A4266

An Act establishing the “2020 New Jersey COVID-19 Medical Assistance Program” and making a $10 million appropriation.

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

1. a. There is established in the Department of Human Services the “2020 New Jersey COVID-19 Medical Assistance Program” for the purpose of providing financial assistance to individuals to cover unreimbursed medical expenses related to the medical treatment of COVID-19.

b. Within 60 days following the effective date of P.L. , c. (C. ) (pending before the Legislature as this bill), the Commissioner of Human Services shall administer this program and adopt, pursuant to the “Administrative Procedure Act,” P.L.1968, c.410 (C.52:14B-1), rules and regulations to implement this program. The commissioner shall determine eligible medical expenses related to the medical treatment of COVID-19, establish a maximum amount of assistance per applicant, and devise a formula for the distribution of an amount of program funds to each applicant based on household income and need.

c. Determination of an applicant’s eligibility for program participation shall include:

(1) review of a written application, accompanied by the applicant’s proof of income and residence; and

(2) verification of the need for financial assistance, as evidenced by a medical bill that lists unreimbursed medical expenses and contains appropriate billing codes for the medical treatment of COVID-19.

d. All approved applications will be reviewed by a program administrator. The program administrator shall disburse a payment of the program’s funds, to the extent that funds are available, directly to the applicant’s health care provider and provide a copy of the disbursement directly to the applicant. The financial assistance shall include, but is not limited to, payments or reimbursements for the cost of hospital care, drugs, nursing care, rehabilitative services, and physician services related to the medical treatment of COVID-19.

e. The commissioner shall identify amounts of federal government assistance provided to this State for COVID-19 emergency relief, which can be allocated to this program.

f. As used in P.L. , c. (C. ) (pending before the Legislature as this bill):

“COVID-19” means the coronavirus disease 2019, which is a highly infectious disease that causes respiratory illness.

“COVID-19 crisis” means the duration of the public health emergency and state of emergency, as declared by the Governor in Executive Order 103 of 2020.

2. a. There is appropriated to the Department of Human Services the sum of $10 million to be credited to the “2020 New Jersey COVID-19 Medical Assistance Program” to effectuate the provisions of P.L. , c. (C. ) (pending before the Legislature as this bill). The amounts appropriated herein shall be funded first from assistance provided from the federal government to the extent not prohibited by federal law. The remaining amounts necessary to fund this program are appropriated from the General Fund.

b. In the event a person or entity wishes to make a monetary donation to the State for this program, the Commissioner of Human Services is hereby authorized to accept such monetary donations.

3. This act shall take effect immediately and shall expire one year following the rescission of Executive Order No. 103 of 2020 by the Governor.

STATEMENT

This bill appropriates $10 million and establishes in the Department of Human Services the “2020 New Jersey COVID-19 Medical Assistance Program,” a medical assistance program for individuals to cover unreimbursed medical expenses related to the medical treatment of COVID-19. This COVID-19 global pandemic has resulted in thousands of positive COVID-19 cases and hospitalizations in New Jersey, in addition to causing economic hardships through the shutdown of businesses and mass job losses. While cost sharing has been eliminated for COVID-19 testing-related services for most health insurers, pursuant to the federal “Families First Coronavirus Response Act” and P.L.2020, c.7, cost-sharing for the medical treatment of COVID-19 can still apply. While some health insurers have opted to waive cost-sharing for the medical treatment of COVID-19, other individuals will be required to make out-of-pocket payments for unreimbursed medical expenses. For severe cases of COVID-19 requiring hospitalization and intensive care, unreimbursed medical expenses are estimated to average $1,300, placing an additional financial burden during a time of economic disruption.

This bill directs the Commissioner of Human Services to implement this program. The commissioner will determine eligible medical expenses related to the medical treatment of COVID-19, establish a maximum amount of assistance per applicant, and devise a formula for the distribution of an amount of program funds to each applicant based on household income and need.

Determination of an applicant’s eligibility for program participation includes a review of a written application, accompanied by the applicant’s proof of income and residence, and verification of the need for financial assistance, as evidenced by a medical bill, which lists unreimbursed medical expenses and contains appropriate billing codes for the medical treatment of COVID-19. All approved applications will be reviewed by a program administrator. The program administrator will disburse a payment of the program’s funds directly to the applicant’s health care provider and provide a copy of the disbursement directly to the applicant.

The bill specifies that the $10 million being credited to the “2020 New Jersey COVID-19 Medical Assistance Program” will first be funded using any available federal assistance given to the State and that the remaining amounts necessary to fund this program are appropriated from the General Fund. In the event a person or entity wishes to make a monetary donation to the State for this program, the Commissioner of Human Services is authorized to accept such monetary donations.