This bill increases Medicaid payment rates for specific behavioral health services provided to adults in New Jersey. It raises reimbursement rates for in-person partial care (20+ hours/week) and intensive outpatient services (9+ hours/week) by 35%, covering costs like counseling, psychiatric evaluations, and medical services. It also sets a minimum $10 reimbursement per one-way trip for transportation to these providers. The changes apply to adult Medicaid beneficiaries (21+) with severe mental illness or substance use disorders receiving these services, effective after the bill's enactment.
S 2264 establishes the "New Jersey Reproductive Health Care Equitable Access Fund" within the state Treasury. Taxpayers can voluntarily add a contribution to their New Jersey gross income tax return to support this fund, with net contributions (after administrative costs) deposited into it. The Legislature would annually allocate all funds in the account equally to the three largest Medicaid reproductive health care providers in the state, requiring them to use the money to provide services (including pregnancy-related care and pregnancy termination) to low-income individuals who cannot afford them. The bill defines "reproductive health care services" broadly to cover medical, surgical, counseling, and referral services related to the human reproductive system. The bill was introduced in the Senate on January 13, 2026, and referred to the Health Committee.
This bill (S 1265) adds coverage for home blood pressure monitors and cuffs under New Jersey's Medicaid program for pregnant individuals at risk of preeclampsia - a serious pregnancy condition involving high blood pressure. It directly affects low-income pregnant people who qualify for Medicaid and are identified as having elevated preeclampsia risk. The bill amends existing Medicaid rules to include these devices within "comprehensive maternity care," ensuring they are covered as part of standard prenatal services. This change requires the state to pay for the devices, reducing out-of-pocket costs for at-risk pregnant patients. The policy change specifically targets preventive monitoring to improve maternal health outcomes during pregnancy.
S 1829 establishes a three-year "Food is Medicine NJ Pilot Program" within New Jersey's Department of Human Services, appropriating $5 million to provide nutrition services to Medicaid recipients. The program directly serves up to 3,000 high-risk Medicaid participants with complex chronic conditions (like diabetes, heart failure, or obesity) through medically tailored meals, and an additional 7,000 at-risk Medicaid recipients via produce prescriptions and nutrition education. It requires a third-party evaluator to measure impacts on emergency room visits, hospitalizations, medication adherence, and Medicaid cost savings, with reports to the Legislature due within 18 months and at the program's conclusion. The bill aims to address diet-related chronic diseases - identified as leading causes of death and healthcare spending in New Jersey - by integrating nutrition interventions into the healthcare system.
This bill (S 3006) would require New Jersey Medicaid to cover fertility preservation services (like egg or sperm freezing) for individuals who develop infertility as a direct result of medically necessary treatments, such as cancer therapy. It would specifically apply to New Jersey Medicaid beneficiaries who experience iatrogenic infertility (infertility caused by medical care) due to treatments deemed necessary by their healthcare providers. The bill amends existing Medicaid coverage rules to add these fertility preservation services to the list of covered medical benefits under the program. The bill was introduced on January 13, 2026, and referred to the Senate Health Committee for review.
This New Jersey bill (S 2279) establishes registration and operational rules for retail health clinics (located in stores/pharmacies offering walk-in care for minor issues) and urgent care facilities. It requires annual registration with the Department of Health, mandating clinics to submit details like location, staff names (including medical/operational supervisors), and services offered. Key provisions include requiring clinics to provide patient records to primary care providers within 5 days and to patients within 24 hours (free of charge), urging patients to follow up with a primary care provider, and prohibiting services to minors or Medicaid patients except in emergencies. The bill directly affects all retail clinics and urgent care facilities operating in New Jersey that aren’t already licensed as ambulatory care facilities.
This bill would require New Jersey Medicaid to cover family-based counseling services as part of substance use disorder treatment for eligible beneficiaries. It amends existing Medicaid coverage rules to specifically include these counseling services under authorized treatments provided in licensed facilities meeting state requirements. The policy would directly affect Medicaid recipients receiving substance use disorder care who would now have access to family-involved treatment options. Coverage would apply to both inpatient and outpatient settings where such services are prescribed by a physician.
This bill (S 2270) allows New Jersey hospitals and healthcare entities to transfer state funds to the Division of Medical Assistance to maximize federal Medicaid payments for faculty physicians and non-physician professionals affiliated with public medical/dental schools. It specifically enables these transfers under the MAPS program, which provides enhanced Medicaid reimbursement rates similar to private insurers for services delivered by public medical school-affiliated practices. The transfers must comply with federal Medicaid guidelines and require approval from the Director of Budget and Accounting. This policy change directly affects healthcare providers at public medical institutions by optimizing federal funding for their services.
This bill establishes a new Medicaid Managed Care Organization (MCO) Oversight Program to improve access and quality of care for Medicaid and NJ FamilyCare enrollees in New Jersey. It requires MCOs (the private insurers contracted to provide health services) to submit quarterly data on providers and beneficiaries, and mandates annual verification that 20% of provider contact information and online directory listings are accurate. MCOs must also confirm all directory providers are Medicaid-eligible and that provider panel sizes comply with state limits. Non-compliant MCOs face fines of at least $50,000 per violation and potential exclusion from the program for up to five years, with annual oversight reports to the Legislature.
This bill requires New Jersey Medicaid to pay hospice programs the same rate for inpatient room and board services as it pays nursing homes for similar care. It directly affects licensed hospice providers and nursing homes participating in the state's Medicaid program. The key provision mandates that reimbursement rates for hospice inpatient room/board (under Section 20(b)) must equal those for nursing home residents receiving hospice services. This change applies specifically to inpatient hospice units, excluding home-based care and certain federal-covered days. The bill aims to align payment structures without altering existing hospice service coverage.
