This bill increases the Supplemental Graduate Medical Education (GME) Subsidy by $496,000 in the FY2026 state budget to fund a 15th acute care hospital with a residency program. It directly affects hospitals ranked by Medicaid revenue ratio (RMP), expanding eligibility from 14 to 15 hospitals - the 15th hospital receives $496,000 while the existing 14 hospitals maintain their current subsidy amounts. The subsidy is calculated based on a hospital’s Medicaid revenue percentage using 2023 cost reports, with funds allocated to the top 15 hospitals meeting the RMP criteria. This change aligns the appropriations act with prior law (P.L.2018, c.116), which intended to cover one-third of eligible hospitals (now 15 of 45), reversing a prior 14-hospital cap.
This bill revises New Jersey's Medicaid application process to better handle incomplete applications and exempts asset transfers of up to $500 per month during the look-back period from affecting eligibility for long-term care services. The look-back period is the standard 5-year review period used to assess asset transfers when determining Medicaid eligibility for nursing home or long-term care benefits. These changes directly impact New Jersey residents applying for Medicaid, particularly those seeking long-term care, by preventing denial due to small, regular financial transactions like monthly support payments. The bill does not alter overall asset limits but creates a specific exception for modest monthly transfers during the eligibility review.
S 3523 establishes a 36-month pilot program to expand access to mental health care for children aged 5-14 in New Jersey. The bill directs the Department of Human Services to modify NJ FamilyCare reimbursement rules, allowing partial hospitalization services (intensive outpatient mental health treatment) to be provided at non-hospital locations instead of requiring hospital settings. One provider must be selected to participate, meeting specific criteria including exclusive service to this age group and approval through the Children’s System of Care. The program requires a final report to the Governor and Legislature within 36 months, evaluating clinical and budgetary outcomes before potential expansion. This change aims to increase access to lower-cost, structured care while leveraging federal Medicaid funds.
This bill would require New Jersey Medicaid to cover assisted living services for individuals with serious mental illnesses. It amends the Medicaid statute to explicitly add these services as a covered benefit, expanding current coverage that primarily includes intermediate care facilities. This change would directly affect Medicaid beneficiaries with serious mental illnesses who currently lack access to Medicaid-funded assisted living care. The bill does not specify funding details but would expand the range of services Medicaid must provide under state law.
This bill requires all health insurance plans and Medicaid in New Jersey to cover medically necessary speech therapy for stuttering, including both habilitative (helping develop speech skills) and rehabilitative (helping regain lost skills) therapy. It applies to all health insurance policies sold in New Jersey, including individual, group, and hospital service contracts, and mandates coverage whether therapy is provided in-person or via telehealth. Insurers must cover these services at the same level as other medical treatments, without additional restrictions. The law directly affects residents with stuttering who rely on insurance for speech therapy, ensuring they receive consistent coverage for this specific treatment.
Bill A 2571 establishes New Jersey’s "Food is Medicine NJ Pilot Program" within the Department of Human Services (DHS), appropriating $5 million to provide nutrition services to Medicaid recipients. The program directly affects up to 10,000 high-risk Medicaid recipients: 3,000 with complex chronic conditions (like diabetes or heart failure) receive medically tailored meals, while 7,000 others at risk of diet-related illness get produce prescriptions and nutrition education. Key provisions require DHS to partner with healthcare providers and nonprofits to deliver these services, with a third-party evaluator measuring impacts on hospitalizations, health metrics (e.g., A1C levels), and Medicaid cost savings over three years. The pilot expires after the final evaluation report is submitted.
This bill would require New Jersey Medicaid to cover ovulation-enhancing drugs and related medical services without restrictions for beneficiaries experiencing infertility. It directly affects low-income New Jersey residents enrolled in Medicaid who seek infertility treatment. The key provision amends Medicaid law to explicitly include these services as a standard benefit, removing prior authorization requirements. This change would expand current coverage to ensure these treatments are accessible as routine care for eligible individuals.
Bill A 2150 requires Medicaid and NJ FamilyCare managed care organizations to offer a patient-centered medical home model (a team-based care approach led by a primary care provider for comprehensive, continuous care) or an alternative payment model that rewards high-quality, cost-efficient care to primary care providers in their network. Managed care organizations must annually report detailed information about their chosen model - including financial structures, quality metrics, and provider participation - to the state and make this public. The state will establish standardized quality metrics that all such models must use for provider payments, ensuring consistency across the system. This policy directly affects Medicaid and NJ FamilyCare managed care organizations and the primary care providers serving Medicaid and NJ FamilyCare enrollees.
This bill requires New Jersey's Department of Transportation (DOT) to create a paratransit brokerage program that consolidates Medicaid medical transportation and ADA paratransit services under a single management system. The program would use an online platform to let riders schedule trips, allow competing transportation providers (like NJ Transit and county agencies) to bid for service requests, and monitor service quality. It directly affects Medicaid beneficiaries needing non-emergency medical transport and people with disabilities relying on ADA paratransit services. The goal is to reduce costs and improve efficiency by streamlining how these essential transportation services are delivered across the state.
This New Jersey bill requires the Department of Human Services (DHS) to disregard certain federal pension benefits when determining Medicaid eligibility for veterans. It directly affects veterans who receive federal pensions but apply for Medicaid, as these pension payments would no longer count toward their income limit. The key provision amends existing Medicaid rules to exclude these specific benefits from income calculations during eligibility reviews. This change ensures veterans' pension income does not disqualify them from Medicaid coverage they otherwise qualify for under federal and state standards.
