Healthcare (Medicaid) in New Jersey

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 ✓ Healthcare

Sub-Topics Insurance Medicaid

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 · General Assembly Jan 13, 2026

A 2223: Provides for voluntary contributions for taxpayers on gross income tax returns to support reproductive health care services.

This bill creates a voluntary contribution option on New Jersey's gross income tax returns, allowing taxpayers to direct part of their refund or add a contribution to the "New Jersey Reproductive Health Care Equitable Access Fund." Funds collected would be distributed equally each year to the three largest providers of reproductive health care services for Medicaid patients, to cover costs for low-income individuals seeking services. The bill defines "reproductive health care services" to include medical, surgical, counseling, and referral services related to pregnancy or pregnancy termination. It applies to tax returns for years beginning after enactment, with no requirement for taxpayer participation.

Topics ✓ Budget & Taxes ✓ Healthcare

Sub-Topics Income Tax Medicaid Women's Health

in committee · New Jersey · General Assembly Feb 12, 2026

A 434: 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 prevents 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 provider changes. It requires coverage continuity if a patient was taking the medication before the plan change and the new plan covers that specific drug class. The law applies to state employees, school staff, and Medicaid recipients who rely on ongoing medication for conditions like diabetes or hypertension. It ensures these individuals won't lose access to essential medications due solely to administrative shifts in their health coverage plans.

Topics ✓ Education ✓ Healthcare ✓ Labor & Employment

Sub-Topics Insurance Medicaid Prescription Drugs

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

A 4308: Requires DHS to increase home and community-based services under Medicaid.

This bill requires New Jersey's Department of Human Services (DHS) to shift Medicaid funding toward home and community-based services for eligible residents who currently receive nursing home care. By 2027, DHS must aim for 80% of these individuals to receive services at home or in community settings, with 60% of long-term care funding allocated to these options. By 2029, the target increases to 70% of funding for home and community-based services. The bill also mandates DHS to create a strategic plan to reduce institutionalization, ensure living wages for caregivers with inflation adjustments, and coordinate housing and care services across state agencies. These changes directly affect Medicaid recipients eligible for nursing home care, DHS, healthcare providers, and home care workers.

Topics ✓ Healthcare

Sub-Topics Long-Term Care Medicaid

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

A 2194: Authorizes use of county inmate welfare funds for certain reentry services.

This bill allows New Jersey county correctional facilities to use inmate welfare funds for reentry services that help incarcerated individuals transition to community life after release. Specifically, it permits counties to spend these funds - currently used for amenities like recreation, library materials, and commissary items - to pay staff salaries for coordinating access to benefits such as Medicaid, housing assistance, and substance abuse treatment. The policy directly affects county correctional facilities and the inmates they serve, expanding the permitted use of existing welfare funds beyond in-facility amenities. It requires no new funding, instead redirecting existing county inmate welfare resources toward post-release support.

Topics ✓ Criminal Justice ✓ Healthcare ✓ Housing

Sub-Topics Corrections Probation & Parole Medicaid Substance Abuse

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 Feb 19, 2026

A 2202: Establishes pilot program to provide Medicaid coverage of remote maternal health services for eligible beneficiaries.

This bill (A 2202) establishes a three-year pilot program in New Jersey to provide Medicaid coverage for remote maternal health services to eligible pregnant Medicaid beneficiaries. It would cover specific remote services including remote monitoring of health data (like blood pressure or glucose levels), remote non-stress tests, and tele-ultrasound, all delivered securely via digital technology. Eligibility includes beneficiaries with high-risk pregnancy factors (such as pre-existing conditions, age, or lifestyle factors) or those facing access barriers like lack of local providers, transportation, or childcare, but participation requires a provider referral and remains voluntary. The program depends on federal reimbursement and must comply with HIPAA and FDA regulations for data security and device approval.

Topics ✓ Healthcare

Sub-Topics Medicaid Telehealth Women's Health

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

A 2309: Establishes long-term services and supports workforce engagement and sustainability program in DOH.

This bill establishes a program within New Jersey's Department of Health to address shortages in the long-term care workforce. It requires the department to implement specific strategies - including reviewing Medicaid payment policies, creating standardized training, offering tuition support, streamlining certification, and developing career advancement paths - to increase the supply of direct care workers in nursing homes and community settings. The program also mandates an annual report to the Governor and Legislature on progress and needed changes. These provisions directly affect long-term care workers, their employers, and future workers entering the field through new educational pathways.

Topics ✓ Healthcare ✓ Labor & Employment

Sub-Topics Healthcare Workforce Long-Term Care Medicaid Professional Licensing

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

A 894: Establishes annual cost of living adjustment, based on Consumer Price Index, to base Medicaid per diem rates for assisted living programs; makes appropriation.

This bill requires New Jersey's Medicaid program to automatically increase daily reimbursement rates for assisted living facilities, comprehensive personal care homes, and assisted living programs each July 1. The increase must match the previous year's rise in the Consumer Price Index (CPI), as reported by the U.S. Department of Labor. These rate adjustments directly affect facilities receiving Medicaid payments for resident care, ensuring their reimbursement keeps pace with inflation. The bill also mandates funding from the state General Fund and requires state officials to seek federal approval for the changes.

Topics ✓ Budget & Taxes ✓ Healthcare

Sub-Topics Appropriations State Budget Long-Term Care Medicaid

All healthcare bills