SENATE, No. 2374

STATE OF NEW JERSEY

216th LEGISLATURE

 

INTRODUCED SEPTEMBER 22, 2014

 


 

Sponsored by:

Senator  JOSEPH F. VITALE

District 19 (Middlesex)

Senator  PAUL A. SARLO

District 36 (Bergen and Passaic)

 

Co-Sponsored by:

Senator Lesniak

 

 

 

 

SYNOPSIS

     Increases Medicaid reimbursement rates for certain evidence-based behavioral health services.

 

CURRENT VERSION OF TEXT

     As introduced.

  


An Act concerning behavioral health services and supplementing Title 30 of the Revised Statutes.

 

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

 

     1.    a.  The reimbursement rate for a behavioral health care service provided to an adult or a child that is billed to the State Medicaid program shall be no less than the market rate for the service, provided the following conditions are met:

     (1)   The behavioral health care service is evidence-based;

     (2)   The service is limited to individual or group counseling provided in an outpatient setting; and

     (3)   The billing provider is a substance abuse treatment facility licensed by the Division of Mental Health and Addiction Services or a health care professional licensed or certified to practice a health care profession pursuant to Title 45 or Title 52 of the Revised Statutes.

     b.    As used in this section:

     “Behavioral health care service” means a procedure or service rendered by a health care provider for the treatment of mental illness, emotional disorders, or drug or alcohol abuse.

     “Evidence-based” means an intervention that is included in the National Registry of Evidence-based Programs and Practices published by the federal Substance Abuse and Mental Health Services Administration, or meets other criteria established by the Commissioner of Human Services, in consultation with the Commissioner of Children and Families, for evidence-based treatment.

     “Medicaid” means the Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.).

 

     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 and the Commissioner of Children and Families shall adopt rules and regulations pursuant to the "Administrative Procedure Act" P.L.1968, c.410 (C.52:14B-1 et seq.) to effectuate the purposes of this act.

 

     4.    This act shall take effect on the first day of the fourth month next following the date of enactment, and shall apply to all services provided on or after the effective date, except that the Commissioner of Human Services and the Commissioner of Children and Families may take any anticipatory administrative action in advance as shall be necessary for the implementation of this act.

 

 

STATEMENT

 

     This bill would increase Medicaid reimbursement rates for certain evidence-based behavioral health services under the State Medicaid program.

     Under the bill, reimbursement rates could be no less than the market rate for the service, provided that the service meets certain criteria.

     Specifically, the bill would provide for increased reimbursement to licensed providers for individual or group counseling programs that are included in the National Registry of Evidence-based Programs and Practices published by the federal Substance Abuse and Mental Health Services Administration, or meet other criteria established by the Commissioner of Human Services, in consultation with the Commissioner of Children and Families, for evidence-based treatment.

     The bill would take effect on the first day of the fourth month next following the date of enactment, and would apply to all services provided on or after the effective date.