ASSEMBLY HUMAN SERVICES COMMITTEE
STATEMENT TO
[First Reprint]
ASSEMBLY, No. 3792
STATE OF NEW JERSEY
DATED: DECEMBER 8, 2022
The Assembly Human Services Committee reports favorably
Assembly Bill No. 3792 (1R).
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. 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.