Sponsored by:
Senator LORETTA WEINBERG
District 37 (Bergen)
Senator KRISTIN M. CORRADO
District 40 (Bergen, Essex, Morris and Passaic)
SYNOPSIS
Establishes minimum Medicaid reimbursement rates for private duty nursing services.
CURRENT VERSION OF TEXT
As reported by the Senate Health, Human Services and Senior Citizens Committee on January 14, 2021, with amendments.
An Act concerning Medicaid reimbursement for private duty nursing 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 hourly reimbursement rate for private duty nursing services under the Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.), whether the services are provided in the Medicaid fee-for-service delivery system or through a managed care delivery system, shall be no less than $60 per hour when a registered professional nurse provides the services and no less than $48 per hour when a licensed practical nurse provides the services. 1[The Division of Medical Assistance and Health Services in the Department of Human Services shall establish criteria indicating the portion of the hourly reimbursement rate that shall be used by providers for wages of workers who directly provide private duty nursing services.]1
b. Every provider that receives reimbursement for private duty nursing services pursuant to a Medicaid managed care contract shall annually provide a report to the Division of Medical Assistance and Health Services in the Department of Human Services regarding the use of funds received as reimbursement for private duty nursing services, including the prior salary, current salary, and other changes to the salary of the workers who directly provide personal care services, in order to ensure compliance with subsection a. of this section.
2. Within 180 days after the enactment of this act, 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 secure federal financial participation for State Medicaid expenditures under the federal Medicaid program.
3. 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.), to effectuate the purposes of this act.
4. This act shall take effect immediately, except that the provisions of section 1 shall remain inoperable until the commissioner receives approval, from the United States Secretary of Health and Human Services, of the State plan amendments or waivers that are necessary to obtain federal financial participation for the State Medicaid expenditures that are to be made pursuant to that section.