New Jersey Assembly Bill A3794

New Jersey 2022-2023 Regular Session

• Introduced: 5/2/22
• Refer: 5/2/22

Caption

Extends COVID-19 Medicaid per diem rate, and requires Medicaid coverage without prior authorization, for certain partial care behavioral health and substance use disorder treatment services.

Impact

This bill is expected to have a significant impact on state laws concerning Medicaid service reimbursement. By extending the previously established per diem rate for 180 days after the federal Medicaid waiver expires, A3794 provides partial care providers time to adjust their operations and maintain financial stability while shifting back to in-person services. This continuity is essential to avoid disruptions in care that could lead to patient relapse or the need for more intensive treatment, including hospitalization.

Summary

Assembly Bill A3794 aims to extend the Medicaid per diem reimbursement rate established during the COVID-19 pandemic for partial care behavioral health and substance use disorder treatment services. It mandates that these services be provided without prior authorization while maintaining coverage up to five hours daily for eligible individuals. This measure is important for ensuring continuity of care in light of the disruptions caused by the pandemic, allowing patients to access necessary support services without bureaucratic hindrances.

Contention

Notable points of contention may arise around the implications of the bill on prior authorization requirements, which some stakeholders argue could allow for potential overutilization of services without checks in place. Advocates for the bill contend that lifting these requirements simplifies the process for providers, enabling them to make quicker, patient-centered decisions. However, opponents may express concerns about the potential for abuse and the impact on overall patient care quality if oversight is reduced significantly.