Sponsored by:
Assemblyman HERB CONAWAY, JR.
District 7 (Burlington)
Assemblywoman PAMELA R. LAMPITT
District 6 (Burlington and Camden)
SYNOPSIS
Permits flexible scheduling of private duty nursing services for eligible Medicaid recipients.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning private duty nursing services covered by Medicaid and supplementing Title 30 of the Revised Statutes.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. An individual eligible to receive private duty nursing services pursuant to N.J.A.C.10:60-5.1 et seq. may choose to schedule fewer hours of private duty nursing services in a 24-hour period than the individual is eligible to receive. Any service hours that the individual was eligible to receive but did not receive in a 24-hour period may be scheduled in a future 24-hour period, at the discretion of the individual and the private duty nursing service provider. Up to 24 service hours may be scheduled in a 24-hour period, provided that any service hours in excess of the number of service hours for which the individual is normally eligible to receive in a 24-hour period are drawn from the pool of unused service hours. Unused service hours may be accumulated in this way with no maximum, except that any unused service hours shall expire at the end of each month.
2. The Commissioner of Human Services shall adopt rules and regulations, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), in order to effectuate the purposes of this act.
3. This act shall take effect on the first day of the seventh month next following the date of enactment, but the Commissioner of Human Services may take such anticipatory administrative action in advance thereof as shall be necessary for the implementation of this act.
STATEMENT
This bill permits a greater degree of flexibility in scheduling private duty nursing services for individuals eligible to receive these services through Medicaid.
Current regulations limit Medicaid reimbursement for private duty nursing services to a certain number of approved hours in a 24-hour period for each individual, to a maximum of 16 hours in a 24-hour period. The bill permits an individual to schedule fewer than the approved number of hours in a 24-hour period, and instead schedule those hours on a later date. This would allow an individual to exceed the number of approved hours in a 24-hour period, and exceed the 16-hour maximum, if the individual uses “banked” hours to cover the difference. Unused service hours may be accumulated with no maximum, except that any unused service hours will expire at the end of each month.
The bill takes effect on the first day of the seventh month following the date of enactment, but authorizes the Commissioner of Human Services to take prior administrative action as necessary for its implementation.