[First Reprint]

ASSEMBLY, No. 3928







Sponsored by:

Assemblyman  GARY S. SCHAER

District 36 (Bergen and Passaic)


District 2 (Atlantic)

Assemblyman  JOSEPH A. LAGANA

District 38 (Bergen and Passaic)

Assemblyman  DANIEL R. BENSON

District 14 (Mercer and Middlesex)

Assemblywoman  ANNETTE QUIJANO

District 20 (Union)

Assemblywoman  SHAVONDA E. SUMTER

District 35 (Bergen and Passaic)


Co-Sponsored by:

Assemblyman Giblin, Assemblywoman Jimenez, Assemblyman Singleton, Assemblywomen Vainieri Huttle, Lampitt and Caride






     “Uncompensated Pending Medicaid Beneficiary Payment Relief Act”; provides compensation relief to nursing facilities when resident’s Medicaid eligibility determination is delayed more than 90 days.



     As reported by the Assembly Health and Senior Services Committee on March 2, 2015, with amendments.


An Act providing compensation relief to 1[long term care] nursing1 facilities when Medicaid eligibility determinations are delayed, designated the “Uncompensated Pending Medicaid Beneficiary Payment Relief Act,” and supplementing Title 30 of the Revised Statutes.


     Be It Enacted by the Senate and General Assembly of the State of New Jersey:


     1.    The Commissioner of Human Services shall make an advance payment to a nursing facility 1[, an assisted living residence, or a comprehensive personal care home]1 licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.), at the facility’s request, whenever the facility is providing uncompensated services to one or more residents whose eligibility for Medicaid has not been determined more than 1[ninety] 901 days after an application has been filed.  Any such advance payment shall not exceed fifty percent of the estimated amount due for the uncompensated services.  No later than 30 days after any such application is granted and payment has been made to the facility, or after any such application has been denied, the commissioner shall:  provide reimbursement for any balance due to the facility; or recover any advance payments made on behalf of an applicant deemed ineligible for Medicaid by reducing any payments due to the facility.


     2.    The Commissioner of Human Services shall apply for such State plan amendments or waivers as may be necessary to implement the provisions of this act and to secure federal financial participation for State Medicaid expenditures under the federal Medicaid program.


     3.    The Commissioner of Human Services shall, in accordance with the “Administrative Procedure Act,” P.L.1968, c.410 (C.52:14B-1 et seq.), adopt any rules and regulations as the commissioner deems necessary to carry out the provisions of this act.


     4.    This act shall take effect on the first day of the fiscal year next following the date of enactment, except that the Commissioner of Human Services may take such anticipatory administrative action in advance thereof as shall be necessary for the implementation of the act.