SENATE, No. 2791

STATE OF NEW JERSEY

219th LEGISLATURE

 

INTRODUCED JULY 30, 2020

 


 

Sponsored by:

Senator  ROBERT W. SINGER

District 30 (Monmouth and Ocean)

Senator  NELLIE POU

District 35 (Bergen and Passaic)

 

 

 

 

SYNOPSIS

     Requires DHS to review various aspects of Medicaid managed care program.

 

CURRENT VERSION OF TEXT

     As introduced.

  


An Act concerning the Medicaid managed care program.

 

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

 

     1.    The Department of Human Services shall review and evaluate any existing requirements for Medicaid managed care organizations to contract with any willing provider for the delivery of nursing home services, and determine whether to request State plan amendments or waivers as may be necessary to allow managed care organizations to terminate or suspend a contract with a nursing home that has a history of multiple violations related to State or federal licensure requirements, or that has a history of one or more violations of licensure requirements that  resulted in severe adverse health consequences for facility staff or residents.  The Department of Human Services shall additionally evaluate whether managed care plans can be used to assist the Department of Health in monitoring compliance and quality of care in nursing homes and, if so, shall identify any actions as may be needed to allow managed care plans to assist the Department of Health.

 

     2.    This act shall take effect immediately.

 

 

STATEMENT

 

     This bill requires the Department of Human Services (DHS) to review and evaluate any existing requirements for Medicaid managed care organizations (MCOs) to contract with any willing provider for the delivery of nursing home services, and determine whether to request State plan amendments or waivers as may be necessary to allow MCOs to terminate or suspend a contract with a nursing home that has a history of multiple violations related to State or federal licensure requirements, or that has a history of one or more violations of licensure requirements that  resulted in severe adverse health consequences for facility staff or residents. 

     The bill additionally requires the DHS to evaluate whether managed care plans can be used to assist the Department of Health in monitoring compliance and quality of care in nursing homes and, if so, identify any actions as may be needed to allow managed care plans to assist the Department of Health.