Healthcare (Medicaid)

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

A 3476: Increases Medicaid reimbursement rates for private duty nursing services by $4.

This bill increases Medicaid reimbursement rates for private duty nursing (PDN) services by $4 per hour. It sets a minimum rate of $65 per hour for registered nurses (up from $61) and $53 per hour for licensed practical nurses (up from $49), applying to both fee-for-service and managed care Medicaid delivery systems. The change directly affects nurses providing in-home PDN services and requires the state to seek federal approval for the rate adjustment. The policy change takes effect immediately upon enactment.

Topics ✓ HealthcareSupports HealthcareIncreases Medicaid reimbursement rates for nursing services, directly boosting funding for healthcare providers under Medicaid coverage.95% confidence

Sub-Topics Medicaid

Track

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

A 3066: Requires DHS to review, and implement certain improvements to, Medicaid Managed Long-Term Services and Supports Program and to establish public-facing report card of managed care organization's coordination of program.

This bill requires New Jersey's Medicaid program to review and improve its Managed Long-Term Services and Supports (MLTSS) Program, which coordinates long-term care for Medicaid members. It directs the state to assess quality oversight, barriers to moving members from nursing homes to community settings, and successful payment models nationwide. The state must then mandate managed care organizations (MCOs) to reduce caseloads for nursing home residents, conduct more frequent face-to-face visits, annually review member preferences for community transitions, and create transition teams for complex moves. Additionally, the state must create public report cards on its website showing MCO performance metrics, enrollment data, disenrollment rates, member feedback, and quality ratings to help Medicaid members choose providers. The report cards must be updated annually, and the state must submit a progress report to the legislature within 18 months.

Topics ✓ HealthcareSupports HealthcareRequires DHS to improve Medicaid MLTSS program, mandate MCOs to reduce caseloads and increase visits, strengthening long-term care coordination and oversight.95% confidence

Sub-Topics Long-Term Care Medicaid

Track

in committee · New Jersey · General Assembly Feb 19, 2026

A 4349: Requires health insurance and Medicaid coverage for family planning and reproductive health care services; prohibits adverse actions by medical malpractice insurers in relation to performance of legally protected health care services.

This bill requires health insurance plans and Medicaid in New Jersey to cover all reproductive health care services, including family planning and abortion. It also prohibits medical malpractice insurers from raising premiums or canceling coverage for providers who offer these legally protected services. The law applies to all health insurance companies, Medicaid, and malpractice insurers operating in the state. By mandating coverage and preventing insurance penalties, the bill aims to remove financial barriers to reproductive health care access for all residents.

Topics ✓ HealthcareSupports HealthcareMandates insurance/Medicaid coverage for reproductive health services including abortion and prohibits malpractice insurer penalties against providers.95% confidence

Sub-Topics Insurance Medicaid Women's Health

Track

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

A 2250: Establishes commission to examine impact of federal funding cuts on State's Medicaid program.

This bill establishes a nine-member commission within New Jersey’s Department of Human Services to analyze how projected federal Medicaid funding cuts affect the state’s Medicaid services. The commission will monitor federal and statewide Medicaid trends, assess the impact of federal policy changes, and recommend legislative or other actions to address these changes. It consists of the Medicaid program director (ex-officio), four legislative members appointed by chamber leaders, and four public members appointed by the governor. Within 12 months of its first meeting and annually thereafter, the commission must submit written reports to the governor and legislature detailing its analysis and recommendations, which will be posted publicly online. The bill does not change Medicaid funding or eligibility but creates a process to evaluate federal policy impacts.

Topics ✓ HealthcareSupports HealthcareEstablishes commission to analyze federal Medicaid funding cuts' impact and recommend protective actions, safeguarding healthcare coverage.90% confidence

Sub-Topics Medicaid

Track

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

A 2039: Requires Division of Developmental Disabilities to make comprehensive list of its programs available to public.

This bill requires New Jersey's Division of Developmental Disabilities (DDD) to create and maintain a publicly accessible list of all its programs and services for individuals with developmental disabilities. The list must include detailed descriptions of each program (like home-based supports, group homes, and self-directed services), eligibility requirements (including Medicaid needs and care level assessments), and information on transitional planning and guardianship. DDD must post this list on its website, provide it in print upon request, and update it regularly to reflect current offerings. It also mandates that DDD promote webinars or presentations to help people access these services.

Topics ✓ HealthcareSupports HealthcareBill requires public listing of developmental disability programs including Medicaid eligibility, improving access to healthcare services for individuals with disabilities.85% confidence

Sub-Topics Medicaid

Track

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

A 1631: Establishes pilot program providing NJ FamilyCare eligibility for children with special needs who would otherwise be ineligible due to parental income and assets, and requires DHS commissioner to conduct study.

This bill (A1631) establishes a 3-year pilot program to expand NJ FamilyCare eligibility for children with special needs who live at home but would otherwise be ineligible due to parental income or assets. It directly affects middle-income families caring for children under 21 who meet the federal SSI definition of "blind or disabled" but are denied benefits because their parents' income or assets exceed limits. The program requires annual reviews to confirm the child still meets the disability definition, with an appeals process if benefits are terminated. After the pilot, the state must report on participation, costs, and whether to make the program permanent. The bill does not change existing Medicaid rules for children requiring nursing-home-level care.

Topics ✓ HealthcareSupports HealthcareExpands NJ FamilyCare eligibility for children with special needs denied due to parental income, increasing healthcare access for vulnerable children.90% confidence

Sub-Topics Medicaid

Track

in committee · New Jersey · Senate Feb 5, 2026

S 3321: Requires DHS to implement payment strategy to encourage the use of long acting reversible contraceptives.

This bill (S 3321) requires New Jersey's Department of Human Services (DHS) to create a Medicaid payment strategy that improves access to long-acting reversible contraceptives (LARCs), such as IUDs and implants, for Medicaid clients. It mandates specific actions: ensuring comprehensive coverage for LARCs, separately reimbursing for immediate postpartum insertion, removing supply chain barriers, and eliminating administrative hurdles for providers. The strategy must be implemented by all Medicaid health insurers (managed care organizations) serving low-income women. The bill aims to address existing reimbursement gaps that limit LARC use, which the CDC identifies as highly effective contraception with very low pregnancy rates.

Topics ✓ HealthcareSupports HealthcareMandates Medicaid coverage expansion for LARCs, removing access barriers - directly advances reproductive healthcare access under public health programs.95% confidence

Sub-Topics Medicaid Women's Health

Track

in committee · New Jersey · Senate Mar 2, 2026

S 3712: Prohibits SHBP, SEHBP, and Medicaid from denying coverage for maintenance medications for chronic conditions for covered persons solely because of change in health benefits plan or pharmacy benefits manager.

This bill prohibits New Jersey's State Health Benefits Program (SHBP), School Employees' Health Benefits Program (SEHBP), and Medicaid from denying coverage for maintenance medications treating chronic conditions when a person's health plan or pharmacy benefits manager changes. It specifically prevents coverage loss if the person was already taking the medication before the change and the new plan covers that medication class. The law applies to all covered individuals under these programs who experience such plan transitions. It ensures continuity of essential medications without requiring new prior authorizations due to administrative changes.

Topics ✓ HealthcareSupports HealthcarePrevents denial of maintenance medications for chronic conditions during plan changes, ensuring continuous coverage and access to necessary treatments under SHBP, SEHBP, and Medicaid.95% confidence

Sub-Topics Insurance Medicaid Prescription Drugs

Track

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

A 2432: Requires Commissioner of Human Services to ensure coverage of respite care services for eligible Medicaid beneficiaries when primary payer denies coverage of such services for any reason.

This New Jersey bill (A 2432) requires the Commissioner of Human Services to ensure Medicaid beneficiaries receive respite care coverage when their primary health insurer (public or private) denies it, provided the beneficiary is otherwise Medicaid-eligible for such services. It mandates the Commissioner to create procedures guaranteeing this coverage without changing existing Medicaid eligibility rules for respite care. The law applies directly to Medicaid recipients who face coverage denials for respite care from their primary payer. It takes effect immediately upon enactment, with the Commissioner required to adopt implementing rules under the Administrative Procedure Act.

Topics ✓ HealthcareSupports HealthcareMandates Medicaid coverage for respite care when primary insurer denies it, expanding access to necessary care for eligible beneficiaries without changing eligibility rules.95% confidence

Sub-Topics Insurance Medicaid

Track

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 ✓ HealthcareSupports HealthcareMandates nursing homes to submit Medicare/Medicaid cost reports and ownership disclosures, enhancing transparency and oversight of public health program funding.75% confidence

Sub-Topics Long-Term Care Medicaid Medicare

Track