New Jersey Senate Bill S1896

New Jersey 2022-2023 Regular Session

• Introduced: 3/3/22
• Refer: 3/3/22

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

One of the critical aspects of S1896 is its permanent extension of coverage for partial care services without any prior authorization. This means eligible individuals can receive up to five hours of such services daily, five days a week, without needing approval from Medicaid. This change is poised to significantly reduce administrative burdens on providers, allowing them to concentrate on delivering care and improving patient outcomes, rather than navigating complex authorization processes.

Summary

S1896 is a bill designed to extend certain Medicaid reimbursement policies that were implemented during the COVID-19 pandemic. Specifically, this legislation mandates the reimbursement of partial care services for behavioral health and substance use disorder treatment under Medicaid at a per diem rate for 180 days after the expiration of the federal Medicaid waiver. This rate reflects the payments established for telehealth services that were essential during the pandemic when in-person visits were limited. The aim is to support providers as they transition back to in-person care.

Contention

Despite its intentions, S1896 may raise concerns among various stakeholders. Proponents, including mental health advocates, argue that easing prior authorization requirements and extending per diem rates will enhance access to critical services for individuals with severe mental health issues or substance use disorders. However, critics may argue that such a sweeping change could challenge state budgeting priorities and require further resources to ensure the quality of care provided under the expanded framework.