at least 6,000 Medicaid recipients aged 60 or older (with a control group of 6,000) to reduce falls. It provides proven prevention services including individualized risk assessments, counseling, and rehabilitative care - tailored for high-risk seniors and Medicare-Medicaid dual eligibles - with funding from an $11.7 million appropriation. The program requires a review of Medicaid reimbursement policies and a cost-effectiveness evaluation within three years, aiming to lower healthcare costs by preventing falls, building on successful models from states like Pennsylvania and Florida.

Topics ✓ Budget & Taxes ✓ Healthcare

Sub-Topics Appropriations Medicaid Medicare

in committee · New Jersey · General Assembly Jan 13, 2026

A 2301: Requires certain issuance standards and open enrollment for Medicare supplement policies.

This bill prohibits insurers from denying or charging more for Medicare supplement policies based on an applicant's health status, medical conditions, or claims history. It requires year-round open enrollment, meaning people can apply for these policies anytime without waiting periods, regardless of whether they qualify for Medicare due to age or disability. The law directly affects Medicare beneficiaries seeking supplemental coverage, ensuring they cannot be turned down or charged extra for pre-existing conditions while maintaining access to policies.

Topics ✓ Healthcare ✓ Veterans

Sub-Topics Medicare

in committee · New Jersey · General Assembly Jan 13, 2026

A 1962: Establishes cap on amount that hospital can charge patients for laboratory services to 150% of Medicare.

This bill sets a 150% cap on hospital charges for laboratory services, limiting what hospitals can bill patients to 150% of the federal Medicare payment rate for those services. It applies to patients who do not qualify for the existing 115% cap under P.L.2008, c.60 (which covers uninsured patients with family income under 500% of the federal poverty level). Hospitals must adhere to this 150% limit for all laboratory services provided to qualifying patients, excluding those already covered by the lower 115% threshold. The policy change specifically targets lab service billing and does not affect other hospital charges or services.

Topics ✓ Healthcare

Sub-Topics Hospitals Medicare

in committee · New Jersey · General Assembly Jan 13, 2026

AR 79: Memorializes Congress to provide Medicare coverage for eyeglasses, hearing aids, and dentures.

This New Jersey Assembly Resolution (AR 79) requests Congress to enact Medicare coverage for eyeglasses, hearing aids, and dentures. It directly addresses elderly Medicare beneficiaries, noting that nearly 100% of those aged 55+ require reading glasses, 42% have significant hearing loss, and many need dentures - yet current Medicare excludes these essential devices. The resolution formally asks Congress to expand Medicare to cover these costs, aiming to reduce financial strain on seniors. Introduced to the Assembly Aging and Human Services Committee in January 2026, it is a non-binding memorial urging federal action.

Topics ✓ Healthcare

Sub-Topics Medicare

in committee · New Jersey · Senate Feb 5, 2026

SR 66: Memorializes Congress to provide Medicare coverage for eyeglasses, hearing aids, and dentures.

This Senate Resolution (SR 66) requests Congress to add Medicare coverage for eyeglasses, hearing aids, and dentures. It directly affects elderly Medicare beneficiaries who currently pay out-of-pocket for these essential assistive devices. The resolution cites that Medicare does not cover these items despite widespread need among seniors, with 42% of elderly Medicare recipients experiencing hearing loss and many requiring dental care. It formally memorializes Congress to enact legislation providing this coverage, aiming to reduce financial burdens and improve quality of life for older Americans. The resolution is non-binding and serves as a formal request to the U.S. Congress.

Topics ✓ Healthcare

Sub-Topics Medicare Tags Seniors

in committee · New Jersey · General Assembly Jan 13, 2026

A 3826: Establishes initiatives related to behavioral health care, including increasing reimbursement rates, providing cost-of-living adjustments, establishing grant programs for facility upkeep and provider training, and relaxing clinical supervision requirements.

This bill (A 3826) proposes key changes to New Jersey's behavioral health care system. It requires Medicaid to pay residential behavioral health providers at rates matching Medicare (100% of Medicare rates starting July 2024), mandates annual cost-of-living adjustments based on the Consumer Price Index, and creates two new grant programs: one for facility maintenance and another to fund training and internships for behavioral health professionals. These provisions directly affect residential behavioral health providers, Medicaid beneficiaries, and the behavioral health workforce by increasing provider payments and supporting facility upkeep and staff development. The bill aims to improve access to and quality of care within the state's Medicaid program.

Topics ✓ Healthcare ✓ Labor & Employment

Sub-Topics Medicaid Medicare Mental Health

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