ASSEMBLY HEALTH COMMITTEE
STATEMENT TO
ASSEMBLY, No. 3792
with committee amendments
STATE OF NEW JERSEY
DATED: OCTOBER 13, 2022
The Assembly Health Committee reports favorably Assembly Bill
No. 3792 with committee amendments.
As amended by the committee, this bill increases Medicaid
reimbursement rates for partial care behavioral health and substance
use disorder (SUD) treatment services by 35 percent, when such
services are provided to an adult Medicaid enrollee on an in-person
basis. The bill also provides that the aggregate Medicaid
reimbursement rate for transportation services and mileage to or from
a partial care services provider is to be no less than $10 for each one-
way trip, an increase of $3 from the current $7 rate, which is
composed of $4.50 for transportation services and $2.50 for mileage.
As amended, these rate increases will apply to services provided
through the fee-for-service or managed care delivery system on or
after the effective date of this bill.
Under current law, NJ Medicaid covers partial care behavioral
health and SUD treatment services for most adults through the fee-for-
service delivery system. The reimbursement rate for in-person partial
care behavioral health services is $17.92 per hour, with service
providers required to deliver a minimum of two hours and a maximum
of five hours of services per day, limited to 25 hours per week.
Medicaid additionally pays a per diem rate of $78.31 for in-person
partial care SUD treatment services; providers are required to deliver a
minimum of four hours of services per day, or no less than 20 service
hours per week.
By contrast, the State provides partial care behavioral health and
SUD treatment services through the managed care delivery system for
clients of the Division of Developmental Disabilities (DDD),
individuals enrolled in a Fully Integrated Dual Eligible Special Needs
Plan (FIDE-SNP), and enrollees in the Medicaid Managed Long Term
Services and Supports (MLTSS) program. Therefore, Medicaid
reimbursement for partial care services provided for these beneficiary
groups is proprietary and embedded in the State’s contracted capitation
payments to the Medicaid managed care organizations.
COMMITTEE AMENDMENTS:
The committee amendments:
1) clarify that the increased Medicaid reimbursement rates are
permanent in nature; and
2) make a technical correction involving punctuation.