Healthcare (Medicaid)

in committee · New Jersey · Senate Mar 5, 2026

S 3768: Revises procedures for processing incomplete Medicaid applications; exempts asset transfers of up to $500 per month during look back period for determining eligibility for long-term care services.

This bill updates how New Jersey processes Medicaid applications that are missing information and changes rules for asset transfers when determining eligibility for long-term care services. It affects individuals applying for Medicaid assistance and those transferring assets during the eligibility review period. The legislation streamlines application procedures for incomplete submissions and allows asset transfers of up to $500 per month without penalty during the look-back period used to assess eligibility. These changes aim to simplify the application process and provide flexibility for asset transfers while maintaining eligibility standards for long-term care services.

Topics ✓ HealthcareSupports HealthcareBill streamlines Medicaid application processes and exempts small asset transfers, improving access to long-term care services for eligible individuals.75% confidence

Sub-Topics Long-Term Care Medicaid

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in committee · New Jersey · Senate Mar 5, 2026

S 3822: Requires Medicaid coverage for remote stress tests for pregnant women.

This bill requires New Jersey Medicaid to cover remote stress tests for pregnant women. It amends existing Medicaid regulations to explicitly include this specific diagnostic service under the program's authorized benefits. The change directly affects pregnant women enrolled in Medicaid and the healthcare providers who administer these tests. The legislation does not alter other Medicaid services or introduce new requirements beyond this specific coverage addition.

Topics ✓ HealthcareSupports HealthcareBill expands Medicaid coverage for remote stress tests for pregnant women, improving patient access to diagnostic services and strengthening healthcare benefits.95% confidence

Sub-Topics Medicaid Telehealth Women's Health

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in committee · New Jersey · Senate Mar 19, 2026

S 3988: Amends law to extend length of postpartum coverage for Medicaid services for eligible pregnant women to 180-day period.

This bill extends Medicaid postpartum coverage for eligible pregnant women in New Jersey from the current 60-day period to 180 days. It directly affects pregnant women who qualify for Medicaid services by allowing them to continue receiving medical care and support for six months after giving birth instead of just two months. The change is made by amending the state's Medicaid law to update the definition of coverage duration for postpartum care. This policy adjustment aims to provide longer-term health support during the postpartum period without changing other eligibility requirements or program structures.

Topics ✓ HealthcareSupports HealthcareBill extends Medicaid postpartum coverage from 60 to 180 days, expanding health coverage and improving patient access to essential healthcare services for pregnant women.95% confidence

Sub-Topics Medicaid Women's Health

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

A 3120: Requires Medicaid provide health benefits coverage, and places certain requirements on insurers and State Health Benefits Program regarding existing mandate on health benefits coverage, for certain over-the-counter contraceptives.

This bill requires New Jersey Medicaid to cover over-the-counter contraceptives and imposes certain requirements on insurers and the State Health Benefits Program regarding existing mandates on health benefits coverage for these products. The legislation directly affects Medicaid recipients, private health insurance plans, and state health programs by ensuring access to contraception without additional cost-sharing. Key provisions include expanding the list of authorized medical services under the Medicaid program and clarifying how contraceptive coverage must be provided within the state's health benefits framework. The bill amends existing statutory law to incorporate these coverage requirements while maintaining compliance with federal Social Security Act regulations.

Topics ✓ HealthcareSupports HealthcareBill expands Medicaid coverage for contraceptives, improving patient access to healthcare services without additional cost-sharing.95% confidence

Sub-Topics Insurance Medicaid Women's Health

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in committee · New Jersey · General Assembly Mar 10, 2026

A 4559: Eliminates 16 hour per 24-hour period coverage limit on private duty nursing services for certain Medicaid enrollees who are 21 years of age or older.

This bill removes the 16-hour daily limit on private duty nursing services for Medicaid recipients in New Jersey who are 21 years of age or older. Under the new rules, eligible individuals whose medical condition requires it can receive up to 24 hours of nursing care in a single day, as determined by the state's Commission of Human Services. The legislation also directs the Commissioner of Human Services to seek necessary federal approvals and update regulations to implement these changes.

Topics ✓ HealthcareSupports HealthcareBill removes daily nursing care limits for Medicaid recipients, expanding access to essential healthcare services and protecting patient rights.95% confidence

Sub-Topics Medicaid

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in committee · New Jersey · Senate Mar 12, 2026

S 3905: Establishes program for certain individuals to become certified homemaker-home health aides and provide services to certain Medicaid and Medicaid-Medicare dually eligible enrollees under increased reimbursement rates.

This bill creates a program allowing family members or approved third parties to become certified home health aides and provide care to older adults enrolled in Medicaid or NJ FamilyCare. Under the program, eligible individuals aged 65 or older would receive services through home care agencies, with the agency covering all certification training costs and prohibiting repayment from the caregiver. Services provided by these certified family members would be reimbursed at a rate of at least $30 per hour, with tasks limited to those a registered nurse can delegate to certified aides. The Division of Medical Assistance and Health Services must establish the program within six months and develop tools to identify eligible enrollees.

Topics ✓ HealthcareSupports HealthcareBill expands home health care access for Medicaid enrollees by creating certification programs and increasing reimbursement rates for family caregivers.90% confidence

Sub-Topics Healthcare Workforce Long-Term Care Medicaid

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in committee · New Jersey · General Assembly Mar 10, 2026

A 4599: Establishes three-year Medicaid demonstration project to pay for certain drugs according to value-based system.

This bill creates a three-year pilot program in New Jersey's Medicaid system to test a value-based payment approach for certain high-cost prescription drugs. Under the program, the state would negotiate with drug manufacturers to tie reimbursement amounts to observed patient outcomes rather than just the price of the medication. The initiative would focus on at least three expensive drugs with measurable health results and would require Medicaid managed care organizations to participate. At the end of the three-year period, the state would report findings to the Governor and Legislature to determine whether to expand or modify the program.

Topics ✓ HealthcareSupports HealthcareBill establishes Medicaid demonstration project to improve drug payment system based on patient outcomes, strengthening healthcare value and access.85% confidence

Sub-Topics Medicaid Prescription Drugs

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in committee · New Jersey · Senate Mar 19, 2026

S 4030: Designates minimum percentage of residential substance use disorder treatment facility beds for use by NJ FamilyCare eligible individuals as condition for licensure.

This bill requires all new and existing residential substance use disorder treatment facilities in New Jersey to reserve at least 40 percent of their beds for individuals eligible for NJ FamilyCare, the state's Medicaid program. Facilities must meet this requirement within 12 months of initial licensure or license renewal and maintain it going forward. The Department of Health will not issue or renew licenses for facilities that fail to comply with this bed allocation mandate. The law applies to various types of residential treatment settings, including halfway houses, extended care facilities, and detoxification centers.

Topics ✓ HealthcareSupports HealthcareBill mandates 40% of treatment beds for Medicaid-eligible individuals, expanding access to substance use disorder care for vulnerable populations.90% confidence

Sub-Topics Medicaid Medical Licensing Substance Abuse

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in committee · New Jersey · Senate Mar 19, 2026

S 4036: Requires Medicaid and health insurance network contracts to provide participating health care providers with certain notifications.

This bill requires insurance companies and Medicaid programs in New Jersey to give health care providers at least six months' notice before making policy changes that could lead to coverage denials. It directly affects doctors, hospitals, and other providers who have contracts with managed care plans, ensuring they have advance warning of potential restrictions on the services they can offer. The law applies to all insurance carriers and state health programs authorized to issue health benefits in the state, including the State Health Benefits Program and School Employees' Health Benefits Program. This change takes effect 120 days after enactment and applies to any new or renewed contracts signed after that date.

Topics ✓ HealthcareSupports HealthcareBill protects healthcare providers by requiring advance notice of coverage changes, preventing sudden restrictions on services and maintaining provider-patient access.85% confidence

Sub-Topics Insurance Medicaid

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in committee · New Jersey · Senate Mar 19, 2026

S 4003: Requires Medicaid coverage for continuous glucose monitors and related supplies for individuals diagnosed with diabetes who meet certain coverage eligibility criteria.

This bill requires New Jersey Medicaid to cover continuous glucose monitors and related supplies for individuals diagnosed with diabetes who meet specific eligibility criteria. The legislation amends existing Medicaid statutes to include these medical devices and necessary supplies as authorized services under the program. Directly affected individuals are Medicaid recipients with diabetes who would gain access to these monitoring tools through their state health insurance coverage. The bill operates within federal Medicaid guidelines and does not alter eligibility requirements for the program itself.

Topics ✓ HealthcareSupports HealthcareBill expands Medicaid coverage for diabetes monitoring devices, improving patient access to essential healthcare supplies and strengthening health services.95% confidence

Sub-Topics Insurance Medicaid

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